Joaqlin Estus
ICT
A new law in Washington state will greatly increase access to dental services and help address oral health disparities, say supporters.
On May 15, Washington Gov. Jay Inslee, a Democrat, signed into law a bill authorizing dental health therapists statewide. The new law expands a program that was available only on tribal lands and to tribal patients in Washington. The National Indian Health Board Tribal Oral Health Initiative said the earlier restriction “caused confusion with the Center for Medicare and Medicaid Services (CMS), which had denied Medicaid reimbursement until ordered to do so by the Ninth Circuit Court of Appeals earlier this year.”
”All health starts with oral health, and with more dental therapists operating in Washington state, we’re going to see positive health outcomes by taking care of people’s teeth,” said Rep. Marcus Riccelli, D-Spokane, chair of the House Health Care & Wellness Committee, in a prepared statement. He was the prime sponsor of the bill.
Sarah Chagnon, a Swinomish Tribal citizen, is a licensed dental therapist for the Swinomish Dental Clinic. She earlier said of the bill, it “means healing and peace. It is a big step in creating oral health equity in our own and surrounding communities. Having a dental therapist opens the door to more care. Oral health is overall health; everyone deserves a happy and healthy smile.…. I love what I do and hope to inspire future dental therapists.”
“Today, 70 percent of Swinomish dental providers are Native American,” said Dr. Rachael Hogan, director of the Swinomish Dental Clinic. “Compare that to the less than one percent of Native dental providers nationwide. This is just one example of how dental therapy models increase representation of underserved and underseen communities. We are a dental home to our patients where they have ownership of their treatment and we are accountable to them to provide only the best care.”
Under the new law, dental therapists can practice in public health settings. The oral health initiative said that “will make it easier for dental therapists to find jobs in Washington, for education institutions to recruit dental therapy students across the state, and for tribes to employ these providers in their own communities.”
In an interview with ‘ICT Newscast with Aliyah Chavez,’ Mescalero Apache dentist Dr. Felicia Frizzell spoke about a report from CareQuest Institute for Oral Health, the Society of American Indian Dentists and the National Indian Health Board’s Tribal Oral Health Initiative. The report outlined factors that influence oral health for Native Americans, including structural racism and a lack of necessities such as access to water, healthy food and adequate housing.
Frizzell said as a child she wanted to be a dentist then considered becoming a medical doctor. She went back to her childhood dream after “I heard some presentations from public health people and the Indian Health Service. They were mentioning that American Indians and Alaska Natives have the highest oral health disparities in the country.
“I started asking more questions because growing up, you see the children with the silver teeth, you see our elders who don’t have teeth, and it’s just accepted. I learned that there weren’t that many Native dentists. And in fact, the very first Native dentist, Dr. George Blue Spruce is still alive and well,” Frizzell said.
Frizzell said she enjoys “just having that hands-on encounter with a patient where you physically do a procedure on them, and then you get them out of pain…It’s the best feeling when you’ve changed someone’s competence and self esteem where they feel comfortable going to get a job, when before maybe they couldn’t smile without uncovering their mouth.”
Related:
— Swinomish Hires Dental Aide Therapist in Washington State, ADA Objects – ICT News
— Washington state attorney general joins Swinomish tribe to push for Medicaid funding for dental health aide therapists
— Access to Dental Care in Indian Country Is About to Change – ICT News
— Overcoming Barriers to Dental Care One Kid at a Time – ICT News
Dental therapists got their start in the United States in 2004 through an initiative by the Alaska Native Tribal Health Consortium. After two years of intensive training, the mid-level Dental Health Aide Therapists provide routine care and preventative education under the supervision of a dentist. They often operate in their home villages in remote areas unable to attract or support more advanced care. Dentists have praised the program for providing more preventive care for children and fewer extractions for adults.
In addition to Washington, other states have followed the Alaska model, including Oregon, Minnesota, Maine, Vermont and Arizona. Legislation authorizing dental therapists is being considered in other states. Dental therapists are also widely used in advanced English-speaking countries such as Canada, New Zealand, Australia, and the United Kingdom.
ICT’s Shirley Sneve contributed to this report.
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