The Tulalip Tribes is a federally recognized Indian Tribe located on the Tulalip Reservation in the mid-Puget Sound area. The Treaty of Point Elliot established the reservation to provide a permanent home for the Snohomish, Snoqualmie, Skagit, Suiattle, Samish and Stillaguamish Tribes and allied bands living in the region.

Our practice is part of a multi-disciplinary group on an Indian Reservation that serves only Native Americans. There are 3 family medicine doctors, 1 pediatrician, and 1 internal medicine doctor. We have a mix of privately insured, publicly insured and Indian health insured patients. The Tulalip Tribal Health Clinic provides a variety of primary care services including a dental, optometry, and alternative modalities. Our dental clinic has 3 general dentists, 1 orthodontist and 1 pediatric dentist. The dental clinic also provides general anesthesia once a month for the oral needs of the kids in the tribe who are young, uncooperative or have special needs.

Given the high level of poverty and lack of fluoridation of the drinking water and the easy access to sugary drinks in our country, the children of our community are at very high risk for developing dental caries. Our infants are also at high risk for being low birth weight and premature, which both can place these babies at risk for enamel defects and high caries risk. The children will often seek primary care providers first due to childhood illnesses before they seek the dentist.

We are referring the kids at risk to the dental clinic as soon as there is a tooth in the oral cavity or by their 1st birthday. Patients and families can also seek care at the dental clinic without any referral. Our site currently applies fluoride varnish in the dental clinic. We have programs where kids who are at ECAP or Head Start get oral exams by the pediatric dentist, and get fluoride varnish applied at that one visit. Cards given to parents regarding their DMFT (decayed, missing, filled teeth) score and asked to have their child brought into the dental office for routine care or urgent care. Sealants are placed in the first and third grade once a year by the dental clinic doctors and staff.