NZ dental teaching sparks US row

New Zealand dental training for health workers in Eskimo communities in Alaska is at the centre of controversy in the United States.

The two-year diploma of dental therapy courses, at Otago University's dental school, have started providing indigenous cultures, with health workers trained to carry out preventative and restorative dental care.

The students arrived in New Zealand in February 2003 to begin their training, but are now being criticised by some members of the US Congress -- and the American Dental Association (ADA) -- as having insufficient experience, and having the potential risk of doing permanent harm to their patients.

Other members of Congress from the mainland states outside Alaska have said they accept the benefits of bringing dental therapists to some rural areas, but don't want to see the practice come to their own backyards.

This is despite health care for other indigenous people in Indian tribes being at Third World levels in many areas.

Among those being treated are Athabascan and Tsimshian Indians and Inupiat and Yupik Eskimos.

The quality of the Otago training has become a pivotal point in a debate over whether medical training has been sacrificed for increased access to dental care.

The political row has been branded a "turf war" by Ron Nagel, a dentist and manager of the dental health aide program for the Alaska Native Tribal Health Consortium, who negotiated the training programme in mid-2002.

Dr Nagel told the Associated Press news agency he knew of no permanent damage from dental therapists working around the world and he criticised the ADA campaign. He said the rate of tooth decay among Alaskan Inuit, who often live in towns which are not accessible by road, was 2.5 times the national rate in America.

This claim was backed by congressional investigators, who said in a report issued earlier this year many Alaskan Inuit and American Indians did not have adequate access to specialist dental care, particularly in rural Western states, where reservations were often many miles from the nearest dentist.

Dr Nagel said the therapists' training done in New Zealand was actually more rigorous than many American dental schools.

But American Dental Association president, Robert Brandjord, a dentist from Minnesota, said dental therapists are useful but should avoid complicated procedures and focus solely on prevention.

Myra Munson, an attorney for the Alaska Native Tribal Health Consortium, said the ADA had exaggerated the risks associated with the programme: "It is easy for people who have gone through a lot of education to say that only people that have had a similar level of education could do what they do."

- NZPA