However, there were plenty of untroubled smiles inside the yellow-hued, spartan auditorium of Choctaw Health Center gave hundreds of bubbly American Indian students oral health examinations, fluoride varnish, oral hygiene education and goodie bags filled with toothpaste and toothbrushes provided by the ADA, through the generous donation of Henry Schein and Colgate, to take back to their reservation homes.
It was a Give Kids A Smile event not only for the children of the Mississippi Band of Choctaw Indians but also no fewer than 117 Indian Health Service dental programs across 24 states that were participating in GKAS with the events alone estimated to involve 14,000 American Indian/Alaska Native children.
According to Dr. Timothy L. Ricks, chief dental officer of the U.S. Public Health Service and deputy director of the Indian Health Service Division of Oral Health, this was the first-ever Indian Health Service-ADA Give Kids A Smile collaboration, especially noteworthy with it coinciding with National Children’s Dental Health Month.
Dr. Ricks not only initiated the ADA-IHS collaboration nationally, but was also one of the dentists participating in the event, evaluating the condition of the Choctaw students’ teeth.
A total of 222 children were the beneficiaries of the day, with them lining up patiently for their turn in the folding chairs that served as operatory chairs. The temporary clinic was situated atop a small hill, one of many that shaped the rural, wooded and often unspoiled landscape.
“We chose this location for our joint event because of the tremendous work that the Choctaw Health Center Dental Program has done over the years in the prevention of dental caries,” Dr. Ricks said.
“We feel fortunate to be the chosen ones,” said Dr. Neva Eklund, pediatric dentist at the Choctaw Health Center, who helped out by applying fluoride varnish.
The balloon-festooned Indian Health Service event was also attended by Dr. W. Mark Donald, ADA Speaker of the House and past president of the Academy of General Dentistry; the Honorable Cyrus Ben, chief of the Mississippi Band of Choctaw Indians; Dr. Angela Filzen, state dental director of Mississippi; Beverly Cotton, DNP, Nashville Area Indian Health Service director; Jerry Walters, representing Henry Schein; Dr. Joe Park, Nashville Area dental officer; Mary Harrison, Choctaw Health Center acting director and host of the event; and Elisah Monique Jimmie, 2019-20 Choctaw Indian Princess. The following day, the dentists and dental hygienists would go on to treat and educate approximately 250 children from other Choctaw communities.
Dr. Donald practices in nearby Louisville, Mississippi, and cited a long history of treating American Indian patients at his clinic. He said his grandfather was born not far from the reservation, and he welcomed the chance to return to his roots and celebrate the occasion.
“February is always on my calendar because of National Children’s Dental Health Month,” he said. “And Give Kids A Smile is always a big event.”
The Choctaw Dental Program provides oral health services to 13,454 American Indians from the Choctaw region. The program prides itself in being the busiest Indian Health Service or tribal facility east of the Mississippi River, Ms. Harrison said, providing more than 65,000 dental services annually.
The Mississippi Band of Choctaw Indians, like many of the other 574 federally recognized tribes in the U.S., suffers disproportionately from dental disease, Dr. Ricks said in remarks at the health center before the clinical event.
“Despite the years of preventive services provided by the great dental team, Choctaw children have the highest prevalence of disease east of the Mississippi, with 62.6% of children having decay experience and 45.7% having untreated decay,” Dr. Ricks said. “This is almost double the prevalence of the next highest tribe in the area and four times the rate of U.S. white children.”
Dr. Ricks was quick to point out recent strides in improving access to care to young Indian Health Service patients. Early childhood caries has steadily declined nationally since 2010, and untreated early childhood caries in American Indian/Alaska Native preschool children has “significantly” declined, according to a data brief released in 2019 by the Indian Health Service Division of Oral Health.
“The 14% reduction in untreated decay is statistically significant and may be the first measured reduction in decay in this age group ever recorded at a national level,” said Dr. Ricks.
Chief Ben was thankful for the Give Kids A Smile care given by the dental team members.
“I appreciate the compassion [they] bring to our community and our tribal members,” the chief said.
Dr. Cotton now occupies a senior position within the Indian Health Service administration, but she was once the school nurse at the very same school where IHS and the ADA held their Give Kids A Smile event. She said she would often encounter students complaining of toothaches.
“It was absolutely a big reason for kids coming to the nurse’s office,” Dr. Cotton said.
Dr. Cotton said the day’s collaboration with the ADA was dear to her heart.
“It’s important to be supportive of the physical, spiritual, social and mental health of American Indians,” she said. “We can’t do that in silos. We need to partner with other organizations, like the ADA, to promote these initiatives."
Dr. Park, who as a captain in the U.S. Public Health Service spends much of the year practicing dentistry at the Saint Regis Mohawk Tribe in New York, said he came from an underserved community when he was growing up, which explained why he became a dentist and is committed to Give Kids A Smile.
“It’s very rewarding at the end of the day,” said Dr. Park. “I know I’m helping people who need it the most.”
The Indian Health Service, an agency within the U.S. Department of Health and Human Services, is responsible for providing federal health services to American Indians and Alaska Natives. The IHS provides a comprehensive health service delivery system for approximately 2.6 million American Indians and Alaska Natives, according to its website.
The Choctaw Indian Reservation consists of 35,000 acres of trust land scattered over 10 counties in east central Mississippi. Tribal members of the Mississippi Band of Choctaw Indians live in the eight reservation communities of Bogue Chitto, Bogue Homa, Conehatta, Crystal Ridge, Pearl River, Red Water, Standing Pine and Tucker.
As one of the United States' original first nations, the Mississippi Band of Choctaw Indians is the only federally recognized American Indian tribe living within the state of Mississippi. According to the band’s website, the Choctaw Nation was the first American Indian tribe to be removed by the federal government from its ancestral home to land set aside for them.
Give Kids A Smile, which was launched nationally in 2003, aims to increase access to dental services for children who go without care. Since its inception and stewardship by the ADA with help from its national sponsors Henry Schein and Colgate, more than 6 million underserved children have received free oral health services. Each year, about 7,000 dentists and 30,000 dental and community team members provide preventive and restorative services at over 1,500 Give Kids A Smile events across the country.
For more information about how GKAS programs are organized across the country, visit ADA.org, and to learn about programs taking place in your area, email gkas@ada.org or contact your state or local dental association.