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Celebrating 10 years of better dental care in Alaska

By Louis W. Sullivan, MD


I had the pleasure of addressing the 2014 graduates of the Dental Health Aide Therapist (DHAT) program (as well as program alumni, students still in training, faculty, staff, and administrators) in Anchorage, Alaska earlier this month. This is a particularly special year because it’s also the 10th Anniversary of the DHAT program.

Here is an excerpt from my June 6th remarks that captures my thoughts about the DHAT program, the 10th anniversary, and the current state of oral health care in America.

Dr. Sullivan with DHAT Graduates“Congratulations Graduates and Happy 10th anniversary to the DHAT program.... [And] thank you to the Alaska Native Tribal Health Consortium! Thank you for your vision of a better future for your people and your communities. Thank you for your courage, your tenacity and for your leadership in establishing a new health order in Alaska. Thank you for refusing to accept the status quo in dental health in Alaska. That is why we are here to celebrate with you today.

You have changed the dental landscape in Alaska. You changed the healthcare environment in this state. You are charting a new course for better health today and tomorrow in Alaska.

The rest of America is watching Alaska with great interest and fascination. Your success is beginning to be emulated in the lower 48 states. Minnesota and Maine have passed legislation authorizing the training and deployment of mid-level dental providers in their states. More than 15 other states are examining this possibility for their populations . . . and they should!

More than 49 million people in America live in places where it is difficult to access dental care. Many more receive less than optimal oral health care, including preventive services. Our nation needs more dentists, hygienists and mid-level dental providers, to achieve appropriate levels of dental services and improved oral health at reasonable costs and with easy access. Dental Therapists have existed in other countries, for more than 80 years, including Australia, New Zealand, England and Canada. They are well accepted and are providing needed and valued quality services at a lower cost. And now Dental Therapists are providing needed care here.

Our nation’s current health system has many strengths. We also spend more on health care than any other nation. In spite of this, the United States is not the world’s healthiest nation. Many other developed countries have a longer life expectancy, a lower infant mortality and other indices of better health status. What is the reason for this?

We have a distribution problem. Not all of our citizens have access to our array of health services — a reality beginning to be addressed with the implementation of the Affordable Care Act.

AlaskaAs a nation we must strengthen our emphasis on prevention of illness and injury, including maintenance of good oral health. Here in Alaska, you are already contributing to a better future for America by producing well-trained dental health aide therapists available to work and live in communities across your state.

In the nation’s health system, we are witnessing many changes to better address today’s health challenges. Our country has begun a process which will extend health insurance to millions of Americans who previously had no health insurance. If implemented successfully, the Affordable Care Act will not only provide health insurance, it should lead to more appropriate, and more rational use of our nation’s health care resources. This means access to care earlier, in practitioners’ offices, in community clinics, it will mean continuity of care, as opposed to episodic, sporadic and expensive care in our nation’s hospital emergency rooms. It means greater utilization of dental preventive services, childhood immunizations, pregnancy counseling, fitness programs, avoidance of tobacco and other addicting substances.

The transformation of our health system will not occur overnight. It will unfold over the next 1-2 decades, and many changes will occur in how health services are delivered. A recurring theme is, and will be, individuals taking more initiative and more responsibility for protecting, enhancing and maintaining their own health.

We must also improve the health literacy and health behavior of our citizens, to successfully address problems such as tooth decay, the most common chronic disease in children. Good oral health is an important component of overall health.

We are witnessing more interprofessional education in health professions schools, between physicians and dentists, and between physicians, dentists, nurses, pharmacists, psychologists, public health professionals and others – another welcome development.

81 Alaskan villages participating in the DHAT programOur health system must be open to exploring the training of new kinds of health professionals. In medicine, in the 1960’s and 1970’s we saw the introduction of physicians assistants and nurse practitioners, to work with physicians as members of the health care team. Initially resisted by my colleagues in medicine, today nurse practitioners and physician assistants are well-accepted, valued colleagues on the staffs of the nation’s hospitals and in physician practices around the country.

In this second decade of the Twenty-First century, we have much to be proud of. Significant improvements in health and healthcare were achieved in the Twentieth Century. Yet, much remains to be done, to further improve the health and the lives our citizens. Improvements in oral health are an important part of the challenges we confront.

Because of the vision and generosity of W.K. Kellogg Foundation, the Rasmuson Foundation and the Bethel Community Services Foundation, Alaska is leading the nation in innovations in the education of a new dental professional. The University of Washington School of Medicine is also to be commended for its academic supervision of today’s graduates of the DHAT program.

And so, today, we celebrate this 10th anniversary of the DHAT program, which has trained dental therapists who work under the general supervision of dentists, and have provided basic dental care to more than 40,000 Alaskans, and has improved oral health in 81 villages.

I congratulate today’s graduates and all of you, and urge you continue to lead the nation in finding ways to see that all our citizens have access to preventive dental services and basic dental care. As Alaska continues to lead, the rest of the country will follow, to improve the oral health of our citizens.”

DHAT Students and Graduates

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