February 15, 2006
Honorable John McCain
U.S. Senator
241 Russell Senate Office Building
Washington, D.C. 20510-0303
Dear Senator McCain:
On behalf of the American Association of Public Health Dentistry (AAPHD), I am writing to express our strong support for the Alaskan Dental Health Aide Therapist (DHAT) program developed under the authority of the Alaskan Native Tribal Health Consortium (ANTHC). Attached is a resolution overwhelmingly adopted by AAPHD members in support of such innovative programs aimed at addressing inadequate access to oral health services.
The AAPHD resolution demonstrates our strong support for the DHAT program and the use of dental therapists to address the great unmet oral health needs of Alaska Natives, who might otherwise not receive badly needed dental care, such as fillings and extractions to alleviate pain and suffering. We are disappointed with the tactics of the American Dental Association against the Alaskan Dental Health Aide Therapist program, which has taken many forms, including lobbying in Congress, full page advertisements in Alaskan newspapers to convince the Governor and Attorney General to shut down the program, and even a lawsuit. These latter actions were taken despite the state's Attorney General having previously ruled this program to be legal. AAPHD is not supportive of these attempts to end the program. We urge Congress to continue to authorize and fund the Indian Health Act so that access to oral health services for this vulnerable population can be addressed.
AAPHD supports the use of sound, objective evidence in the development of policy and programs to improve access to care to all underserved populations, including the professional evaluation of innovative programs seeking to meet these needs. Rejecting a new program without objective data, such as being done by the American Dental Association is not in the best interest of the population which the program seeks to serve. The DHAT program has presumptive evidence of safety and effectiveness based on the nature of this training in New Zealand, as well as continuing evaluation in Alaska with oversight by the Indian Health Service, and the program's similarities to the New Zealand and many other programs that have long-standing evidence of both effectiveness and safety. Thus, AAPHD believes that the DHAT program should continue to be supported in its present form as an innovative solution while being monitored and evaluated for effectiveness and
safety.
Finally, and perhaps most importantly, AAPHD implicitly supports the autonomy of sovereign governments operating within their legal rights to address health care issues in ways they deem appropriate. Alaska Native governments are such entities and have sanctioned the development of this program by the Alaskan Native Tribal Health Consortium (ANTHC) in accordance with federal law. Consequently, an evaluation of the Alaskan Dental Health Aide Therapist program will provide important information that ANTHC will use in deciding the effectiveness and safety of this program and its future direction.
AAPHD is the sponsoring organization of the specialty of dental public health, one of the nine specialties recognized by the ADA. Our membership is composed of experts in the development, operation, evaluation, teaching and research of prevention and treatment programs for population groups on the local, state and national level. AAPHD is ready to assist you to understand the DHAT program, and share evaluation strategies and recommendations for its future. Please do not hesitate to call upon us. AAPHD hopes you will do everything in your power to support the DHAT program as an innovative solution in addressing access to oral health care for rural Alaska Natives.
Sincerely,
Robert J. Weyant, DMD, DrPH
AAPHD President
Indian Affairs and Appropriations
