I remember being a young dental school graduate years ago and hearing about a "new" dental therapy program that was being implemented to help Alaskan Natives receive dental care in remote villages. As I understood it then, there was great need for trained dental providers in these areas since access to care was limited and, historically, dentists were few and far between in servicing these areas and people. At the time, it seemed reasonable to me. But that was the extent of my knowledge and experience with dental therapy. Until now.
Not only do I currently work with a dental therapist, but I helped in her clinical training. In fact, I am the dental program manager for the Port Gamble S'Klallam Tribe (PGST), a somewhat remote coastal tribe in Washington State. Being this tribe's dentist has added depth to my understanding of tribal culture, patient needs, and the role that I can play in helping advance the quality and delivery of dental care for the next generation.
Full disclosure: I am not an American Indian or Alaskan Native. I am, however, an entrepreneur, a classic "ideas" thinker, a builder, and a clinical teacher. I have designed and built my own private practice, which I owned and operated for a decade. I have practiced in large group settings, served as a full-time faculty member teaching dental students for six years, and served as a dentist in the U.S. Air Force for three years. I have lectured to large dental audiences for state dental association meetings, and I have been featured during an international conference regarding my role in implementing new dental software for universities. Oh, and I am a patented dental inventor.
So, I have had some experience in the practice and management of dental clinics and in dental education. But I believe that being the dental program manager for PGST has provided the most meaningful experience of my entire career. It gave me exposure to the great need for mid-level dental providers who have similar stories and backgrounds with the patients we serve. There exists a natural cultural competency when our providers have historical ties and, in many cases, familial relationships and friendships because they are a part of the same community.
As mentioned, I had the privilege of helping our dental therapist during her clinical training. Jessica had worked as a dental assistant and front desk employee for many years, so our tribal members and patients already knew her well. When she started her education, it was difficult to go without her help in the clinic. As a program manager, I had to be creative when scheduling our staff to keep our clinic operating as efficiently as possible. For a few years, I was the only dental provider other than our one hygienist. It was not easy, but the payoff was worth the challenge.
The day finally arrived when Jessica was ready for her clinical preceptorship. This created unique challenges because I needed to closely supervise her, schedule appropriate patients for her, and manage my own patients. What made a significant difference was Jessica's training from the Skagit Valley College dəxʷx̌ayəbus Dental Therapy Program. Their dentists, dental therapists, and support staff performed admirably and prepared Jessica well. Implementing her dental therapy skills into our clinic was seamless, and she simply needed practice to improve speed and round out her clinical experience.
Jessica completed her clinical preceptorship in three months, and the tribe hired her as a full-time dental therapist in April of this year. She now provides clinical care within her scope of practice, and her confidence continues to grow. Our patients enjoy seeing Jessica as their provider. By having a dental therapist in our clinic, we have been able to tighten up our schedules to reduce wait times for routine care from months to weeks.
Our dental therapist is also great with children. We can schedule more "Happy Visits" and child prophies with her, which helps create positive first dental experiences for our kids. Hopefully, this will create future adults with less trauma and more confidence in receiving quality dental care in this tribe and elsewhere.
In summary, dental therapy is a vital component for a healthy dental clinic within a tribal community health setting. Dental therapy education provides a significant opportunity for career advancement within tribes and while among a familiar culture. Dental therapists like Jessica are a natural fit in tribal clinics and provide a needed skill and service for our communities. Dental therapy is improving oral health care in our clinic, and our patients are already smiling about that!