With dental care in short supply and oral disease rates high on tribal lands, Native American leader Brian Cladoosby recently announced that his Swinomish Indian Tribal Community in Washington state will begin employing midlevel dental providers to offer preventive and restorative services to the tribe.
The Dental Health Aide Therapist (DHAT) model that the tribe has endorsed has been used in many parts of the world, including Alaskan tribal areas, as a way of expanding services in poor, isolated and minority communities.
Such midlevel dental provider models are controversial though. They have been strongly opposed by some dental organizations, including the powerful American Dental Association. The groups contend that only dentists have the training to drill, fill and extract teeth and that relying on auxiliaries would not be effective in reducing disease.
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