Northwest Portland Area Indian Health Board: Indian Leadership for Indian Health

Dental Health

Key Indian Health Issues: Oral Disease

It is well documented that American Indians and Alaska Natives (AI/AN) carry a disproportionate burden of oral disease.  According to the Indian Health Service (IHS) 1999 Oral Health Survey, the majority of AI/AN children have tooth decay, most adults have lost teeth because of dental disease, periodontal disease is a significant problem for adults, and there is limited access to both preventive and restorative dental care.

Early Childhood Caries (ECC) is the most prevalent chronic disease of childhood and is five times more prevalent than asthma.  Approximately 70 percent of AI/AN children experience dental decay in their primary dentition (baby teeth).  Almost half of those children have severe ECC, which causes both pain and infection and can affect a child’s overall health and well-being. A Washington State Department of Health survey evaluated the oral health status and treatment needs of children in Washington State.  Compared with the survey’s random sample of elementary school children, 37% of AI/AN children had a history of rampant decay, as compared with 15% of all children surveyed.  The findings suggest a problem with dental access that is confirmed by IHS data showing that AI/AN children are served by fewer dentists, are less likely to be served by fluoridated water systems, and have greater treatment needs than the general population. 

In addition to the burden of disease, there is a tremendous backlog of dental treatment needs among AI/AN dental patients in all age groups.  Unfortunately, sufficient staffing and facilities are simply not available to meet all the dental needs of the AI/AN population.  For the general U.S. population there are approximately 1,500 patients per dentist, while there are more than 2,800 AI/AN patients per dentist employed by the IHS and tribal dental clinics.  It is essential that dental clinics serving the AI/AN population operate efficiently while also devoting time and dollars to the primary prevention of dental disease.  Most dental professionals do not receive adequate training in terms of either clinic efficiency or community-based prevention.

The overall goal of the Northwest Tribal Dental Support Center (NTDSC) is to improve the oral health of American Indian people in the Pacific Northwest.  By providing technical assistance to the 33 dental programs that serve AI/AN people, we help these programs to improve clinic efficiency and access to care, implement clinical and community prevention programs, and monitor the oral health status of the population they serve. 


Visit the Northwest Tribal Dental Support Center for more information.