A Scoping Review of Tribal Oral Health Services

Tribal health care systems are evolving, and dental health has been a priority area for many tribes working to improve the health and welfare of their sovereign nations’ citizens. Historically, the Indian Health Service (IHS) has provided dental care either directly through employed dentists or via contracted services. Despite this, American Indian and Alaska Native (AI/AN) populations suffer from oral disease at extraordinary rates, and representation of AI/AN practitioners has been very low. Tribes have been leading the way in redesigning the oral health workforce in a community responsive and culturally sensitive manner. They have sought to build healthier Native communities by connecting oral health to overall health and wellness through peer support, collaboration, and community engagement. In addition, they have led in the introduction of dental therapists. Literature exists that examines the variation in models of primary care services in tribal systems, but there is little recent data on how oral health care systems are evolving in tribal health systems.

The aim of this study is to conduct a scoping review, short survey, and qualitative interviews to assess possible workforce development needs that could be supported through Health Resources and Services Administration (HRSA) funding opportunities now or in the future. This study will also focus on developing the capacity and early partnership development to do future workforce and community oral health needs assessments in Indian Country. Sovereign status of tribes makes tribal and non-tribal systems of care a complex multi-jurisdictional system to understand where policy, practice, and impacts can be studied in a robust and culturally responsive way. This contribution to the field and literature can provide a significant and unique understanding of tribal nations and indigenous populations that is greatly underrepresented in evidence-based policy and practice.