Chinle Service Unit (CSU), Navajo Area Indian Health Service is the sole source of health care for the 16 chapters, or communities, in the central region of the Navajo Nation. Pediatric outpatient services are provided primarily at Chinle Comprehensive Health Care Facility (CCHCF), a 60 bed hospital and outpatient facility, and two outlying clinics, Tsaile Health Center and Pinon Health Center. In addition to inpatient and comprehensive primary outpatient services with adult, pediatric and maternal health clinics, CSU provides emergency, surgical, optometry, pharmacy and dental services. We see all pediatric patients that present to the clinics, resulting in a wide mix of cases. Dental decay is prevalent in our patient population with approximately 80% of our pediatric patients with multiple untreated caries by 5 years of age.
The oral health program at the Chinle Comprehensive Health Care Facility consists of our general dentistry services at the Chinle, Pinon, Tsaile and Many Farms Facilities. There is not currently a pediatric dentist available at our facility, but the four general dentists do perform oral health assessments and some restorative care. Unfortunately, restorative care is provided with local anesthesia only, resulting in the use of papoose boards and restraints in children as old as 8 years of age. The resultant fear in these children likely leads to less compliance with later dental exams. The dental department offers a limited number of appointments due to a high no-show rate, resulting in long wait times for initial evaluations, which are on a walk-in basis only without a referral from a primary care physician.
Preventative dental care is provided in a variety of settings. Chinle general dentists will see children of all ages, but have requested a referral from a pediatrician or family practice doctor to provide evaluations at 9mo-12mo of age. Fluoride varnish is provided at most pediatric clinic visits. Fluoride application is prioritized to well child checks, but also is offered at sick visits. Fluoride varnish is also offered by a dental technician every other Friday at the Chinle Program for Women, Infants and Children. The Oral Health Risk Assessment Preceptorship Program will be utilized to teach pediatric clinic staff how to perform initial oral health assessments and to expand the application of fluoride treatments to our two rural clinic sites in Pinon and Tsaile.
