Craig Bruce
Taking
Care of Children
Craig
Bruce, Turtle Mountain Band of Chippewa, DDS, is now
the National Pediatric Dentist Consultant for the
Indian Health Service. When the article below was
first written, he was the Navajo Area Regional
Specialty Consultant at Tuba City Regional Health Care
Corporation Complex
Dental Unit. Dr. Bruce is still based at the Tuba City
facility and still has the clinical and research tasks
described below.
Dr. Craig Bruce works with a relatively large staff at a
small, remote hospital at the Western end of Navajo Nation.
As a pediatric dentist, Bruce is responsible for a range of
dental services for children. Several days a week he cares
for children in the clinic. Once a week he does full mouth
dental rehabilitation in the operating room for children
with serious dental problems.
“American
Indian children have very high rates of early childhood
decay,” says Bruce. Sixty to 75% of children in Head Start
have some type of decay. In my own studies of children in
the Tuba City area, I’m finding that 90% of the children
have some type of tooth decay; 75% of those have very
severe ECC [early childhood caries]. Sometimes I have to
remove the upper front teeth."
In an attempt
to prevent tooth decay, Bruce is involved in several
prevention projects. “At Head Start we are putting fluoride
on children’s teeth. It’s in the form of a varnish that we
paint on to the teeth after drying the teeth with varnish.
This form of fluoride stays on teeth much longer than the
rinses or gels we used in the past.” Craig also identifies
children with bad decay and arranges for their care.
Bruce is also the local coordinator for a multi site study
of chlorhexidine varnish. (Chlorhexidine is an
anti-microbial that kills bacteria, including the bacteria
that cause tooth decay.) Mothers who have untreated tooth
decay can transmit the decay-causing bacteria to their
babies and children. In the study Craig and his staff are
identifying mothers with babies who are about 4 to 5 months
old and don’t yet have teeth. Craig and his staff provide
any needed dental care to the mothers and paint their teeth
with the chlorhexidine varnish. “After 18 months, we’ll
look at the decay rate in the moms as well as the babies.
Hopefully we’ll see a significant difference.”
Bruce and his
staff provide dental education on both the family and
community level. They warn against letting babies and
children sip juice and pop throughout the day. If children
eat or drink at bedtime, they need to brush their teeth
before going to bed. In general Bruce urges people to have
good eating habits and good oral hygiene.
Turning
Point
While growing up Bruce didn’t know any dentists or doctors.
Bruce worked for his father, who owned a small construction
company, and entered college as a business major. At the
University of South Dakota he discovered he didn’t like
business. He was intrigued as he heard some of his friends
talk about their plans to be doctors and started taking the
prerequisites for medical school, though he wasn’t sure
that medicine was the field for him.
Serendipitously, at a ski resort, Bruce met a dentist who
helped him see that as a dentist he could work with his
hands but also have some involvement with medicine.
“Talking to that dentist was a turning point for me,” says
Bruce. “I liked the idea of fixing things and making them
right. When I got back to school I started shadowing
dentists and decided this was the profession for me.”
Knowing that dental school was highly competitive, he
proved he could handle graduate level work in science by
successfully completing a master’s degree in science at the
University of South Dakota.
Bruce
was challenged by his dental studies at the University of
Nebraska Medical Center College of Dentistry. “The material
wasn’t difficult to understand,” he said. “There was just
so much to learn.” Some Indian Health Service externships
helped Bruce with his hands-on skills. “During the summers,
I had a lot of experience under the supervision of an IHS
dentist. This helped me immeasurably.”
Following graduation from dental school, Bruce worked on
his reservation for two years. “The biggest gain was
reconnecting with my family and distant relatives. I
learned more about myself and where I came from. It was
nice to be where I felt I belonged.”
Bruce particularly enjoyed reconnecting with his
grandfather with whom he had spent many summers on the
reservation. His grandfather, in turn, was proud to have
his grandson back home. “When I was out in the community
with Grandpa, he introduced me to people, saying, ‘This is
my grandson, Dr. Bruce, the dentist.’ Sometimes he took out
the dentures that I made for him and showed people that I
had put his name on them.”
During the two years on the reservation, Bruce became more
aware of his strengths and deficiencies as a dentist. This
helped him clarify what he needed in the general practice
residency at Phoenix Indian Medical Center.
Diana
Cudeii, Navajo, her husband, Craig Bruce, and
patient
At the dental
clinic at the Phoenix Indian Medical Center, Bruce met and
soon married Diana Cudeii, Navajo, who had been a dental
hygienist for several years. The couple then moved to the
Turtle Mountain Band of Chippewa Reservation where both of
them provided dental care for a few years.
Next Bruce did a residency in pediatric dentistry at Denver
Children’s Hospital. He felt that his commitment to serving
American Indian children helped him get into this
competitive program. “This residency helped me learn more
about myself,” says Bruce, “I thought I was kind of a tough
macho guy because I raced cars and snow mobiles and rode
and broke horses. Working with young kids who had a short
life expectancy brought out sensitivities that I didn’t
know that I had.” He also developed close bonds with
colleagues with whom he shared experiences, such as the
death of a patient.
Bruce and his wife returned to the reservation for another
year and a half and then moved south. After 8 months on the
Hopi Reservation, Bruce transferred to his current job.
A
Gratifying Profession
“Dentistry is
probably one of the most challenging and fulfilling
professions. Many people are afraid of dentists so you have
to deal with their emotional needs as well as their
physical needs. After Hurricane Katrina, I worked in a
mobile clinic in Mississippi where I was able to treat a
woman who was in a agonizing pain and was terrified about
having an injection.” Bruce calmed the woman and was able
to relieve her pain almost immediately. After Bruce
extracted her tooth, the woman thanked him effusively. “I
feel fortunate that I’m needed and can help. I can’t think
of another profession that is more gratifying. I feel very
lucky to have found this profession and way of life.
This
article was originally published in the Spring 2007 issue
of
Winds of Change. (The cover
artist, Buffalo Gouge, Creek and Cherokee, works with
bright colors. Portraits are his main interest. For more
information visit Art Exchange Galleries.)
Update
2010
Dr. Bruce says, “All is well. We still live in Flagstaff,
AZ, and I am still working in Tuba City, AZ in the Indian
Health Service. The only update I have is that I have been
chosen to be the new National Pediatric Dentist Consultant
for the Indian Health Service. I am still a clinical
pediatric dentist but now I have the added task of
consulting with our IHS Dental Director and the other
approximately 26 pediatric dentists in the Indian Health
Service. We are currently working on implementing new
strategies to prevent early childhood caries in our
children.”
The study for the FDA approval of chlorhexidine varnish in
which Dr. Bruce was participating at the time of the above
article, is completed. He and his staff are awaiting the
results and expect the FDA to approve the use of the
varnish as an anticavity agent.