Rural health aides have a long, successful history of improving access to health care in Alaska.
Now, a dental program based on that model is improving oral care in the Yukon-Kuskokwim Delta.
The Dental Health Aide Therapist program was controversial when it started a decade ago, but a new study suggests that smiles have gotten healthier, cleaner, and toothier in villages where it’s appeared.
Phylicia Wilde grew up in Mountain Village on the Yukon River. When she was 12, she got a toothache. It started small, but soon she couldn’t sleep. With the pain, she began missing school. Then, a dentist arrived for the village’s yearly dental visit.
“I was entered into that list to get seen, but the list was so long. It was four or five pages of patients,” Wilde said.
Wilde didn’t make the cut and had to fly to Bethel for treatment. By then, the tooth had abscessed, or become infected.
“It was on a permanent tooth that had a huge cavity, and I needed a root canal,” Wilde said.
If Wilde had had a dental provider in her village, she said that the problem may never have occurred.
Now, Wilde herself is a provider, certified as a dental health aide therapist for the Yukon-Kuskokwim Health Corporation. After training for two years, she offers many of the same services that dentists do such as X-rays, fillings and extractions.
This program was started by the state’s tribal health organizations because nothing else was working.
Dentists were willing to travel to rural areas and donate services, but it was never enough.
National dental groups sued to stop the program, saying that it wouldn’t be safe.
They lost, and the program began turning out trained health aides capable of doing dental therapy.
Donald Chi is an associate professor of Dentistry at University of Washington and a pediatric dentist who’s practiced in the YK Delta. Recently, he published a study evaluating the impact of dental therapists on Delta communities. The findings are significant.
“Dental therapists seem to be making a difference in terms of providing the type of care that you and I would want for ourselves and maybe family members,” said
The study is the first long-term review of health impacts by dental therapists, and Chi said that the results could change the way dental care is provided in rural areas across the U.S.
“The more number of dental therapist treatment days communities got, the more preventive care people got, and fewer people were getting extractions,” Chi said.
Dentist Judith Burks, who coordinates YKHC’s 10 dental therapists, has seen the transformation.
“I go out to villages and instead of the main focus being on emergencies, we get to focus on things like prevention and higher level care for the patients,” Burks said.
In other words, dental therapists can now educate communities on how to live healthier lifestyles for a healthier mouth, like not using tobacco and avoiding sugar.
Wilde knows her efforts mean that villagers are having fewer of the painful, sleepless nights and missed school days like she experienced growing up.
“It’s been awesome, just seeing the patients and their gratitude,” Wilde said. “That feeling is just amazing.”
YKHC hopes to nearly double the number of dental therapists serving the region over the next two years.
They’re offering full scholarships, and applications will be available on the YKHC website in February.