The American Indian and Alaska Native dentist workforce in the United States.

Abstract

The purpose of this article is to describe the American Indian/Alaska Native (AI/AN) dentist workforce, the general practice patterns of these providers, and their contributions to oral health care for AI/AN and underserved patients. A national sample survey of underrepresented minority dentists was conducted in 2012 and received a 34 percent response rate for self-reported AI/AN dentists. Data were weighted for selection and response bias to be nationally representative. Descriptive and multivariable statistics were computed to provide a workforce profile. Comparisons to Census data and published information on dental students and dentists were used to examine practice patterns. The AI/AN dentist workforce (weighted n = 442) is very diverse with 55 reported individual tribal affiliations. Tribal heritage was provided by 95.7 percent of AI/AN dentists (n = 423), and of these, 93.9 percent (n = 400) reported an affiliation with only one tribe. The largest share of AI/AN dentists were born in the United States (98.2 percent, n = 434), married (75.6 percent, n = 333), and had dependent children under age 18 (52.0 percent, n = 222). Only 0.9 percent (n = 4) of AI/AN dentists spoke a traditional AI/AN language in patient care, while 10.6 percent (n = 46) were raised on tribal land or reservation. Initial practice in the Indian Health Service was reported by 15.8 percent of AI/AN dentists while 16.2 percent report currently practicing in a safety-net setting, and 42.0 percent report working in a practice that primarily serves underserved patients. AI/AN dentists provide a disproportionate share of care for AI/AN populations, yet the number of AI/AN dentists would need to increase 7.4-fold in order to meet population parity.