This article was produced and provided by the W.K. Kellogg Foundation.
George Blue Spruce, D.D.S., M.P.H., is a member of the Laguna and Ohkay-Owinge Pueblos. He became the first American Indian dentist in the United States upon graduation from Creighton University School of Dentistry in 1956. Nineteen years later he recruited the second, and he hasn’t stopped recruiting since. Today there are about 190 American Indian dentists—still a tiny fraction of the total number of U.S. dentists—and the nation’ 58 dental schools add only about 30 American Indian students per year. Dr. Blue Spruce is committed to building the dental profession and improving oral health in Indian Country. His message to young people: You can do this, and you are needed.
Why does Indian Country need more Native dentists?
We need to “grow” our own. The massive turnover of dentists in the Indian community is a problem and results in many vacant dental positions. Many non-Indian dentists on the reservations are there for only two years, as part of paying back their student loans, before leaving to enter private practice. Many Indian people, like other people, are apprehensive about going to a dentist. When they find one that they are finally comfortable with, it’s a sad day when that dentist announces that he or she is leaving. The key to delivering dental care to American Indian communities is recruiting dental students from those communities.
Second, when you visit health facilities in Indian Country you find very few American Indians in meaningful leadership positions. We’ll never realize the intent of the Indian Self-Determination Act until we can manage and control our own health programs, and to do that we need many more dentists, physicians, pharmacists, and other doctoral-level health professionals.
Why are there so few Native dentists?
Our students don’t see American Indian dentists growing up. They do not have a parent or grandparent who is a dentist. So many of them don’t even have support from parents, the extended family, or tribe. High school counseling is better than it used to be but even today counselors in our Indian communities too often talk to students about a marketable skill right out of high school and not enough about going to college. Oftentimes their high school courses do not include those subjects that will prepare them for college. And of course, there are the financial issues. Our students need help to overcome each issue. But one serious barrier is the dental schools themselves. Very few dental schools have made a genuine commitment to enrolling American Indian students. One exception is my school, the Arizona School of Dentistry & Oral Health.
What will it take to increase the number of Native dentists?
“Pathways” from childhood through completion of dental school need to be established. It is said that a child commits to a profession as early as eight years old. A genuine and permanent involvement of parents, extended family, and organizations such as the Society of American Indian Dentists is needed to offer role models and encouragement. School administrators, teachers, counselors, colleges, universities, and organizations offering scholarship opportunities must all play responsible roles in ensuring the success of talented Native students.
Would adding more auxiliary providers strengthen the dental team?
Many Native individuals will not have the opportunity to become dentists. However, they can enroll and train in an auxiliary program, such as those for hygienists, assistants, and therapists, where they can be part of a dental team striving to extend and improve oral health at the various levels of treatment. They will help to improve and develop a comprehensive dental care delivery system for Native people, especially those people in remote and rural areas. A dentist’s supervision will always be needed in those situations where treatment is more complicated and beyond the parameters of treatment by auxiliaries.
Dr. Blue Spruce founded the Society of American Indian Dentists in 1990 after retiring as director of the Phoenix Area IHS with the rank of assistant surgeon general. He is assistant professor and assistant dean for American Indian affairs at A.T. Still University’s Arizona School of Dentistry & Oral Health. He has played tennis since high school and is at present the only male tennis player in the American Indian Athletic Hall of Fame.