American Indian/Alaska Native outreach grows
"There is no doubt that fully staffing all Indian Health Service and tribal dental clinics with dentists is the best way to meet the oral health concerns of American Indians/Alaska Natives," the Association said in written testimony on IHS dental appropriations. "However, the ADA also recognizes that using volunteers can help to fill the gaps until that day comes."
The dental needs are critical, the ADA said. AI/AN children experience rampant early childhood caries at a rate approximately 50-100 times higher than non-AI/AN children. "This may represent the largest health disparity in the U.S. today." While disease is at epidemic levels, use of dental services among Indian people is declining. Indian Health Service dental vacancies, population growth, medical inflation and flat budgets "are at the heart of this problem," the Association said. There is a need for training additional IHS dental specialists. Within a year, 65 percent of Indian Health Service specialists will be eligible for retirement, a situation described as "approaching a severe crisis."
The Association proposed a $1 million line item increase for dental residencies and urged congressional appropriators to indicate that "it is to continue as part of the base in future budgets of the IHS dental program."
Public-private volunteer efforts provide "an excellent opportunity to improve access to care for AI/AN communities and increase awareness among the dental profession about the tremendous oral health disparities among Native people," the Association told Congress.
The Association under 2006 House of Delegates policy has recruited some 25 dentists to volunteer service for at least two weeks in Indian country and this year will expand the base of recruits and sites. On the public side, some 427 dentists and dental student volunteers have provided 297,653 additional Indian Health Service patient visits and dental services since 2004. "This proved so successful that the IHS could use an additional $250,000 to expand the program," the Association said. The per dentist cost, slightly more than $2,000, "demonstrates the program's cost effectiveness."
The Association also called for additional funding for loan repayment "as the best recruiting tool" for IHS dentists and for school-based sealants, community water fluoridation, dental education and other community-based activities to prevent dental disease. "The ADA believes that this request represents a relatively 'bare bones' approach to rebuilding the IHS dental public health infrastructure and is essential to accomplishing increased access to care throughout Indian country."
In separate testimony, the American Association for Dental Research supported an ADA request for $1 million a year for three years for research and clinical studies on early childhood caries in cooperation with the Indian Health Service.