Dentist Wants To Bring Cincinnati Program To Rural Alaska


A program that helps low income families in Cincinnati help get dental care may work for families in rural Alaska. (KTUU-TV)


Dr. Larry Hill says the program he is in charge of is a great one, but there are over a thousand people still waiting to be seen in their clinics. (KTUU-TV)


Deamonte Driver of Maryland died after an infection in his mouth spread. (KTUU-TV)


ANCHORAGE, Alaska -- Several years ago eight Alaskans were sent to New Zealand to learn how to become dental health aide therapists. America had never had such a profession until eight of them went to work in Alaska last year doing many things only a dentist had done before.

Although therapists can only work in the bush, dentists across the country are keeping a close eye on their progress.

"We have to walk before we run. I think we have to take some first steps. And the first steps we have to take is Alaska," said Dr. Larry Hill.

Dr. Larry Hill has never been to Alaska, but he was an early supporter of Alaska's efforts to train health aides to do basic dentistry. He's hoping it will lead to more alternatives for care. Hill is director of the city of Cincinnati's dental program, which serves the poor.

"We have a really good program, a program we're really proud of. By the same token we have more than a thousand people waiting lists at almost everyone of our clinics," said Hill.

It can take up to two years to get an appointment here so many patients don't get attention until it's an emergency, which pushes others further down the list. Children suffer the most. Forty percent of the 8-year-olds served by this clinic have untreated tooth decay.

"That means that some of those kids are going to bed at night in pain, that they can't eat, that they don't sleep. And those kids are not gonna do well in school," said Hill.

Another reason for the backlog is a growing number of dentists in private practice who no longer accept Medicaid or Medicare. They say the system is broken and it's not fair to expect them to subsidize these patients.

Beyond private dentistry there are other bottom lines to consider. At Cincinnati's University Hospital dental emergencies are a big drain on the budget. Two years ago it found that toothaches were at the top reasons for trips to the emergency room. Most of those patients couldn't afford a dentist.

"Sometimes I don't even understand why that didn't, in and of itself, become a major story. But it didn't. It didn't in our community. But it should be a major story," said Hill.

The death of a 12-year-old Maryland boy did make the news. Deamonte Driver's picture was in newspapers across the country. He was the child of a single mom with no health insurance. What started out as a toothache turned into a deadly infection. By the time his mother was able to find care bacteria from Deamonte's abscessed tooth had spread to the brain.

Despite six weeks of care and two surgeries and a bill that could run more than $200,000 it was not enough. Early Sunday morning, February 25, his mother got a call from the hospital to come right away.

"And when I got there he was gone," said Elsie Driver, Deamonte's mom.

This tragedy may help children in places like Cincinnati and Alaska.

The search for more access to dental care has brought attention to an experiment underway in the bush, where a new profession was pioneered/to bring basic dental care to remote villages where the rate of tooth decay is more than twice the national average.

"People really don't know what an Alaska dental therapist is," said Dr. Myron Allukian.

At a national conference in Little Rock, Ark. last year there was an uproar over news that the American Dental Association had filed a lawsuit against Alaska's dental therapists.

Dr. Larry Hill called on dentists across the country to support Alaska's
pilot program.

"If ever there were an issue of public health dentistry, this is one," said Hill.

Hill and other dentists questioned the attack on a program the ADA had neither studied nor observed.

"Most people, when they see this picture, think that this child was battered, but this is all the result of dental infections," said Hill.

Hill is back in the picture again. He and other national leaders in oral health, including those from the American Dental Association, were invited to travel to bush Alaska to watch dental therapists in action.

"I've heard the mud is a foot high and that we'll be maybe sleeping on the floor in a clinic somewhere," said Hill. "But it's more an exciting opportunity to see a program that has been tremendously successful in other countries, that hasn't reached our shores yet."

The shore of Toksook Bay is a long way from the skyscrapers of Cincinnati, two very different worlds. Yet when it comes to dental care...

"The bottom line is the same and that there's not the available and
accessibility of care," said Hill.

Hill was part of a group of dentists that traveled to Toksook Bay and Kasigluk earlier this month. Also part of the tour was Dr. Kathy Roth, president of the American Dental Association. KTUU-TV will hear from her tomorrow.

As for the lawsuit against the dental therapists, Dr. Roth says the ADA is working hard to resolve the differences. But as far as KTUU-TV knows, the lawsuit hasn't been dropped.

The number of emergency room dental patients is not only high in Cincinnati, but here too. Providence Alaska Medical Center gave KTUU-TV a snapshot of four months last year. There were about 80 a month who came for treatment of dental pain. Those visits can start at a round $100 and go over $600.

Top 10 Things to Know About Your Dental Hygienist

These days, a visit with your dental hygienist may result in more benefits than just cleaner teeth and healthier gums -- you might even decide to stop smoking, improve your nutrition or check to see if you might be at risk for diabetes.

"Most people simply don't realize just how educated and skilled their dental hygienists are," said Susan McLearan, president of the California Dental Hygienists' Association (CDHA). "The profession has evolved to the point where we actually can save lives."

In keeping with its mission to raise public awareness about dental health and to promote the value of seeing a dental hygienist, the association has issued the following list of the Top Ten Things Californians Should Know About Their Dental Hygienists.

"The list is intended to show how dental hygienists play such an integral role in overall public health -- in many different ways and on many different levels."

That role is reflected in the following facts about Registered Dental
Hygienists (RDH):

1. Highly Educated Professionals -- The minimum level of education for licensure is equivalent to a four-year degree with two years specializing in dental hygiene.

2. Committed to Expanding Access to Care -- Specially licensed hygienists can go into underserved communities and provide dental hygiene services to some of the millions of Californians who would otherwise have no access to dental care.

3. Screen for Oral Cancer -- Dental hygienists possess the skills to be the first health professional to identify potential signs of oral cancer and refer a patient to a physician.

4. Promote Healthy Nutrition -- Dental hygienists can tell if a patient is eating poorly or is malnourished; they can then offer helpful advice and information.

5. Spot Signs of Eating Disorders -- Also related to nutritional issues, eating disorders can also be recognized in the mouth during a check up.

6. Recognize Signs of Diabetes -- Dental hygienists can alert patients that they might be in danger from diabetes, and refer them to seek confirmation from a medical doctor.

7. Promote Smoking Cessation -- When examining patients who smoke tobacco, dental hygienists often will counsel them to quit and provide resources and information about steps they can take to stop smoking.

8. Prevent Gum and Periodontal Disease -- By cleaning and examining teeth and gums, dental hygienists play a major role in preventing common oral diseases.

9. Understand the Link Between Oral Health and Emotional Health in Children -- Dental hygienists are passionate about promoting good oral health among children, who can often suffer speech impediments, social ridicule, diminished self esteem and other problems related to poor oral health.

10. Represented by CDHA, the Official Voice of Dental Hygiene -- Since CDHA was established 20 years ago, dental hygienists have been making continuous strides toward becoming the skilled, autonomous and essential public health professionals that they are today.

Furthermore, dental hygienists are qualified to detect a wide range of other life-threatening conditions, including high blood pressure and HIV.

"The items on our list really underscore that the mouth is a window into a person's comprehensive health," said CDHA's McLearan. "And because the average person sees a hygienist more often than a physician, it is especially important for people to understand the many facets and benefits of the dental hygiene profession."

The California Dental Hygienists' Association (CDHA) is the authoritative voice of the state's dental hygiene profession. While registered dental hygienists have worked in the state for nearly a century, CDHA was established 20 years ago when two regional associations merged to form a unified professional group. CDHA represents thousands of dental hygienists throughout the state and is dedicated to expanding opportunities for the
profession and access to care for all Californians.

Source: California Dental Hygienists' Association