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Standing Rock Oyate Councilman Jay Taken Alive offered a prayer in the Lakota language along with a childhood memory of poor dental care to open the first South Dakota Native American Oral Health Summit in Rapid City on Thursday.

About 200 dental practitioners and health care policymakers from tribes, state and federal governments, private dental practices and the nonprofit sector gathered at Best Western Ramkota Hotel for the day-long conference to discuss oral health disparities facing South Dakota’s nine tribes.

“The tribes can’t do it themselves. IHS can’t do it themselves. The only way we’re going to make any progress is if we work together,” said Dr. Jan Colton, a pediatric dentist with Indian Health Service, Aberdeen Area, which covers the nine reservations of South Dakota as well as those in North Dakota, Nebraska and Iowa.

Taken Alive, who is missing several teeth, described himself as an example of oral health problems facing tribal people in America. He retains the memory of pain caused by outdated, ineffective Novocain before the Indian Health Service dentist treating him discovered the problem.

“After the sixth time raising my hand (to tell him it still hurt), he realized the vial of Novocain was outdated,” Taken Alive said.

The incidence of poor oral health is a generational problem, and today, early childhood dental cavities are at least five times more prevalent among Native American children than asthma or obesity, Colton said.

The dental decay rate for very young children is particularly alarming: Native American children in South Dakota between the ages of 2 and 5 have, on average, more than four teeth with decay. The rates of teeth decay for Hispanic children is just over two teeth, and the rates for African American and Caucasian children is slightly more than one tooth.

Colton told of a recent day in the operating room where she crowned every primary tooth in the mouth of a young patient under general anesthesia. The child was the sixth and youngest child in the family to have the same procedure.

“Obviously, I missed the boat somewhere when I was trying to talk to the family about the importance of good oral health,” she said.

Improving oral health literacy -- the knowledge of what to do and how to do it to prevent oral disease -- is an important component in addressing an epidemic of poor oral health throughout America, said the top federal dental expert in the U.S.

“Oral health literacy is key,” said Rear Admiral William Bailey, chief dental officer for the U.S. Public Health Service. Bailey, who spent 13 years working in the Aberdeen Area IHS, spoke to the group about national oral health statistics gathered by the Centers for Disease Control and Prevention, which include but do not isolate statistics for the Native American population.

IHS is trying to address the lack of accurate data with an ongoing oral health surveillance project, an attempt to provide documented evidence of oral health statistics specific to Native Americans that is expected to take 10 years to complete.

About 126,000 people qualify for IHS health care services, including dental care, in the IHS Aberdeen Area. Its annual “access goal” for dental care is 27 percent of its service area, which means that fewer than 35,000 people in the Aberdeen Area accessed dental care of any kind last year. But IHS also battles a 33 percent “broken-appointment” rate at its dental facilities, Colton said.

“Our population has grown. Our provider numbers have not kept pace with that growth,” Colton said.

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Although the average dentist-to-patient ratio in the Aberdeen Area is 1 to 3,400, some more remote areas have only one dentist for every 8,000 patients.

“One dentist cannot take care of 8,000 patients,” Colton said. For dental hygienists, it’s even worse: there is one hygienist for every 9,300 people.

Those disparities in dental care and preventive services are reflected in the health outcomes for tribal people, Bailey said.

Colton and other summit participants said the conference was an important first step in addressing them.

“I think this conference is a good start. It is the first evidence of collaboration that we have had in a long time,” she said.

Contact Mary Garrigan at 394-8424 or mary.garrigan@rapidcityjournal.com

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