Program to Bring Dentists to Rural Alaska Under Fire Children in rural Alaska suffer dental decay at 2 1/2 times the national rate -- partially because few dentists are willing to work in rural Alaska. The Indian Health Service program has brought in foreign-trained dental therapists to work in rural areas. But the American Dental Association opposes the practice.
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Program to Bring Dentists to Rural Alaska Under Fire

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Program to Bring Dentists to Rural Alaska Under Fire

Program to Bring Dentists to Rural Alaska Under Fire

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From NPR News this is ALL THINGS CONSIDERED. I'm Robert Siegel.


Alaska's the only state that allows dental therapists to work legally and the ADA says the more complicated procedures should be reserved for dentists. Alaska's Public Radio Network's Annie Feidt reports.

ANNIE FEIDT: The Indian Health Service launched Alaska's dental therapy program more than a year ago. The federal agency allows the therapists to treat Alaska natives. But the American Dental Association thinks they should be subject to state licensing laws like dentists. Jim Toll is executive director of the Alaska Dental Society which signed on to the lawsuit and echoes the concerns of the ADA. He says the therapists are practicing dentistry illegally.

JIM TOLL: When we learned that there were training people taking people with essentially only a high school education. Sending them out of the country, and they were coming back and doing irreversible surgical procedures, we said wait. That's not good and it's not safe.

FEIDT: There are no dental therapy training programs in the United States. So Alaska's dental therapists study in New Zealand instead, where therapists have been working since the early 1920s. Dental therapists practice in other countries too, like Canada and Australia. But Alaska's therapists are the first to treat patients in the U.S. There are currently eight working in rural Alaska with four more in training. They're allowed to perform simple fillings and extractions. But Jim Toll says even minor procedures can lead to serious complications.

TOLL: I have yet to meet a dentist who would tell you that there's any such thing as a simple extraction until it's over. Dentists are trained to deal with all of the anomalies once they get in there and start doing that, to recognize to know how to respond and compensate.

FEIDT: At a clinic in Bethel in western Alaska, 10 dentists serve a region the size of Washington State.

BLOCK: A little tiny sweep, and then brush down.

FEIDT: Most patients aren't on the road system so even a minor problem requires a long and expensive plane trip. The Bethel Clinic is trying to entice six more dentists to join their team with compensation packages of almost $180,000 a year. But the positions have been open for six years. Dentist Mary Willard says therapists are beginning to fill the need.

MARY WILLARD: We have a whole waiting room full of people with tooth aches basically and we tend to treat our patients on a as-need basis sometimes because we're so short of staff. That's not really the most efficient way to do dentistry.

FEIDT: Kids in rural Alaska suffer from tooth decay at two-and-a-half times the national average. Lillian Magilten (ph) is a dental therapist who just began practicing in Tuksuk Bay, a small village on the Baring Sea.


When I was in Christ's Church, the dental therapist, my host dental therapist, Esreket (ph). She's like oh, look at all these bombed out teeth. You know and I'd look over her shoulder and then they'd come up, and then you come back to Alaska and it's like, man, those bombed out teeth are nothing compared to what I'm seeing today.

FEIDT: The tribal organization that oversees the program is hopeful the therapists will win the right to continue practicing. Legal Affairs Director Valerie Davidson says a lot is at stake.

VALERIE DAVIDSON: I think it will be a significant loss. Right now the dental health therapists are providing a service in many villages in which they have no other access to dental care. The dentists aren't there.

FEIDT: For NPR News in Anchorage, I'm Annie Feidt.

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