Tribal Oral Health Newsletter
Issue 13
Winter 2022
The Latest Quarterly News on Oral Health from Across Indian Country
Tribal Dental Therapy News
New Resource Available: Model Dental Therapy Rule Making Guide
Dental therapy advocates have a new tool at their disposal: The Model Dental Therapy Rule and Best Practices Guide. The document will serve as a guide to developing model rules for dental therapy implementation following passage of a dental therapy licensing law by a state legislature. Implementation rules can expedite or hinder the utilization of dental therapists in a state depending on how successful advocates are in the rulemaking process. This document will assist dental therapy advocates, policymakers, dental boards, and other stakeholders nationwide.

The Model Rule document provides options for Tribes to implement dental therapy once a state licensing law has passed. For example, Tribes can establish a certification board under the Community Health Aide Program, adopt Tribal requirements, or use the state licensing structure to employ dental therapists.

The National Indian Health Board joined the National Model Dental Therapy Rule Panel to collaborate with dental therapy experts from across the country to create the document.
Society of American Indian Dentists Offers DAT Scholarships for Pre-Dental Students
The Society of American Indian Dentists (SAID) is offering a scholarship to cover the costs of the Dental Admission Test (DAT) for pre-dental students who are members of SAID. DAT is a standardized test required for admission to most dental schools in the US. The scholarship aims to prepare American Indian & Alaskan Native (AI/AN) students to enter the practice of dentistry with academic coaching, admission test preparation and mentoring to enable AI/AN pre-dental students to gain admission to a U.S. dental college and see success in their first year. This scholarship is available to AI/AN undergraduate students who are members of SAID and are planning to take the DAT before December 31, 2022.

The application deadline is February 28, 2022. More information is available here.
What is the Status of My State?
Use the National Indian Health Board's state legislative tracker to learn more about dental therapy legislation in your state and how you can help make access to oral health care a reality for the Tribes!
Third Thursday of Every Month

2:00 PM Eastern

To be added to the invitation list,
contact Brett Weber, Program Manager, Public Health Policy and Programs at [email protected]
NIHB COVID-19 Tribal Resource Center
The National Indian Health Board has developed a Resource Center for Tribes during the COVID-19 pandemic.

Publications include funding opportunities, community health tools, webinars, and other resources to assist Tribal leaders and public health professionals.
Updates from Capitol Hill and the Administration
Bills in Congress Would Expand Dental Benefits for Veterans
Legislation that would provide for dental services at the Veterans Administration (VA) has been introduced in the House and Senate. The Veterans Dental Care Eligibility Expansion and Enhancement Act of 2021 (S. 3017) and the Dental Care for Veterans Act (H.R. 914) are each awaiting committee hearings.

Nearly nine million veterans are enrolled in the VA healthcare system, but in 2020, only 463,000 veterans received dental services from the VA due to statutory requirements limiting the number of eligible veterans that can receive dental care (see page 96).

Of the nine million VA enrollees, only 1.4 million are eligible for comprehensive dental care under the current requirements, excluding 8 in 10 veterans from the benefit. The legislation would remove those limitations and allow all VA enrollees to receive dental care through the VA healthcare system. Additionally, the Senate legislation creates a student loan repayment program for dentists, oral surgeons, and dental hygienists working at high need VA sites.

The House Committee on Veterans Affairs held a hearing on a similar bill in July 2020, during the 116th Congress.
HHS Releases Follow Up Report on Oral Health in America
In December 2021, the National Institute of Dental and Craniofacial Research, an agency within the National Institutes of Health housed in the US Department of Health & Human Services, released a 20-year follow up report to the 2000 US Surgeon General's report on national oral health.

The 2021 follow up, "Oral Health in America: Advances and Challenges," details the past 20 years worth of changes in the oral health system that have improved oral health outcomes for Americans, as well as the ongoing barriers to equitable oral health across populations.

The report found that American Indians and Alaska Natives have the highest oral disease burden of any ethnic group.

  • 80 percent of AI/AN children will have a cavity by the age of 9, compared to the national average of 45 percent.

  • 17 percent of AI/AN adults had severe periodontal disease compared to 10 percent of adults nationally (28 percent of AI/AN smokers had severe periodontal disease).

  • 83 percent of AI/AN adults had lost at least one tooth by the age of 64, compared to 66 percent of adults nationally.
Oral Health Champion's Corner
This issue’s Oral Health Champion is Joe Salamon, DDS, Clinical Dental Officer for the Seneca Nation Health System (SNHS)!

Dr. Salamon has served the Seneca Nation since 2009 and has been the SNHS Clinical Dental Officer since 2013. A strong believer in creating pathways for Indigenous people, Dr. Salamon collaborates with the University of Buffalo and created the Native American Pre-Dental Gateway Program in 2016. Gateway allows a handful of American Indian/Alaska Native (AI/AN) students to travel to Buffalo, New York, and gain exposure to dental education and career opportunities. Over a dozen AI/AN potential dental students participated in Gateway before the COVID-19 pandemic, and Salamon is already planning on an expanded program for 2022 and future years. The expansion will support additional dental education exposure and aims to connect AI/AN dental school applicants with financial resources to make entry into dental school more accessible. SAVE THE DATE: Gateway 2022 will take place the week of July 25, 2022! 
To encourage new dentists to consider working in Tribal communities, the Seneca Nation hosts over 40 dental interns and residents every year to increase access to care and offer new providers the opportunity to experience clinical work and patient-doctor interactions at a tribal health center.

To learn more about the impact of historical trauma on health care access, Salamon has visiting providers watch two documentaries: Unseen Tears, about the boarding school experience on the Seneca Nation territory, and Remember the Removal, about a twentieth century dam construction that forcibly removed community members from their land. This helps participants understand the ties that bind the Seneca Nation together and the need for dignity in health care.

Dr. Salamon and the Seneca Nation Health System’s Dental Department worked to keep care available for the community throughout the COVID-19 pandemic. In 2020, the dental clinics at Seneca Nation had to close to all but emergency cases for four months as the Tribe tried to limit the spread of coronavirus and keep the community safe. Now, as the dental clinic remains open and has worked through a significant backlog of cases, Dr. Salamon is working to address pandemic fatigue in his community members and his staff. “I’m here along with my colleagues and co-workers because the mission is ongoing. Every new patient is an opportunity to improve someone’s health. Thanks for all you do to keep Indian Country smiling, Joe!"
The Latest from State Legislatures
Washington Bill Demonstrates Dental Therapy’s Persistence
Lawmakers have reintroduced legislation in Washington State that would expand dental therapy statewide. H.B. 1885 would establish a state licensing process for dental therapists to practice in underserved settings throughout the state.

Currently, state law allows dental therapists to practice only on Tribal lands and on American Indian/Alaska Native patients. While this has allowed several Tribal nations to employ dental therapists, expanding the number of places dental therapists can work will increase demand for the providers and increase interest in community recruitment for people to become dental therapists.

Washington passed its Tribal dental therapy law in 2017, and lawmakers have considered expanding dental therapy statewide in every year since. H.B. 1885 follows the December 2021 release of the legislature's Dental Therapy Taskforce final report that recommended statewide adoption of dental therapy.

The 2022 bill shows dental therapy is not going away as an issue in the state, and until lawmakers pass a statewide bill, advocates will keep calling for the legislation.
New Webinar Highlights Free Market Benefits of Dental Therapy
Dental therapy is a nonpartisan issue, famously drawing support from both the Trump and Biden Administrations. Advocates often speak to the workforce model’s success in health equity, based in part on data from Alaska showing a narrower gap between Alaska Native oral health and the state average.
A new webinar from the National Partnership for Dental Therapy highlights another aspect of dental therapy: the model’s free market oriented approach to expanding access to care. By improving consumer choice, dental therapy makes the oral health care market more competitive for the consumer and makes providers more efficient. The webinar was co-hosted by the Wisconsin Oral Health Coalition and featured leading state and national voices on how dental therapy gives greater health care choice and access to patients.
Watch a recording of the webinar here and view the slides here.
Funding Opportunities and Resources
Medicaid Adult Dental Benefits: Improving Access for Tribal Populations
Community Catalyst, in collaboration with the National Indian Health Board, the Southern Plains Tribal Health Board, and Native American Connections created this policy brief explaining how a standard dental benefit for adult Medicaid enrollees would improve Tribal health. Read the brief here.
CDC Resources on Oral Health Services During COVID-19 Pandemic
The Centers for Disease Control and Prevention (CDC) has published several fact sheets, guidance documents, and other resources related to providing and accessing safe oral health care services during the COVID-19 pandemic. These documents are entitled “Interim Infection Prevention and Control Guidance for Dental Settings During the COVID-19 Response.” Read more here.
Indian Country ECHO: CHAP Learning Collaborative
The Community Health Aide Program (CHAP) ECHO Learning Collaborative is designed to bridge the gap between traditional practices and modern standards of care through bringing together several types of practitioners, including Dental Health Aide Therapists (DHATs), Behavioral Health Aides and Practitioners (BHA/Ps), and Community Health Aides and Practitioners (CHA/Ps). Sessions are open to all, but advanced registration is recommended. Sign up here!
2022 IHS Continuing Dental Education Catalog
The Indian Health Service Division of Oral Health offers several webinars and in person trainings for Continuing Dental Education for dentists, dental hygienists, and dental assistants year round. View the 2022 course catalog here.
National Indian Health Board | | (202) 507-4070
Visit the NIHB COVID-19 Tribal Resource Center at: 
To reach the NIHB COVID-19 Response Team, contact: [email protected]
For media inquiries, contact Janee Andrews at [email protected]