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Tribe Uses Sovereignty to Hire Dental Therapist

Jan 20, 2016

By Dean George

The Swinomish Indian tribe of Washington state declared war on tooth decay this month by modeling their oral health care delivery program on one used by Alaskan Native communities for more than a decade.


On January 4th, the tribe became the first in the 48 contiguous states to hire a Dental Health Aide Therapist (DHAT) to deliver basic oral health services for approximately 3,000 tribal patients. Until then, dental needs were only available through a single dentist, meaning that patients would have to wait several weeks for an appointment.

“We cannot stand by any longer and allow Native people to continue to suffer tooth decay at a rate three times the national average,” said Brian Cladoosby, Chairman of the Swinomish Indian Tribal Community.

Cladoosby put his mouth where his sentiment was on Dental Therapist Daniel B. Kennedy’s first day by volunteering to be the first patient.

As Dental Wire has previously reported, Native American children in the United States and Canada suffer from untreated cavities at three times the rate of other kids, according to the American Academy of Pediatrics.

Other studies have shown that 75 percent of Native Americans and Alaskan Natives have tooth cavities by the age of five.  The Navajo Nation is the largest tribe in the United States and Dental Wire has reported that 70 percent of Navajo children have untreated tooth decay.

The Swinomish hope that by hiring Kennedy, a Dental Therapist in Alaska for six years, will help swing the tribe’s oral health care emphasis from treating cavities to preventing them. “Prevention is my main goal, stated Kennedy. “I don’t want to be doing damage control.”

Supported by a grant from the W.K. Kellogg Foundation and a local Indian health board, Kennedy began treating tribal members two weeks ago. The Swinomish are also paying for two years of training for one of their own tribal members to become a Dental Therapist so she can return and treat patients at the local clinic.

Until this month, Alaska, Minnesota and Maine were the only states that permitted Dental Therapists to treat dental patients without a dental license. State and National dental groups such as the American Dental Association (ADA) oppose the DHAT program on the grounds that it violates state laws that govern the licensing of dental professionals.

In 2007, the Alaskan state Superior Court ruled that federal law like the Indian Healthcare Improvement Act supersedes state licensing regulations, opening the door for other tribes to use their tribal sovereignty to improve access to regular dental care.

Since the 2007 ruling, Dental Therapists in Alaska have provided oral care to more than 45,000 Alaskan Natives.  Based on that success and legal precedent, the Swinomish tribe argued they also had the right to hire Dental Therapists to provide oral health care for their tribal members.

“This solution will help our people immediately address their oral health care needs in ways that have not been possible until today,” said Cladoosby.

Sources: drbiscuspid.com, wkkf.org
Photo source: pbs.twimg.com


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