The mission of the Native Dental Therapy Initiative is to connect tribal communities with innovative approaches to address AI/AN oral health disparities, to remove barriers impeding the creation of efficient, high quality, modern dental teams and to provide opportunities for AI/AN people to become oral health providers. According to the IHS 2014 Oral Health Survey, the majority of American Indians and Alaska Natives (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. There is a tremendous opportunity to increase access to oral health care and improve oral health outcomes by training and employing Dental Health Aide Therapists (DHATs). DHATs are highly-trained mid-level providers, much like Physician’s Assistants. Part of a dentist-led team, they have a narrow scope of practice, focusing on routine and preventive services. They are recruited from their communities and go back to serve their communities. Tribes deserve the reliable, culturally relevant care that DHATs offer. The Native Dental Therapy Initiative is working to ensure this solution is available to all Tribes. Read our newsletter to find out more about our current projects and campaigns!
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See why Swinomish is using DHATs to improve oral health!
Dental Health Aide Therapists (DHATs) are part of a dentist-led team. Dental therapists were first introduced to the United States over 10 years ago by a consortium of Alaska Native tribal health organizations. Thanks to their leadership and courage, over 40,000 Native Alaskans now have access to regular dental care for the first time. DHATs are recruited from their communities and go back to serve their communities. DHAT training includes:
- Comprehensive and rigorous coursework
- 3,000 hours of clinical training
- 400 hour dentist-supervised preceptorship
- Mastery of 46 procedures in 2 years. Dentists learn 500+ procedures in 4 years of dental school
Dental Health Aide Therapists:
- Educate patients about oral health and prevention
- Perform dental evaluations
- Give fluoride treatments
- Place sealants
- Clean teeth
- Place fillings
- Perform simple extractions
Tribal communities need the reliable, culturally competent care DHATs offer:
- DHATs expand access to consistent, routine, high quality oral health care
- Grow the number of AI/AN oral health care providers available to tribal communities
- Create a more efficient and effective oral health team that brings care where it is needed most
- Establish cost effective solutions to oral health challenges into tribal communities
Download our DHAT Factsheet Here
Early in the 20th Century, dental disease among American Indians and Alaska Natives (AI/AN) was extremely rare. That is not the case today. Chronic pain, missing teeth, infections, and even life-threatening oral health emergencies are realities for citizens of tribal nations. NPAIHB works hand-in-hand with our member tribes to improve oral health outcomes through our Northwest Tribal Dental Support Center and our Native Dental Therapy Initiative. Despite the slow and steady improvements in the Portland Area, profound disparities continue to exist between AI/AN and non-AI/AN populations. It is clear that AI/AN people carry a disproportionate burden of oral disease, and lack of access to consistent, routine and preventive care stands in the way to improving oral health outcomes:
- Despite the trend toward a reduction in tooth loss in the U.S. population, 25% of AI/AN people aged 35 to 44 years have fewer than 20 of their natural teeth, and 68% had untreated decay in 1999, the most recent year for which nationwide data are available.1
- According to the 2014 IHS Oral Health Survey, the majority of AI/AN children have tooth decay. In fact, by 5 years of age, 76% have experienced dental decay.2
- Historically, access to dental care in IHS, tribal, and urban programs has been lower than the general U.S. population. An estimated 44.5% of persons aged 2 years and older had a dental visit in the past year in the United States, while only 28.8% of American Indians and Alaska Natives accessed dental care in 2014. This low access rate was despite the fewest number of dentist vacancies in the IHS in the past decade.3
- The U.S. Indian Health Service spent an average of only $99 per person on dental care in 2009, compared with average per capita spending of $272 nationwide.4
- Over 2.4 million AI/ANs – one third of which are youth up to age 18 – live in counties with dental health care professional shortages, and half of AI/AN youth live in dental care shortage areas.5
Download the Portland Area 2014 IHS Oral Health Survey National, Area and Clinic Level Results here.
Download our Oral Health in Indian County factsheet here
Download the Data Brief IHS 2016 Adult Oral Health Survey here
1An Oral Health Survey of American Indian and Alaska Native Dental Patients: Findings, Regional Differences and National Comparisons (Rockville, MD: U.S. Department of Health and Human Services, Indian Health Service, 1999) 2The Oral Health of American Indian and Alaska Native Children Aged 1-5 Years: Results of the 2014 IHS Oral Health Survey (Kathy R. Phipps and Timothy L. Ricks, Rockville, MD: U.S. Department of Health and Human Services, Indian Health Service, 2015) 3IHS Fact Sheet: Alternative Workforce Models 4The 2010 Indian Health Service Oral Health Survey of American Indian and Alaska Native Preschool Children (Rockville, MD: U.S. Department of Health and Human Services, Indian Health Service, 2014). These figures refer to IHS fiscal year 2011 data and Medical Expenditure Panel Survey Household Component Data, 2009. 5Oral Health and Native American Youth Center for Native American Youth, the Aspen Center, September 2014
Lewis County Chronicle: BILL IMPROVING DENTAL CARE ON RESERVATIONS INTRODUCED
Indian Country Media Network: OVERCOMING BARRIERS TO DENTAL CARE ONE KID AT A TIME
Indian Country Today: INDIAN COUNTRY LEADS HEALTH REVOLUTION SWEEPING U.S.
The Nation’s Health (APHA): DENTAL HEALTH THERAPISTS BRINGING ORAL HEALTH CARE TO U.S. TRIBAL COMMUNITIES
NPR Marketplace: WHY NATIVE AMERICANS WANT A NEW FORM OF DENTAL CARE
Statesman Journal: TRIBAL MEMBER DENTAL CARE PROJECT LAUNCHED
Seattle Times Opinion: ALLOW NATIVE COMMUNITIES TO RECRUIT DENTAL THERAPISTS
Skagit Valley Herald: SWINOMISH INDIAN TRIBAL COMMUNITY HIRES FIRST DENTAL THERAPIST
The Lund Report: OREGON LOOKS NORTH FOR LESSONS ABOUT EXPANDING DENTAL ACCESS
Download NDTI Fact Sheets:
Additional Fact Sheets, Reports and Studies:
Community Catalyst, 2017. A Sample Dental Therapy Curriculum for Community Colleges
Indian Health Service, 2016. Data Brief IHS 2016 Adult Oral Health Survey
Building Momentum for Dental Therapists Map, WKKF June 2016
Journal of Health Care for the Poor and Underserved, January 2016. American Indian and Alaska Native Access to Oral Health Care: A Potential Solution (Terrence C. Batliner DDS, MBA)
Pew Charitable Trusts, November 2015. Improving Dental Care Access in Rural America
American Journal of Public Health, September 2015. Safety Net Care and Midlevel Dental Practitioners: A Case Study of the Portion of Care That Might Be Performed Under Various Setting and Scope-of-Practice Assumptions,
Pew Charitable Trusts, June 2014. Expanding the Dental Team: Increasing Access to Care in Public Settings
Pew Charitable Trusts, February 2014. Expanding the Dental Team: Studies of Two Private Practices
Community Catalyst, May 2013. Economic Viability of Dental Therapists.
W.K. Kellogg Foundation, October 2010. Alaska Dental Therapist Program: RTI Evaluation Report
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