Evaluation of the dental health aide therapist workforce model in Alaska. Final report

Abstract

A majority of Alaska’s Native population lives in remote villages, accessible only by airplane, boat, four-wheeler, or snow mobile. Because of this, devising effective strategies to meet their oral health needs has posed daunting, nearly insurmountable, challenges for over a century. Since the 1960s, dental care for rural Alaska Natives has been provided primarily by itinerant dentists employed by (or under contract to) the Indian Health Service (IHS) or tribal organizations. With limited access to preventive and restorative care, disparities in oral health continue to grow: 62% of children ages 2 to 5 have untreated caries, a sizably higher proportion than among comparable groups from the lower 48 states.

To address these needs, in 2003 the Alaska Native Tribal Health Consortium (ANTHC), in collaboration with tribal health organizations, began the Alaska Dental Health Aide Initiative to provide dental health aide therapists (hereafter called therapists) to rural villages. Modeled after a program that began in New Zealand in 1921 and that has now been successfully emulated in many other countries worldwide, the Initiative is part of the Community Health Aide Program. There are currently 10 therapists who were trained in New Zealand and who work in a variety of practice settings, including subregional clinics and remote villages. Working under the general supervision of dentists at regional offices, therapists may perform cleanings, restorations, and uncomplicated extractions.