Aide Therapist programs bring dental care to Native children
Health Aide Therapists provide dental care to children in
schools, serving all children in a community, not just those
who can get to a dental clinic. Alaska Dental Health Aide
Therapist Bonnie Johnson shares her story in a YouTube video.
(photo courtesy W.K. Kellogg Foundation/YouTube)
Dental Health Aide Therapist or DHAT programs were pioneered
in the U.S. by the Alaska Native tribes in the early 2000s. Today
the Swinomish Tribe in Washington also has a DHAT program and in
Oregon, the Confederated Tribes of Coos, Lower Umpqua and Siuslaw
Indians welcomed their first Dental Health Aide Therapist in July.
Tooth decay affects 43 percent of American Indian/Alaska Native
children, according to a 2014
study by the Pew Charitable Trusts. Untreated tooth decay in
children can lead to pain, eating problems, sleep disturbances,
hospitalization, systemic infection, school absences and low self-esteem.
Dental Health Aide Therapists are trained to fill cavities, clean
teeth and administer fluoride treatments that help prevent tooth
DHATs go into schools, day cares and Head Start programs to
work directly with children, educating them on good dental
hygiene practices such as brushing and flossing. Working within
the schools means that DHATs are able to serve all children in the
community, not just those who get to dental clinics.
DHATs are usually members of the communities they serve and
are thus able to provide culturally competent dental care. "We're
so proud to have Bonnie [Johnson] as a DHAT worker. She's a Native
like us. She understands the needs of the people," said Norma Shorty,
a community health aide worker in Emmonak, Alaska, in a video sponsored
by the W.K. Kellogg Foundation, one of the backers of Dental Health
Aide Therapist programs.
* Since children see their DHATs in school, on the street and
in the grocery store, they are less likely to fear their oral care
provider than perhaps their parents and grandparents are. "The kids
see DHAT Daniel [Kennedy] all the time, so they are totally comfortable
and trusting when they come into the clinic for exams, treatments
and cleanings," Rachael Hogan, dental director for the Swinomish
Indian Tribal Community, told ICMN.
In remote communities, DHATs go where the children are and set
up temporary treatment facilities, instead of parents having to
find and pay for transportation to a dental clinic, which could
be hundreds of miles away. "We are so happy that we have the therapist
here so we don't have to travel for that purpose anymore," said
Gina McKindy, a resident of Aniak, Alaska, in another Kellogg video.
"Healthy teeth are so important for my kids. I just don't see how
it would be without the program."
DHATs receive two years of rigorous training in the procedures
they will perform. They are trained to the same level as dentists,
but learn fewer procedures, making their education less expensive
than training dentists and putting more practitioners in the field
faster. One in three AI/AN children has unmet
dental care needs, in part because there are not enough dentists
to serve them. More DHATs mean more kids get care.
* DHATs are role models in their communities, showing children
that higher education is a real option.
The first independent
study of the Alaska Dental Health Aide Therapist program in
2010 found that mid-level practitioners were "practicing safely
and provided competent patient care within their scopes of practice"
and that patients reported a high level of satisfaction with the
care they received.
In communities with access to DHATs, fewer children under age
3 had their front four teeth extracted and more children received
preventive care, which included an exam, fluoride treatment, or
both, according to a new
study by Donald L. Chi at the University of Washington School
of Dentistry, who looked at dental services the Yukon Kuskokwim
Delta in Alaska.