Addressing the appalling need for American Indian dentists<br>

A wise American Indian man stated, “We have seen the lightning and have heard the thunder—but when is it ever going to rain?”

He was voicing the frustration of the federal government’s failure to live up to the treaty obligations that promised resources to help American Indian people in their struggle to survive—after their land had been taken away.

It was nearly 50 years before congressional legislation recognized American Indian tribes as sovereign governments and thus began a new era in federal government/American Indian tribal relationships.

However, it was not until July 1970, when the President of the United States, before a general session of Congress, delivered the first “American Indian Message.”

He stated, “On every scale of human measurement, whether it be employment, income, health or education, the Indian, the first American, ranks at the bottom!”

When the President speaks, action usually takes place. Following this important address, there was landmark legislation that has changed the course of history for American Indians.

In 1972, the Indian Education Act was enacted followed by the Native American Programs Act of 1974, the Indian Self Determination Act of 1975 and the Indian Health Care Improvement Act of 1976.

It has been 28 years since the Indian Self Determination Act was enacted. What did this historic act do for the American Indian people?

The question now remains—is Indian Self Determination really working? American Indian health professionals do not believe progress is being made when viewing the data related to health manpower development.

When one visits any of the numerous health facilities in Indian Country, it is very obvious that there are very few American Indian health professionals, especially at the doctorate level—physicians, dentists, pharmacists.

Thus, Indian people (without those doctorate credentials) are not participating in those meaningful leadership positions that allow them to be a part of managing and controlling their own programs.

This scenario is especially appalling when we look at the lack of American Indian dentists. It has been 27 years since the Indian Health Care Improvement Act was enacted. Title I of that act, provides scholarships for American Indian students interested in becoming a health professional. It is disappointing to see how very few students apply for scholarships to pursue a career in dentistry.

It is also disappointing to observe the following data:

• There are 400 dentists employed by the Indian Health Service and 150 dentists employed by tribal health programs. Of these 550 dentists, less than 70 are known to be American Indian dentists!

• It can be further noted that if the American Indian patient population were to have the same number of Indian dentists providing services—as the non-Indian population has non-Indian dentists—there would have to be 1,200 Indian dentists.

• The Society of American Indian Dentists can document only 85 American Indian dentists in the United States! These dentists are enrolled members of their respective federally-recognized tribes.

• There are less than five American Indian dentists in nine of the 10 largest tribes!

Another way of looking at this pathetic picture is that there is only one American Indian dentist for every 35,000 American Indian people!

There are many reasons for this severe lack of American Indian dentists, the least of which are lack of family and extended family support, lack of role models, lack of appropriate counseling, lack of proper course preparation and lack of financial resources.

A network of support at every level of the student’s educational pathway needs to be established to address the above obstacles. However, when all is said and done, there remains a major entity that plays a critical role in the production of American Indian dentists and that is the dental school, itself.

Of the 53 dental schools in the United States, there are very few that have made a genuine commitment to enrolling American Indian students. This is revealed when one looks at the membership of the Society of American Indian Dentists. Only three dental schools have graduated more than five American Indian dentists!

However, it can now be said that the newly established Arizona School of Dentistry and Oral Health has made such a commitment. This is manifested by the fact that an Assistant Dean for American Indian Affairs has been named and that a minimum of 10 percent of its entering freshmen classes (beginning in 2003) will be American Indian students.

Thus, American Indian people now have reason to be hopeful—”that rain is now on its way!”

(Dr. George Blue Spruce, Jr., an alumnus of Creighton University in Omaha, Neb., became the first Native American dentist in the United States and also the first Pueblo American Indian to graduate from Dental School in the United States. This enabled him to treat patients on Indian Reservations and become an Assistant Surgeon General in the United States Public Health Service. He is currently the Assistant Dean for American Indian Affairs at the Arizona School of Dentistry and Oral Health and President of the Society of American Indian Dentists.)

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