Swinomish tribe hires dental therapist despite opposition

SPOKANE, Wash. — An Indian tribe in Washington state on Monday became the first in the Lower 48 states to hire a dental therapist to provide basic oral health services.

In a move opposed by the Washington State Dental Association, the Swinomish Indian Tribal Community started offering its members the services of a lower-cost dental therapist, which is the dental equivalent of a physician assistant.

"There are too few dentists in Indian Country," Brian Cladoosby, chairman of the tribe, said in a press release. "We cannot stand by any longer and allow Native people to continue to suffer tooth decay at a rate three times the national average."

Dental therapists are licensed and can perform procedures such as cleanings, filling cavities and simple extractions. They are much cheaper to train and employ than dentists.

The dental association has fought for years to prevent dental assistants from working in the state, according to The Seattle Times, and they are banned in Washington.

The Northwest Portland Area Indian Health Board, which advises the 43 federally recognized tribes in Washington, Oregon and Idaho, supports the effort.

"We look forward to continued partnership turning the tide on oral health disparities in this community and throughout the Portland area," board director Joe Finkbonner said.

By age 5, three-quarters of American Indians have tooth decay, the Swinomish Tribe said. In Washington, Oregon and Idaho, federal studies show Indian children suffer tooth decay at three times the national average, the tribe said.

The tribe obtained a grant from the W.K. Kellogg Foundation to help hire the dental therapist.

While Washington state bans dental assistants, they have been licensed to practice in Alaska for more than a decade. They are also legal in Minnesota and Maine. Attempts to license them in Washington have failed repeatedly because of opposition from dentists, the tribe said.

The dental association contends that the therapists can pose risks to a patient because they are not trained to handle serious dental problems.

The state group is following the lead of the American Dental Association, which has opposed dental therapists nationwide.