After years of fruitless legislative battles, the Swinomish Native American tribe has stepped forward to create its own licensing system for
dental workers, one designed to bring better dental care to tribe members and
The move ends a five-year political stalemate that pitted the Swinomish tribe against lobbyists from the American Dental Association. After a licensing bill was scuttled in Washington’s legislature in 2015, the tribe created a system that qualifies well-trained therapists to perform procedures and meet reimbursed criteria set by the federal Indian Health Service.
"We had to take matters into our own hands," Brian Cladoosby, chairman of the Swinomish Senate and president of the National Congress of American Indians, said.
Jane Grover, director of the ADA Council on Access, Prevention and Interprofessional Relations, said her group supports tribal sovereignty, but urges caution.
"Drilling on a tooth is a surgical procedure ... (and) should be performed by a dentist," she said.
However, Grover said the ADA has no plans for a court challenge.
The Swinomish Dental Clinic, the first provider operating under the new licensing rules, opened in January some 50 miles north of Seattle. Operator Daniel Kennedy, the first dental therapist licensed under the new plan, studied in Alaska in a program modeled after one in New Zealand -- aimed at training therapists specifically to work in underserved tribal areas.
Rachel Hogan has turned from skeptic to believer after four months of observing Kennedy’s work at the clinic, citing the amount of practice a therapist gets on a specific procedure versus that of a dental student.
"Their fillings are better," she said. "Are we providing substandard care by providing a therapist? Actually, I would say it's the opposite."