Dentist has Natives gnashing teeth

APOLOGY ISSUED: Dave Eichler's remarks on Web called racist, misinformed.

By ALEX deMARBAN
Anchorage Daily News

Published: April 14, 2006 Last Modified: April 14, 2006 at 03:09 AM

The president of the Alaska Dental Society apologized for the first time this week for making what he called "offensive and insensitive" comments about Alaska Natives.

The statements, originally posted March 1 to an online discussion group, inflamed the already-heated dispute over creation of a dental therapist program in rural Alaska.

Tribal health administrators overseeing the unique program — to address high rates of tooth decay and a shortage of dentists in the Bush — called the remarks racist, unprofessional and misinformed.

The dental society and the American Dental Association are suing the Alaska Native Tribal Health Consortium, which runs the program, and eight individual dental therapists now working in rural Alaska.

Dave Eichler, a North Pole dentist, made the comments in an e-mail about public health care in the Bush. It was posted to the ADA's online discussion group for presidents and president-elects of state associations, but was leaked to a wider audience.

In the e-mail, Eichler suggested that oral disease is rampant in the Bush because dependency on the public health care system has left Natives free of personal responsibility.

Rates of tooth decay in rural Alaska are more than twice the national average.

Eliminating special federal assistance for American Indians and Natives will improve matters, he wrote. It will also "allow their integration into American society as dignified citizens."

Eichler, noting that the views are his own, called unchecked tooth decay child abuse.

"Any culture that allows such disease will soon disappear and rightfully so," he wrote.

Dental care in village Alaska has been hotly debated since the therapists entered a special two-year university in New Zealand three years ago. The therapists are federally certified by a board that includes medical and dental professionals but aren't licensed by the state. Alaska is the only state with federal approval to operate the program.

By drilling, pulling teeth and removing nerve endings in baby teeth, the therapists violate state dental licensing laws, the dental associations say.

The associations want only dentists performing those procedures. Tribal health administrators have countered that the dental associations are putting market-share fears above the health of Alaska Natives.

Eichler's statements are racist and rude to Natives, said Valerie Davidson, senior director of legal affairs for the consortium. A Yup'ik from Western Alaska, Davidson said they imply that Natives aren't dignified and don't deserve to exist.

The comments appear to be "an attempt to blame the victim and not address the real public health crisis we're facing in rural Alaska," she said.

Eichler was elected president of the 320-member society last fall and has served as an officer for more than two years. After denying several requests for a phone interview about his statements, he sent an e-mail to the Daily News on Tuesday apologizing for the remarks.

Reached by phone at his office and home Thursday, Eichler said he could not talk because the matter is in court. But he did say he also sent the same e-mail on Wednesday to the online discussion group where he originally made the comment. He made no formal apology to the consortium, he said, because he did not know who to send the e-mail to.

"I apologize for the offensive and insensitive terms and phrases I used in commenting upon the philosophy directing public health programs in Alaska," he wrote.

He hoped, he added, that his apology will allow all sides to "resume a thoughtful and courteous discussion" about the rural dental care problem.

Eichler's editorial was hurtful to Natives and embarrassing to members of the society, said Jim Towle, executive director of the Alaska Dental Society.

It also risked derailing sensitive negotiations aimed at reaching an out-of-court settlement, Towle said.

The day after the comments appeared, American Dental Association president Bob Brandjord replied on the e-mail group. He wrote that the national association does not share Eichler's views.

The comments are harsh, derogatory and incorrect, Brandjord said by phone last week from Springfield, Ill.

The federal government is obligated under various treaties and laws to provide access to health and dental care for American Indians and Alaska Natives, he noted.

Tribal health organizations in Alaska receive hundreds of millions of dollars from the federal government every year to provide free health care to Natives. The money is an exchange for land once occupied by Natives.

Eichler has made similar "ethnocentric" comments in the society's newsletter and in public meetings, said Edwin Allgair, dental director for the Bethel-based Yukon-Kuskokwim Health Corp., which employs two dental therapists.

Allgair quit the association last year for that reason, he said.

Widespread dental problems in rural Alaska are largely the product of geographical isolation, he added. Private dentists rarely serve remote Alaska because the patient base is too small, and many villagers can't afford to fly to large cities for regular dental check-ups, he said.

Clean water is also hard to find — 25 percent of rural villages still lack running water — so sugary drinks may offer an easier alternative for quenching thirst, Allgair said. Fluoridated water for preventing tooth decay is almost nonexistent in village water systems.

The high rates of tooth decay can be reduced by an ADA counterproposal to the dental therapy program, Brandjord said. That plan includes creating a school in Alaska to train community-based dental aides who can clean teeth and install temporary fillings in cavities until a dentist can be seen.

The ADA wants to drop the lawsuit and build the school with money from its litigation budget, he said.

The tribal health consortium agrees with aspects of the counterproposal, said Paul Sherry, chief executive officer of the agency. For example, it supports an idea to send more than 100 volunteer dentists from the Lower 48 to rural Alaska for two weeks at a time.

Still, he said, there will never be enough volunteers to address the problem. Dental therapists are working in villages around Nome, Kotzebue and Bethel. More are on the way.

The consortium doesn't intend to end the program, he added. Finding common ground on other issues will be even more difficult now.

"The dentistry association has come to us and said, 'We'd like to work with you on addressing these problems,' but on the other hand, they're bringing us to court and making these kinds of comments," he said.