For years, the National Indian Health Board (NIHB) has been a driving force in uniting stakeholders—Tribal leaders, Tribal health directors, Area Indian Health Boards, Tribal Epidemiology Centers, and public health professionals—to address oral health disparities and improve access to oral health care and prevention services across Indian Country.
NIHB’s Tribal Oral Health Initiative is an expanding effort dedicated to fostering innovative solutions. This initiative encompasses a variety of resources, including a comprehensive toolkit, research findings, and targeted training for Tribal leaders and healthcare administrators. At its core is the development of the Tribal Oral Health Agenda, a strategic guide for advancing oral health equity.
One solution to Indian Country’s oral health crisis is dental therapy. Dental therapists are midlevel oral healthcare providers that offer basic dental treatment, with a special emphasis on preventative and routine care. Similar to physician assistants, dental therapists operate under the general supervision of a dentist. They are trained to perform the most common dental procedures with proficiency, which meets a significant proportion of patient need. Because of this, dentists can focus their limited time on the most serious cases, practicing at the top of their scope.
Dental therapists have been practicing in Alaska Native communities since 2004. As part of the Community Health Aide Program (CHAP), which provides much needed health services in rural Alaska, dental therapists complete a rigorous two calendar year program, a 400 hour preceptorship under the supervision of a dentist, and then begin practicing in communities where the unmet oral health needs are the highest, usually in rural areas.
Watch this short video to hear from Alaska Native youth on how dental therapy has helped their community:
Oral health disparities and limited access to care remain critical issues for many American Indians and Alaska Natives (AI/ANs). For instance, children ages 2–5 in these communities have, on average, six decayed teeth compared to just one among the same age group in the general U.S. population. Compounding this challenge, half of AI/ANs live in designated “dental shortage areas.” Unfortunately, oral health is often overlooked, leaving many unaware of its vital connection to overall health and well-being.
The dental therapy model offers a practical and cost-effective solution for communities with limited access to oral healthcare, especially in rural reservation areas. Dental therapists working alongside dentists reduce costs and increase access, allowing programs to stretch resources further.
To support all efforts, NIHB provides training for Tribal leaders, offering guidance on how to implement dental therapy programs tailored to their communities. This website highlights Tribes, intertribal organizations, and Area Indian Health Boards that champion dental therapy, along with additional resources on the model.
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