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Locals call it the bush, a term used to describe anyplace you can’t get to by road. And you can’t get to the tiny town of Bethel, in Alaska’s Yukon-Kuskokwim Delta, by road. You have to fly in from Anchorage. That’s how Andrew Jorgensen got there last summer, on a 12-person puddle jumper. The Goldman School of Dental Medicine student spent a three-week externship fixing the teeth of people whose dental decay rate hovers between 7 and 10 times the national average.
The inaccessibility of the YK Delta leaves it with few jobs, little money, and sky-high prices for healthful food. Milk costs $8 a gallon. Soda, on the other hand, can be cheaper than bottled water and has become the beverage of choice for many. That’s one reason that each year about 400 infants and toddlers are sent to the operating room at the Yukon-Kuskokwim Health Corporation (YKHC) in Bethel, where they are strapped to papoose boards and anesthetized so dentists can extract their rotted front teeth.
Jorgensen (SDM’13) arranged his externship through the Indian Health Service (IHS) and YKHC, which serves the people of Bethel, Toksook Bay, and approximately 50 other villages of the YK Delta, an area in the southwestern corner of Alaska the size of Oregon. Summers up there are temperate, with temperatures rising to the 70s, but the winters are unforgiving: the mercury can plunge to as low as -50°F.
There are 12 dentists in the health center here, and they do their best to serve the region’s 25,000 people, putting the dentist-to-patient ratio at about half of what it is nationally. Worse, several YKHC dentists are scheduled to leave when their contracts end. To fill the area’s dental care void, the YKHC has set up five subregional clinics, each of which will be staffed by two dental health aide therapists, whose two years of training equips them to do uncomplicated extractions and fillings. The therapists, who also educate patients about the importance of preventive dental care, are native Alaskans, and they are fluent in Yup’ik, the language spoken by most patients.
Jorgensen, on the other hand, speaks no Yup’ik, although he does have some Native American heritage: his great aunt, a Chippewa from Sault Ste. Marie, Mich., once had back surgery performed by IHS doctors. He first earned a degree in engineering and worked for several years as an aerospace engineer. “Dentistry is a mix of art and technical science,” he says. “It’s a helping profession, and you get to work with your hands.”
During his three weeks in the YK Delta, Jorgensen treated as many as 10 patients a day, working both in Bethel (population 6,000) and in Toksook Bay (population 600). He filled cavities, did root canals, and performed extractions. “Many of the people have teeth that just aren’t savable,” he says. “Really all you can do is an extraction. It gets them out of pain.”