Oral diseases continue to be a significant health problem in the American Indian and Alaska Native population. The three greatest oral health problems facing the Indian Health Service (IHS) and the people it serves are high dental disease rates, poor access to dental care, and severe dental health workforce shortages.

Indian people suffer from dental disease at rates 2 to 10 times that of the overall U.S. population; for Indian patients with diabetes the disparity is even greater. In Fiscal Year (FY) 1999, tribal and IHS dental programs were able to provide care for about 25% of those who needed care. In contrast, about 60% of the population had an annual dental visit. In addition, access to dental care is limited because of a dental workforce crisis: approximately 22 percent of the dentist positions in the IHS are vacant.

In 1999, the IHS conducted its third program-wide survey of clinic users to determine the oral health status and treatment needs of the Indian population. Preliminary findings from the survey indicate that:

 

• 78% of children aged 2-4 years had a history of dental decay
• 56% of 8-year-olds and more than 75% of adolescents had dental sealants
• 68% of adults and 56% of elders had untreated dental decay
• 54% of adults 35-44 years and 84% of elders have periodontal (gum) disease.

In August 1999 the Director of the IHS announced an agency-wide oral health initiative. The initiative has two goals; increasing access to care and improving the oral health status of Indian people.

• Offer greater access to the loan repayment program for dentists as an incentive to seek employment with IHS and tribal programs. Reducing the dental vacancy rate will increase access to dental services for Indian people.
• Increase emphasis on community water fluoridation and dental sealants.
• Improve the infrastructure available to support dental care.
• Increase access to clinical preventive service for patients with diabetes.