A new studyhas found that 40% of children and nearly 60% of adults on the PineRidge Indian Reservation in South Dakota suffer from moderate to urgentdental needs, including infections and other problems that could belife-threatening. The findings of the study—the first in 12 years on thestate of oral health on this reservation—were recently presented at the68th annual National Congress of American Indians, held in Portland, Ore.

Investigators examined 20 communities on the reservation andrecruited 292 adults and children. Each participant received a dentalexam that identified any decay or other problems, and was then offeredrecommendations for treatment. The study found that residents of PineRidge had significantly higher numbers of decayed teeth and lowernumbers of treated or filled teeth than reported by previous studies.

The study, funded by the W.K. Kellogg Foundation,found that 90% of participants showed signs of active decay, a ratethree times that typically found in the United States. The researchersdiscovered that 84% of children in the study and 97% of adults hadongoing decay.

The findings also showed that 68% of the adult participants hadevidence of gum disease and 16% showed signs of an advanced problem.According to the study, the high prevalence of decay and gum diseasesuggests that many participants had chronic pain that could interferewith daily activities.

“Many of the Pine Ridge residents suffer daily from wrenching dentalpain, yet they face huge barriers to getting routine care,” said TerryBatliner, DDS, who is the study’s lead author and a member of theCherokee Nation of Oklahoma. “A severe shortage of dentists willing topractice in isolated areas has left many Americans, including AmericanIndians, with ongoing dental problems that threaten their overallhealth.”

“All Americans, including those living in Pine Ridge, should haveaccess to affordable dental care,” said Sterling K. Speirn, presidentand CEO of the W.K. Kellogg Foundation. “It is time to expand the reachof dentists by employing a new type of dental practitioner to provideroutine care.” The Foundation is currently working with fivestates—Ohio, Kansas, New Mexico, Washington, and Vermont—to considerdental therapists as part of an overall approach to expand care tounderserved populations. Alaska and Minnesota already allow dentaltherapists to practice.

Other approaches identified by this study’s authors to address thecare shortage include allowing hygienists to serve as dental therapistsin federally designated shortage areas. The authors also recommendedthat the tribe could take federal dollars now used to provide dentalcare on the reservation and use the money to create their own oralhealth care system. Currently, only 10 dentists work in three locations,providing care to the tribe’s population of 30,000 in an area roughlythe size of Connecticut.