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APHA Scientific Session and Event Listing

Recorded presentation

Neal A. Demby, DMD, MPH and Susan L. Dietrich, DMD. Dental Medicine, Lutheran Medical Center, 150 55th Street, Brooklyn, NY 11220, 718-630-7177, ndemby@starband.net

The American Indian/Alaska Native (AIAN) population has the highest decay rate of any population cohort in the US. Since 1921 the New Zealand school nurse program has been used effectively in 42 countries. Despite a track record of positive outcomes, the ADA filed a lawsuit to stop the “unlicensed” practice of dentistry by DHATs in Alaska. Fear of economic consequences draped in sheepskins of quality and public accountability have created divisiveness within the profession. The real issue may be contending with cascading effects of DHATs to increase access in the lower 48. In other words a “dental domino theory” writ large. Oral health problems affecting AIAN require diverse approaches to ameliorate oral diseases. The ADA alternative proposal has constructive elements, however none suggests increasing access through the initiation of residency programs. This paper explores the public policy issues, partnerships and incentives necessary to implement such a program. Data from LMC and its partnerships using residents to care for the underserved in Alaska are presented, including the number/ type of visits and services from 8 residents presently in Alaska. The innovative partnerships between LMC and tribal facilities looms large as one of many strategies to improve the oral health of AIAN. The growth potential of the program described could be further enhanced by creative partnerships with the ADA in funding loan repayment for residents who train in Alaska. These resources would be a far wiser and more prudent use of organizational resources , than litigation and negative press throughout the land.

Learning Objectives:

• 1. To review the unmet oral health care needs of the American Indian/Alaska Native population and strategies in place to increase access,
• 2. To explore the public policy issues surrounding the provision the oral health care for the Alaska natives,
• 3. To discuss how innovative partnerships between a large teaching hospital with postdoctoral dental residency training programs and tribal health facilities are a viable strategy for increasing access to care,
• 4. To describe the implications of cross fertilization of postdoctoral dental residents practicing in close proximity to DHATs.

Keywords: Access to Care, Partnerships

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation