'It Just Made So Much Sense'
This article was produced and provided by the W.K. Kellogg Foundation.
The president and CEO of the W.K. Kellogg Foundation says there’s a missing narrative in the health care conversation. “We just don’t talk enough about oral health,” said Sterling Speirn. “The whole way we approach early childhood and early care; we just don’t talk enough about oral health. And dental disease is entirely preventable.”
Yet in Indian Country, what should be preventable dental disease occurs at much higher rates than in the general population. That is why the Alaska Native community came up with its own solution: mid-level dental providers, or Dental Health Aide Therapists, that deliver high quality care to communities.
“I don’t think that the tribes are alone” when it comes to the challenge of improving oral health,” Speirn said.“I know that oral health may be more severe, or the lack of it in Indian Country, but Deamonte Driver, who died from a tooth infection, was living in urban Maryland.”
The Kellogg Foundation , one of the world’s largest philanthropic organizations, has been working to improve oral health since the foundation opened its doors in 1930. But this mission is accelerating now for a variety of reasons, including the links between better oral health and overall health, better information about healthy living, improving the diet, and even health care reform.
“Most people, when they think of chronic early childhood diseases, think of asthma or something like that. They are very surprised to hear that dental disease is the most prevalent disease among our young children ... now we’re looking at more innovations to get oral health care to people,” Speirn said. “The mouth is the gateway to nutrition, gateway to health. There are so many diseases that can be caused by bad oral health.”
Treating chronic diseases is important because that’s what costs the most, consuming about three-out-of-four of all health care dollars. But it’s not just about money, it’s about healthy living by preventing diseases before they take root. “That’s also an idea whose time has come,” Speirn said. “We can prevent disease and we can promote wellness at the same time.”
The Dental Health Aide Therapist program is a good example of how the elements of improving health can be fused. The practitioners don’t just fix teeth. They also visit with their neighbors, their patients. They listen. They teach. It’s one pathway leading to healthy living.
“In every decade since 1930, when we were founded, we have been very active in oral health care ... we helped fund the innovation that was called dental hygienist. Our friends the dentists remind us they were very skeptical to that idea when someone suggested there could be someone in the dentists’ office who could clean your teeth. Now we just take those for granted,” he said. “The idea of a dental therapist, or a licensed practitioner ... seemed to be a natural given our history in dental health care. It was something that was innovated, researched, and developed in a rural community led by the Alaska Native Tribal Health Consortium.”
The Alaska Native Tribal Health Consortium sent a proposal to the Kellogg Foundation after they had already begun their program. “It just made so much sense. Here we are in a time when 50 million Americans really don’t have access to oral health care on a regular basis,” he said. Mid-level dental practitioners have the potential to expand access working under the general supervision of existing dentists. It’s “an affordable way to get more oral health care out to more and more people, and it’s a great workforce development. It’s jobs for people in communities. And, again, I credit the Alaska Native Tribal Health Consortium for saying, we’ll recruit people from these communities, we’ll train them, and they’ll go back into their communities.”
Dental therapists are an economically sustainable model in remote Alaska villages, rural communities, and in urban areas where dentists don’t practice. They talk about the relationship with their patients, knowing they can’t drill and fill their way to better oral health. “That is just the opportunity to sit with families and patients and talk about oral health care. They really feel their mission as health educators, and as health promoters, as much as it is practitioners fixing the problems in the mouth today,” Speirn said. “Getting health messages from someone who understands you is so powerful. That’s what we would love to try and replicate in the lower 48 states and Hawaii. That is the power of the model that Alaska taught us.”