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Fight over dental aides continues

Well, they’re at it again. The American Dental Association is now running ads on TV asking Governor Murkowski to stop the provision of what they term second class dental care to Alaska Natives.  The ad claims that the same unfeeling bureaucrats who have ignored Native dental care needs for years are now proposing second class care as the solution to this long standing problem.

There are so many things wrong with this ad that it’s hard to know where to begin. But let’s start with the fact that it isn’t faceless bureaucrats who are proposing a dental health aide system analogous to the community health aide system that has served bush Alaska so well for over forty years.  It is the Native health corporations themselves who are proposing this solution – the Native health corporations run by the very people they serve, the very people most affected by the spectacular lack of dental care in Bush Alaska.

They are proposing it because dental health care in the Alaska bush has been a disgrace since the day the first non-native food entered Alaska Native diets.  However, it seems that the American Dental Association and the Alaska Dental Society chose not to address the problem until their purses were threatened.

Funny, isn’t it? Last year this time dental care in Bush Alaska was just as horrible as it is this year and neither the national nor the local dental association cared enough to run TV ads decrying the sad state of dental care there and demanding a solution.

In the voice over for the ad, Governor Murkowski is asked if he would allow his children to have second-class dental care.  Well, the problem with that premise is that Governor Murkowski will never have to face that dilemma because he has the two most important things you need in Alaska to get good dental care – money and money.  Money to pay for a dentist and money to fly to where a dentist is.

Because jobs and dental health insurance are both in short supply in places like Atqasuk, money to pay a dentist is practically non-existent.  When you have to chose between paying to fly to a regional hub in the hope of getting an appointment with the one dentist there to get your tooth fixed or buying fuel oil to heat your home, there really is no choice.

It’s interesting that the dental association has the time, money and energy to produce this ad but has yet to propose a viable alternative solution that would bring reliable dental care to remote villages.  I don’t hear this ad touting how many dentists have signed up to go live in the bush and provide dental care on a fixed salary that would probably be a lot less than they’d make in a private practice.

As that old saying goes, if you are not part of the solution, then you are probably part of the problem.  In this case, the American Dental Association has chosen to slam the efforts of Alaska Native health corporations to solve a long-standing health problem without offering any alternative. And once again, let me hasten to add, offering dentists from the lower 48 who would show up in a village for a few weeks and then leave for their fishing trip before going home is not a solution. 

If the Alaska Dental Society has any professional pride and honor at all they will request that the American Dental Association pull this ad or they will publicly distance themselves from it.  To do any less is to lower themselves in the estimation of any and all Alaskans who feel that living here should not equate with living in pain under Third World conditions.

And to any dentist out there who would like to debate me on this, let me make this suggestion.  Hit yourself in the mouth with a hammer until you have a raging toothache. Then wake up with that toothache every day for the next six months.  Go to work with it, eat with it, sleep with it, try to make love to your spouse with it.  You can do anything you want with that toothache for six months but get it fixed by a dentist.  A dental health aide, however, will be available to you the entire time.  How long do you think it will be before you decide that dental health aide has all the qualifications needed to work on your pain?

Until the American Dental Association has a plan of action to address this problem, complete with dentists on the ground in Alaska ready and willing to make long-term commitments to that plan, they should just get out of the way. Because Native health corporations with a solution are coming through.