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Action for Dental Health

South Dakota Dental Partnership Improves Oral Health on American Indian Reservations

November 17, 2014

There has long been an imbalance in oral health among Native Americans, particularly among children living on tribal lands.

The US government, which classifies Native Americans as “American Indian and Alaska Native” (AIAN), reports that children in this ethnic group are three times more likely to have early childhood caries (cavities) as any other U.S. ethnic group. In some communities, up to 50 percent of children have such severe cavities that they require full mouth restoration under general anesthesia – a rate about 50 to 100 times that in the general population.

Preschool children within the Great Plains Indian Health Service (IHS) in South Dakota have one of the highest tooth decay rate of any population group in the country, according to IHS. Due to the need, Delta Dental of South Dakota, a dental insurer, created the Circle of Smiles program to improve the oral health of American Indian children throughout the state.

Through Circle of Smiles, hygienists and community health workers (called oral health coordinators) provide preventive care for children ages nine and younger, pregnant women and people with diabetes who are members of the state’s nine American Indian tribes, according to Zach Parsons, program manager for Circle of Smiles. Private and IHS dentists provide restorative care to patients after referrals from the Circle of Smiles staff. To date, about 6,400 people have received treatment.

“Our idea is to bring care to people where they are at, so we’re willing to provide that care anywhere we can find a way,” he said.

The program is funded through a three-year federal grant. Services began in January.

Seven dental hygienists work under the collaborative supervision of dentists to provide preventive care to children on the tribal lands. Oral health coordinators ensure children receive follow-up treatment, help schedule appointments, and help families apply for Medicaid.

The hygienists bring mobile dental equipment to places such as Head Start buildings, community clinics and schools, where they provide cleanings, fluoride varnishes and sealants, said Mr. Parsons. Dentists meet with the hygienists at least once a month to discuss any serious dental issues.

One of the hygienists is Native American and lives on the reservation, he noted. In addition, all program staff receive annual cultural competency training in order to be appropriately aware of the cultural values of potential patients and families.

“We essentially divide the state into regions and hire folks who are in positions to reach the reservations easily,” he said.

The Circle of Smiles program has also partnered with the South Dakota Dental Association, Rosebud IHS, and Saint Francis Mission to host two Dental Days events. At the events, Circle of Smiles staff worked alongside volunteer dentists as well as staff from another Delta Dental program focused on restorative and preventive care, Dakota Smiles, to provide care to children and adults on the Rosebud reservation. A similar event was hosted on the Cheyenne River Reservation by Circle of Smiles, Dakota Smiles, and Cheyenne River Sioux Tribe staff.

Bringing dental health education and disease prevention into communities—especially underserved inner city, remote rural and Native American Communities--is one of the major initiatives of Action for Dental Health, the American Dental Association’s nationwide, community-based movement to improve oral health in America.






The Circle of Smiles program is supported by Grant Number 1C1CMS330980-01-00 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services.  The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies.