ADA urges lawmakers to ensure American Indians, Alaska Natives have access to care

The ADA sent a letter to the House and Senate Appropriations committees Dec. 4 urging lawmakers to ensure that American Indians and Alaska Natives have access to quality dental care.

The Association also sent a letter asking the committees to prioritize military dental research, which not only aids wounded soldiers but also civilians who suffer head or facial injury due to trauma, burns or surgery.

Regarding American Indians and Alaska Natives, ADA President Daniel J. Klemmedson, D.D.S., M.D. and Executive Director Kathleen T. O’Loughlin, D.M.D., urged the committees to support the House’s request of $222 million for the Indian Health Service Dental Program in the final 2021 Interior appropriations bill.

“The IHS Dental Health Program works to raise the oral health status of the American Indian/Alaska Native population through the provision of quality preventive and treatment services, at both community and clinic sites,” wrote Drs. Klemmedson and O’Loughlin, noting that more than 80% of AI/AN children ages 6-9 and 13-15 years old suffer from dental caries, while less than 50% of the U.S. population in the same age groups have experienced cavities. Also, AI/AN adults have more than double the prevalence of untreated tooth decay as the general U.S. population.

The ADA requested designated funding for the expansion of IHS Dental Clinical and Preventive Support Centers to help meet the health infrastructure needs of all 12 service regions.

The ADA also praised legislators for their continued support of the IHS Electronic Dental Record system, which is now working in 244 IHS federal, tribal and urban dental clinics.

"However, more funding is needed to upgrade the system and expand to additional centers. Additionally, dentists would like the EDR system to be interoperable with the IHS (medical) Electronic Health Record system, a need that has been made more apparent due to COVID-19, allowing for greater patient-centered interdisciplinary health care. Within the amount requested for the dental program, $3 million would enable the Service to implement EDR updates and expansion efforts, with funding allocated at the discretion of the Director of IHS Division of Oral Health."

Drs. Klemmedson and O'Loughlin closed by asking Congress to pass S 2871, the Indian Health Service Health Professions Tax Fairness Act, to make IHS scholarships and loan repayments tax-free.

Regarding military dental research, ADA noted that the research focuses on reconstructing and restoring function of craniofacial tissues and structures, which is “unique and not duplicated by any other federal dental program.”

“[Military dental research] is the only program focused on head and facial trauma and oral disease,” Drs. Klemmedson and O’Loughlin wrote. “Over 42% of injured service members have had wounds to the head and face. In the last decade alone, over 4,000 service members experienced facial injuries. These injuries cause significant physical and emotional challenges for the service member, often resulting in difficulties breathing, eating and speaking. Military dental researchers are the only investigators conducting research to mitigate the loss of facial tissue function and restoration with high quality bone and skin for these service members.”

In the letter, the ADA said an important aspect of repairing facial wounds is finding better methods to address infections that are drug-resistant and that developing prophylactic and drug therapies that prevent facial scarring from a burn injury is also a research priority. They noted that military dental researchers are currently developing a prototype for the anti-scar patch to help reduce burn wound progression and complications, but additional funding is needed. In addition, many entering military members have dental disease that can advance to a state that results in active duty personnel being prevented from carrying out their duties. An example of success in this arena was the development of an anti-plaque chewing gum that has proven to significantly reduce bacteria that causes oral disease.

"Because of your support, this research continues to advance as phase 2 of the clinical trials have proven to be safe and efficacious in reducing plaque buildup during the absence of oral hygiene for soldiers in field," Drs. Klemmedson and O'Loughlin said.

"The ADA strongly believes that the funding for the MDR program is worthy and justifiable, even in today’s difficult budgetary environment, since the program has a direct and lasting impact on saving lives and improving the quality of life for our military personnel," the letter concluded.

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