There is an oral health crisis in Indian Country and as a member of the Sault Ste. Marie Tribe of Chippewa Indians, I have seen it firsthand. People in tribal communities simply do not have access to the dental care they need, and as a result, children and adults suffer terribly with untreated tooth decay, live in pain, and are at risk for serious infections, even death.
However, an announcement from Swinomish Indian Tribal Community Chairman and NCAI President Brian Cladoosby at the National Congress of American Indians (NCAI) Mid-Year Convention could change all of that for tribal communities in the Pacific Northwest. The Swinomish Indian Tribal Community, exercising their right as a sovereign government, will be expanding their dental team to include Dental Health Aide Therapists (DHATs), also known as dental therapists. One of their members started training in Alaska as a DHAT just this past month.
Dental therapists have been successfully improving oral health in Alaska Native communities for more than a decade. They are practicing in 81 communities, most of them remote, and have increased access to culturally competent dental care for more than 40,000 previously underserved patients. Dental therapists are reducing the need for emergency care for oral health and increasing preventive care delivered in communities.
Despite all of this success and overwhelming evidence that DHATs provide safe, high quality care, the American Dental Association (ADA) is fighting the expansion of dental therapist at every turn. In Alaska, they went so far as to file a lawsuit to stop DHATs from practicing. While the lawsuit failed to prevent dental therapists from practicing in Alaska, the ADA did not give up fighting the use of dental therapists. The ADA has tried to restrict the use of dental therapists to tribal communities in Alaska by funding state campaigns against dental therapists and by lobbying against funding for dental therapist demonstration projects.
Even though the ADA continues to publicly express their dedication to increasing access to dental services for tribal communities, it is clear that they are preventing them from using a dental therapist as a proven solution to increasing access to care. The consistent opposition shows that the ADA is dedicated to putting their interests ahead of tribal and community interests. They have successfully lobbied over the past five years to kill several bills that would have enabled state authorization of dental therapists in tribal communities and other high-need communities in Washington State By restricting tribal communities’ ability to choose the best provider to deliver care in their communities, the ADA has taken away the rights of American Indian and Alaska Native communities to exercise their sovereignty and hire oral health care professionals who will address the deplorable oral health disparities in their communities across the nation.
However, Chairman Cladoosby’s announcement makes it clear that the Swinomish Indian Tribal Community is refusing to let special interests determine the future of oral health care for its members. The Swinomish cannot wait any longer to modernize its dental team in order to improve oral health. While tribes nationwide have passed resolutions supporting dental therapists, the Swinomish have taken the boldest step yet by announcing that they will be training a dental therapist to practice in their community to expand access to care.
As American Indians, we need to refuse to let our rights and responsibilities to attend to the health and wellbeing of our community members be taken from us. We applaud Chairman Cladoosby in taking a stand for tribal sovereignty, and for his courageous leadership in bringing an innovative, proven effective solution to the oral health crisis to his community.
State Advocacy Manager
Dental Access Project