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In Navajo Nation visit, ADA leaders listen, offer support

July 28, 2017

By Kimber Solana

Window Rock: (From left) Dr. Dan Klemmedson, ADA Fourteenth District trustee; Dr. Tom Schripsema, New Mexico Dental Association executive director; Kevin Earle, Arizona Dental Association executive director; Mae-Gilene Begay, director of Navajo Nation Community Health Representative/Outreach program; Dr. Gary L. Roberts, ADA president; Brenette Pine, Crownpoint, N.M., community health supervisor; Dr. Steve Geiermann, ADA staff. The group of organized dentistry leaders poses for a photo in front of Window Rock, the capital of the Navajo Nation, during a July 6 visit to meet with community leaders and to learn more about the area's oral health needs.
Navajo Nation, Ariz. — Understanding that oral health care challenges remain prevalent in Native American communities, a delegation of organized dentistry leaders had one clear goal when they met with those working to improve health care outcomes in the Navajo Nation: to foster and maintain a working relationship.
During one of the meetings, ADA President Gary L. Roberts said, a community leader turned to him and asked, "What's your agenda? What are you looking for?"
"I responded that I'm here to listen," he said. "I'm here to see what you need, to see how we can work together, and to keep our communications open."
Dr. Roberts, along with Dr. Daniel J. Klemmedson, ADA Fourteenth District trustee, and Dr. Steve Geiermann, senior manager with the ADA Council on Advocacy for Access and Prevention, visited the Navajo Nation July 6 to listen to the challenges facing those who seek to improve the general health care outcomes in their communities, especially oral health outcomes.
The three were joined by Dr. Tom Schripsema, executive director of the New Mexico Dental Association; Kevin Earle, executive director of the Arizona Dental Association; Mike Moxey, NMDA director of communications and advocacy; and Kade Twist, consultant for NMDA and AzDA.
The group held a series of meetings intended to begin to give the ADA leadership a perspective on what the current oral health needs of tribal people, what progress has been made to begin to address those challenges, as well as investigating new opportunities to engage this diverse community.
Through these meetings, the group learned of the importance of community-based prevention efforts to improve the tribal community's oral health. These efforts include encouraging community health representatives to embrace the Community Dental Health Coordinator (CDHC) training and serve as oral health resources to their peers and to integrate an oral health component into the 10-year Navajo Health and Wellness Plan. The ADA-developed oral health plan emphasizes community-based prevention utilizing the existing community health representatives as a catalyst for action.
"I was most impressed by efforts made on the Navajo Nation to add oral health care knowledge and resources to community health representatives skillsets," Dr. Klemmedson said, adding that community health representatives have functioned for many years, at a community and household level, to help with chronic disease management (diabetes, hypertension) and maternal-child health.
Community health representatives have repeatedly stressed that they often do not possess sufficient oral health knowledge to incorporate it into their everyday encounters with patients, said Dr. Geiermann. The ADA is collaborating with them to change that, especially utilizing the ADA-endorsed "Smiles for Life" oral health curriculum as a resource for providing oral health knowledge to community health representatives. About 80 community health representatives were exposed to a two-day educational experience distilled from the "Smiles for Life" curriculum, and four community health representatives are currently enrolled in the CDHC program at Central New Mexico Community College to gain further education and experience in addressing the oral health needs of their communities.
According to Dr. Geiermann, Native Americans, especially children, continue to face challenges with their oral health. Decay is four times more prevalent among Native American children than white children. And 76 percent of Native American children on the Navajo Reservation who enter kindergarten with significant tooth decay.
Jonathan Nez, vice president of the Navajo Nation, welcomed the group to Window Rock, the capital of the Navajo Nation. Dr. Geiermann said that Mr. Nez spoke to them about the importance of oral health to overall health among his people. Mr. Nez also emphasized the importance of building trust and rapport within the community, which makes the Navajo community health representatives an integral resource.
"Our focus on community-based education and pushing for prevention is the right direction," Dr. Roberts said. "We'll never treat our way out of this problem."
In an informal meeting, the group spoke with Central New Mexico Community College administrators, faculty and CDHC students to learn how the ADA can further support their CDHC program.

"When they graduate, they will be able to serve as an oral health care resource for both their community health representative colleagues as well as communities," Dr. Klemmedson said. "Oral health care literacy, prevention and referral for treatment begins in homes and communities, and these individuals are key to that process."