It is well documented that American Indians and Alaska Natives (AI/AN) carry a disproportionate burden of oral disease. According to the 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. Profound health disparities exist between the oral health status of AI/ANs in the Pacific Northwest compared to non-AI/ANs in the same area. These differences result from multiple etiologies, but one clearly identifiable factor is the loss of dental public health infrastructure by the Indian Health Service over the last decade. The Indian Health Service (IHS) has made additional funds available to create dental support centers with the goal to improve the oral health of AI/AN people. The Northwest Tribal Dental Support Center (NTDSC) is currently in its twenty-first year of operation.
The overall goals of the NTDSC are to provide training, quality improvement, and technical assistance to the 39 IHS/Tribal dental programs in the Portland Area, and to ensure that the services of the NTDSC result in measurable improvement in the oral health status of the AI/AN people served in the Portland Area. The objectives are to continue oral health assessment, ensure quality of care, Implement clinical and community-based prevention programs, and provide continuing dental education. Furthermore, NTDSC works closely with IHS and other dental support centers towards meeting national HP/DP objectives. The objectives of NTDSC are supported through ongoing communication with local dental programs via site visits, email groups, telephone consultation, and an annual Area-wide dental meeting.
The NTDSC is in its fourth five-year grant cycle (currently our 19th year).
During the first five-year grant cycle, the clinical consultant provided 70 site visits and the HP/DP consultant provided 69 site visits. Satisfaction surveys were administered following each site visit during the past three years. Survey responses were anonymous. Overall satisfaction averaged 4.8 out of a possible score of 5.0 using a Likert Scale. During the five-year period, the NTDSC increased the number of sealants placed Area-wide by 35%, and topical fluoride treatments for all age groups increased by 54%. Access for infants increased by 16% and topical fluoride treatments for infants increased by 46%. Overall dental access increased by 12% during the five-year grant cycle.
The accomplishments of the NTDSC in meeting our clinical and health promotion/disease prevention (HP/DP) objectives can be attributed to the fierce commitment of those dental providers in the Northwest who have worked both independently and collaboratively to achieve these objectives, adopting them as their own, and putting in the time and effort required to improve the oral health of the people they serve.
1999 Oral Health Survey: 12,881 dental patients ranging from 2 to 96 years of age. For more information and IHS Area data, see the IHS dental program website at http://www.ihs.gov/MedicalPrograms/Dental
Health Promotion / Disease Prevention Manual
Indian Health Service Dental Clinic Efficiency and Effectiveness Manual
Web Link 1, BA Wksht, 4-07.xls
Web Link 2, Data Indic Wksht, 4-07.xls
Web Link 3, Ref Value Calcs, 4-07.xls
IHS Division of Oral HealthIMG_6477
“The Impact of Oral Disease on the Lives of Washingtonians”
Ticey Mason (Siletz), MAOL
NTDSC Project Director
Dr. Sean Kelly
Dr. Miranda Davis
Dr. Lynn Van Pelt
IHS Are Dental Consultant
Day One Orientation