Poor oral health disproportionately affects minorities and low-income populations. According to the Centers for Disease Control and Prevention, blacks, Hispanics, American Indians and Alaska Natives generally have the poorest oral health of any racial and ethnic groups in the U.S. But in tribal lands, there is an attempt to fill those gaps.
American Indians and Alaska Natives, more than any other group, are twice as likely than the general U.S. population to have untreated tooth decay. American Indian and Alaska Native preschool children have the highest level of cavities; more than four times higher than white non-Hispanic children.
"Approximately 75 percent of Native American children start kindergarten with untreated dental decay, and there are options for that. There are some solutions for that, and there strategies that will impact an improvement in that percentage," said Jane Grover, director of the Council on Advocacy for Access and Prevention at the American Dental Association.
One of those solutions is Community Dental Health Coordinators, trained experts who link the community with dental specialists. Most are tribal members who are trained to educate and promote good oral health.
Community Dental Health Coordinator Sonia Vandever said: "Compared to last year there's a big difference. Some of the kids teeth have gotten their fillings done; some of them have gotten better oral hygiene. The teachers remember to say, ‘Brush your teeth, do your circles.’ It really helps them, and the parents like that as well."
Education and access to dentists are factors in the lack of care. Indian Country Media reports "on the Colville Indian Reservation ... one dentist serves a population of 6,000." Other tribes have hired dental health aide therapists, who help alleviate some of the community's needs.
"When my younger patients come in or any patient, I speak to them in Yup'ik," said dental health aide therapist Trisha Patton, "and that to me goes a long way, especially for someone like me who grew up in the village, being from the village. I feel like I have that opportunity to say: ‘I'm just like you. And I could be that advocate.'"
For children, baby teeth serve as guides for facial growth and speech development. They're also necessary for proper nutrition. For new moms, gum disease can affect a baby's development. Left untreated, tooth decay in adults can increase the risk of cancer and other studies have linked poor oral health with heart disease and strokes.
"Unfortunately, yes, we still struggle with this statistic," Grover said, "but we are making and seeing some key changes in communities where oral health is promoted and where we are working to provide dentists in these areas. And there are more dentists graduating now than ever before."
Dental health problems are not limited to American Indians and Alaska Natives. In 2016, some 74 million Americans didn't have dental coverage.