[2] The United States federal government and the Alaska Native Corporations have funded multiple programs in the state to target healthcare discrepancies arising from various factors: distance, affecting accessibility and practitioner retention; environmental or general racism; fear; and lack of access to affordable, quality housing and food.
[3] The cost of transportation worsens many of these factors; in 2011, an estimated 85,000 Alaska Natives lived in rural villages accessible only by boat or bush plane.
Due to low retention of qualified dentists from external regions, dental therapy programs have taken root in the state to create career opportunities and increase healthcare access.
[10] Once Dental Health Aides complete their program, they are permitted, under a Federal Agreement, to directly bill Medicaid for services provided.
In 2018, Arizona and Michigan passed their own laws, and New Mexico, Connecticut, and Nevada joined in 2019; Florida, Kansas, Massachusetts, North Dakota, and Wisconsin have their own programs.
The study found that "Alaska's dental therapists are now providing safe, competent and appropriate care in their scope of practice."
[13][14] One dental health medical hub found that though they struggled to retain fully licensed dentists even with incentives like student loan repayments, DHAT tended to stay in their communities, increasing continuous access to care.
[15] The daily work of the dental therapist is in the rural village – tiny, almost certainly lacking in comfortable amenities, and usually completely cut off from the rest of the world, accessible only by small aircraft and snowmobiles in the winter.
A therapist is lucky if this temporary living space comes equipped with running water or a working septic system – often, more primitive solutions are required.