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Organized dentistry brings oral health awareness to health workers in Navajo Nation

July 15, 2016

By Michelle Manchir

Listening and learning: About 80 Community Health Representatives in the Navajo Nation received oral health-related training earlier this year to help address oral health disparities in their community. Photo by Native Laboratories
Window Rock, Ariz. — The Community Health Representatives in the Navajo Nation here have long been revered for improving residents' general health by helping them navigate the complicated health care delivery system, providing home visits, serving as interpreters, offering health screenings and more.

Now, thanks to a collaborative effort among the Navajo Nation, the Arizona American Indian Oral Health Initiative, the Arizona Dental Association and the ADA's Council on Access, Prevention and Interprofessional Relations, Community Health Representatives are working to provide the same friendly guidance to their communities when it comes to oral health.

The Navajo Nation covers three states — Arizona, New Mexico and Utah — and includes about 180,000 people, but access to health care facilities, including dental, for many of its residents, is limited, said Dr. Rick Champany, a former Navajo Area Indian Health Service dental consultant.

To help improve the community's oral health care, Dr. Champany provided in-person training earlier this year for the Community Health Representatives, discussing nutrition and good oral health habits, while using the Smiles for Life oral health curriculum as a foundation for this training.

Dr. Champany used the curriculum, which consists of eight online 45- to 60-minute courses, and delivered it over a two-day session. He covered curriculum topics including the relationship of oral to systemic health, child oral health, acute dental problems and geriatric oral health. The ADA in 2012 officially endorsed the curriculum, which was first released in 2005.

About 80 Community Health Representatives completed the training, which also involved observing dental screenings, and then practicing screenings on each other.

Teaching oral health: Dr. Rick Champany, standing, leads a training session discussing nutrition and good oral health habits with Navajo Nation Community Health Representatives. Photo by Native Laboratories
One of the ultimate goals, organizers said, is to motivate the health workers to get an adequate understanding of how oral health relates to overall health and enable them to interact more fully with a Community Dental Health Coordinator.

Community Dental Health Coordinators help bridge the medical and dental treatment worlds by providing better management of dental disease and integration of care in medical offices, health centers, multispecialty clinics, nursing homes, assisting living facilities, juvenile programs and school-based health centers. They often play critical roles in managing care for pregnant women and patients with chronic health conditions like diabetes, and can help facilitate other needed services, including child care or transportation, that can be a barrier to accessing care.  Furthermore, some Navajo Nation CHRs are  being recruited to complete the Community Health Dental Coordinator training, which is offered at two Arizona colleges.  Navajo Community Health Representative Director Mae Gilene Begay hopes that 8 to12 Community Health Representatives eventually step forward to be fully  trained as coordinators.

But even if the representatives choose not to pursue the Community Dental Health Coordinator accreditation, many have already learned more about oral care than they knew before, and about  ways to incorporate this new knowledge into their roles, Dr. Champany said.

"Many Community Health Representatives did not realize the extent to which oral health relates to their everyday work.  This training may give them some insight as to the extent of their interest in pursuing more knowledge and skills in dentistry," he said.

Ms. Begay said she envisions other educational opportunities and collaborations to enhance the work of Community Health Representatives, too, including  partnering with medical and hospital leadership to support the importance of oral health to overall health,  and educating tribal leadership to support oral health as an essential element of health care for their people.

Arizona Dental Association executive director Kevin Earle praised the efforts.

"What I'm hearing from people who attended the training is that it was an amazing opportunity to raise  oral health literacy  among the Community Health Representatives and help them integrate that knowledge into their daily work in other Navajo Nation programs, like those addressing diabetes, pregnancy, smoking cessation and cancer care," Mr. Earle said.

For more information about Community Dental Health Coordinators, visit

For more information about the Smiles for Life Curriculum and to access the courses, visit