Dr. Charles Norman

Washington—The Association described an emerging public-private partnership to improve the oral health of Native Americans in congressional testimony April 8 and invited Congress to participate.

“The ADA is committed to working with you, the Indian Health Service and the Tribes to aggressively reduce the disparity of oral disease and to increase the level of dental care that currently exists in Indian Country,” the Association told Congress. “We know oral disease is preventable especially if an adequate dental workforce, individual and community-based prevention programs are in place, and an oral health literacy program supports the whole undertaking.”

Dr. Charles Norman, ADA president, testified on oral health issues that affect American Indians and Alaska Natives and the dentists who serve in the Indian Health Service and tribal programs.

“Tooth decay in Indian Country has reached epidemic proportions,” he told the House Appropriations subcommittee on interior, environment and related agencies, which convened two days of hearings on fiscal year 2015 IHS appropriations and included the American Dental Association among 77 scheduled American Indian and Alaska Native witnesses, each limited to five minutes of oral testimony.

“According to data from the Navajo tribe, tooth decay is present in 48 percent of one-year-olds and up to 94 percent of four-year-olds,” Dr. Norman testified. “The decay rate of preschool Navajo children is the highest in the nation.”

Several years ago the ADA organized the Native American Oral Health Care Project to work with tribes in Arizona, New Mexico, North Dakota and South Dakota, Dr. Norman told the House panel. The dental associations in those states have held many meetings with tribal leaders to hear their concerns regarding needed dental care, he said. These collaborations have resulted in several specific dental activities.

The Association’s written testimony offered information on seven dental activities in Indian Country.

• The North Dakota Dental Association conducted Pediatric Dental Days in October 2013 for the Standing Rock Sioux Tribe. During the two-day event, 367 children were seen and about $ 150,080 of donated dental services were provided.

• In 2013, the New Mexico Dental Association held a Mission of Mercy project in Farmington, which borders the Navajo reservation. More than $ 586,000 in free care was provided to almost 1,000 patients, one quarter of whom identified themselves as American Indian.

• The Arizona Dental Association and New Mexico Dental Association have offered a 10 Year Oral Health Plan for incorporation within the Navajo Nation’s 10 Year Health and Wellness Plan.

• The New Mexico Dental Association is expanding dental care through the use of Community Dental Health Coordinators who bridge the gap between the existing care resources and unmet need. The NMDA is in discussions with a New Mexico community college to incorporate the CDHC curriculum into its educational program to educate American Indian students as CDHCs. Their goal is to have a new class ready to begin in 2014.

• The South Dakota Dental Association, in concert with the Delta Dental Foundation of South Dakota, was awarded a CMS (Centers for Medicare & Medicaid Services) Healthcare Innovation Award to improve Native American oral health in 2012. The grant supported development of a modular CDHC training program to add oral health skills and understanding to existing Community Health Workers across reservations.

• The Arizona Dental Association has conducted regional roundtables with tribal representatives from 18 of the 22 Native American tribes in the state. The meetings have focused on oral health literacy, preventive programs, CDHCs, the educational pipeline and coalition building. Additionally, AzDA has been awarded a DentaQuest Development grant to support the work of the Native Oral Health Alliance, which was founded as an outgrowth of this collaboration. One of the most tangible pipeline project possibilities is in discussion with the San Carlos Apache Tribe.

• The ADA will be offering technical assistance and curriculum support as requested by the Navajo Nation for establishment of the Association’s Community Dental Health Coordinator program. Discussion is underway for a CDHC sabbatical to take place this summer.

The Association also called for a streamlined credentialing process for the Indian Health Service. “We know that if the IHS would streamline its credentialing process to make it easier for local dentists to volunteer we could ensure even more patients, especially children, receive needed care,” the Association testified.