W.K. Kellogg Foundation and Tribal Dental Health

By Dr. Alice Warner, Director of Policy
W.K. Kellogg Foundation

Tribal communities across the country are leading the effort to dramatically improve oral health outcomes for Native children and communities. Mid-level dental providers, pioneered by the Alaska Native Tribal Health Consortium and known as dental therapists, are highly trained professionals qualified to provide preventive and routine dental care, such as applying fluoride treatments and sealants, filling cavities and performing simple extractions. According to research, in addition to significantly increasing in oral health outcomes, dental therapists provide care at a cost savings far lower than having dentists perform those services.

What is more exciting is how dental therapists are making their way to the lower 48, because of Tribal leadership. A year ago, the Swinomish Indian Tribal Community—under the leadership of its Chairman Brian Cladoosby and in partnership with Northwest Portland Area Indian Health Board (NPAIHB)—was the first tribe in the contiguous U.S. to employ a dental health aide therapist for basic oral health services.

Supported by the W.K. Kellogg Foundation in partnership with NPAIHB, the Swinomish Indian Tribal Community program is modeled on the successful oral healthcare delivery model used by Alaska Native communities for over 10 years.

Just this past week, the Washington State House and the Washington State Senate both passed a Tribal Dental Therapy Bill. If signed by the governor, the legislation would expand access to dental care for tribal members through the introduction of dental health aide therapists.

In Oregon, several tribes have launched a pilot program, also in conjunction with NPAIHB, to train dental therapists within the Confederated Tribes of Coos, Lower Umpqua and Siuslaw Indians and the Coquille Tribe of Southern Oregon.

The dental therapy model works. Now, more than 10 years later in Alaska, we’re seeing significant changes in the health of Native children. 40,000 Alaskan Natives now have access to dental care. We’re now seeing, just a generation later, cavity free children.

Additionally, dental therapists create positive economic impact for individuals and communities while meeting the Triple Aim: cost efficiency, patient satisfaction and quality care. Through several studies of established programs, we’ve learned that:

  • In Alaska, the dental health aide program generates 76 full time jobs with a net economic effect of $9.7M (one third spent in rural Alaska).
  • Aggregate patient travel savings amount to $40,000 per year, per dental heal aide in Alaska.
  • Children’s Dental Services, a safety net dental provider in Minnesota, reports that each dental therapist on staff saves the clinic $62,400 a year in salary costs. The average productivity of the entire dental team increased from $280 an hour in 2011 to $326 an hour in 2013.
  • Finally, after just one year in Swinomish Tribal Indian Tribal Community, practicing dental therapist Daniel Kennedy’s participation has also helped cut the wait time for an appointment from 8 weeks down to 3 or 4 weeks.

The dental therapy model provides a lasting career pathway for Native children. They come from the community, stay in the community and take care of the people in their community.

Dr. Alice Warner Director of Policy W.K. Kellogg Foundation
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