Open wide: opportunities rife in Alaska dentistry.

• Author: Sommer, Susan
• Position: HEALTH & MEDICINE

Whiskey, cloves or carrying a potato in your pocket--these plus the dreaded pair of pliers have all been traditional, but less than ideal ways to treat a toothache. Luckily, most Alaskans today can visit a dentist for modern oral care and skip the toothache altogether.

Oral health, of course, begins at home by flossing and brushing regularly, eating a healthy diet and monitoring the mouth and jaw for any changes. According to the American Dental Association, "Infections in the mouth may be associated with heart disease, stroke, diabetes, pneumonia and other health problems." But there's no substitute for regular professional dental care.

Besides dealing with familiar dental issues such as cavities, gum disease, crowns and bridges and cosmetic procedures such as whitening, Alaska's dental professionals can also help identify serious medical problems such as sleep apnea, drug abuse, eating disorders and oral cancer.

More than 800 dentists are licensed in Alaska, as are almost 600 dental hygienists. About 1,150 dental assistants are employed across the state. Currently, 26 dental health aide therapists are certified in Alaska and focus on Alaska Native populations in rural communities.

Two-thirds of Alaska's adults see a dentist annually according to a state report; that's better than the national average. About the same percentage have access to a fluoridated community water system, which the ADA wholeheartedly supports as "safe, effective and necessary in preventing tooth decay." There is, however, a gap between urban and rural oral health in the state, and while education and outreach efforts as well as a relatively new dental aide program have helped shrink the gap, many of Alaska's villagers still struggle to achieve healthy teeth and gums.

Bridging the Gap

A program that has emerged in recent years to serve rural Alaskans is the use of dental health aide therapists, or DHATs. This is the first program of its kind in the nation. The model is based on a similar successful program in New Zealand to where Alaska's first DHAT students traveled in order to train and learn about the program. In 2007, training moved in-state, and is now offered through the Alaska Native Tribal Health Consortium. An intense two-year curriculum teaches basic preventive and restorative oral care skills as well as outreach and education methods to help community members prevent tooth loss and other common conditions. The program is certified under the federal Community Health Aide program.

Dental health aide therapists perform about 80 percent of the work that a dentist would do. DHATs live and work in the communities they serve, most of which had previously been without regular dental services or which only received a visit from an itinerant dentist perhaps once a year. A major benefit of the DHAT initiative has been the...