Nice teeth important to good self-image

There’s a new picture with my column today.  After resisting for years the idea of seeing how much I’d actually aged, I felt like my life was starting to imitate “The Picture of Dorian Grey” in some perverse, reverse way. Ergo, the new picture.

One thing that you will notice missing in the picture is any teeth. My mouth is firmly clamped shut.  That’s because I don’t have the Chicklet teeth of movie stars.  I have the rather normal, somewhat yellow teeth that most of us end up with even after years of good dental care.

What we look like is very important to most of us.  And what our teeth look like is central to how we view ourselves and how the world views us.  Someone with a few teeth missing in the front of their mouth can be the most intelligent person in the world but our first impression will be dumb hillbilly.  Because, let’s face it, when someone wants to illustrate a dumb person having a dumb idea, they print a cartoon or picture of someone smiling who has gaps where their teeth should be.

Which is why the Alaska Dental Society should be absolutely ashamed of their actions last week in asking Governor Murkowski to challenge in court a new dental aide program operating in Bush Alaska.

I lived on the North Slope for over 25 years. I once ran the North Slope Borough’s Health Department. I was the head of the department when we took over the contract for dental services from Indian Health Services.  We did it because dental services had been spotty to non-existent under Indian Health Service. 

When an IHS dentist was available, he was stationed in a hub town like Barrow or Kotzebue and periodically traveled to the smaller villages. But if your toothache started three days after the dentist left, and he wasn’t going to be back for more than a year, you ended up with a rotted tooth in your mouth that you pulled yourself or the dentist pulled the next time he was in town. Either way, you now had a hole in your mouth where a tooth should have been.

And so I met many, many people across the North Slope who were younger than me but looked years older because they had no teeth or only a few scraggly ones left. They talked and laughed with their hand over their mouth.

When the borough took over the dental program, it offered highly competitive salaries. Even with that, we had trouble recruiting and retaining dentists.  We got out to the villages more often than in the past but still not often enough. What was missing then, and is still missing now, are people who live in the Bush who will provide continuity of care, the kind available in the medical field through the Community Health Aide Program.

Dentists who go to the Bush usually go for a very specific amount of time. They are either banking money to get their practice started or working off a federal student loan. Those making a long-term commitment are few and far between.

As for the dentists the society claims they have waiting in the wings from the lower 48 who want to do short stints to help out, no offense, but no thanks. People need ongoing treatment to take care of long and short-term problems. A dentist in a village for a couple of weeks doesn’t meet that need. And when he or she leaves, they leave behind unresolved problems that get to deteriorate till another dentist wants a free vacation in Alaska.

The Alaska Dental Society objects to what they call second class dental care for Alaska Natives. Well, guess what? It’s not second-class and it certainly beats hell out of no care at all.

The dental health care aides who work this program will provide continuing treatment under dental supervision that will allow people to have access to routine dental care, the same type of care provided by community health aides in the medical field. This dental program can be the beginning of regular dental care for people in small, remote villages.

This is something that the bush has never had. This is something the Alaska Dental Society cannot provide.  So they should get out of the way and let the people who live there get on with solving their dental health problems in the best way possible.