By Mark Hartley
A joke about astronauts probably originated from the days of lunar exploration. It involves a Navajo elder who is watching a group of astronauts undergo training by walking on desert rocks in their space uniforms. When he learns that they are going to the moon, the elder asks if he can send a message along with them. So a guy from NASA tapes the message. But everyone on the reservation who is asked to translate the message, which was spoken in the tribal language, just laughs and will not reply. NASA, concerned about just what type of message is being delivered to the moon, finally asks a government employee fluent in Navajo to translate. The message is, "Watch out for these guys. They have come to steal your land."
The punch line ought to be the state motto of my home state of Oklahoma, a place for uprooted Native Americans before the final uprooting to become the 46th state. There are numerous reservations, and the influence of Native Americans on Oklahoma is quite profound — most of it good. However, you can logically debate that the "Indian smoke shops" are not a good thing. Tobacco is readily available at cheap prices. If you're a hygienist dedicated to smoking cessation, you may be tempted to come here and rap a few knuckles.
In other states, hygienists actively lead campaigns to restrict the sale of soft drinks on school campuses. It's a tough fight, as related in past issues of RDH, because the soda manufacturers pay cash-strapped school districts a tidy sum for the right to distribute their sugared beverages to students.
So Alabama shouldn't feel singled out when RDH authors (including myself) take exception to the primary way the state trains its hygienists — the Alabama Dental Hygiene Program (ADHP). We're all trying to work toward a goal of delivering the best oral care possible in all 50 states.
Before I go any further, I should point out that this Editor's Note is mainly a response to Dr. Mark King, a Birmingham resident, who, in a very articulate manner, defends the state's training program. He does a good job of stating his point of view. You should read his letter in the Readers' Forum, as well as those letters from the usual assortment of hygienists commenting on the issue.
In 2000, we polled all 1,641 RDH readers in Alabama and asked them to comment on some questions about the ADHP. In November 2000, we published the results of the survey in an article titled, "Alabama ... in her own words." The article was based on the answers from 207 readers, which equates to 13 percent of those polled (generally considered a good response rate for a survey).
ADHP graduates represented 70 percent of the respondents. Many of them, for example, expressed gratitude for the opportunity for a shortcut to becoming dental hygienists — a career that would have been impossible to attain due mainly to financial or time-management reasons. Many of them proudly defended the quality of care they provide to the state's residents.
However, there were too many "red flags" in the survey responses for me to quietly walk away from this issue. There were too many ADHP graduates who admitted that their employers did not adequately participate in the required training program. There were too many ADHP graduates who admitted that greed was such an obvious factor behind why the doctors basically demolished the infrastructure of traditional dental hygiene — with the exception of one school that has to limp along in a marketplace that undervalues dental hygiene. And, of course, the other 30 percent — the "traditional hygienists" — pointed out too many instances of improper care.
Organized dentistry needs to revisit the blank check it gave to Alabama. In recent years, the landscape of dental hygiene has continued to change. The scientific community, for example, has confirmed the "link" between periodontal disease and other systemic diseases. Has anyone in dentistry bothered to ensure Alabama's residents are being protected in light of this evidence?
Every state likely has some flaws — some red-tape madness — that hinders excellence. The point about Alabama, though, is, one, that the "red flags" that emerge from there suggest a more flawed system than what is acceptable, and, two, Alabama's residents are in the dark about this flawed system.
I love Alabama and its residents. They're Americans too. Shouldn't we be watching out for them?
Mark Hartley is the editor of RDH. He can be contacted at [email protected].
