SWINOMISH VILLAGE, Wash. — The dentist's chair is a place where few people enjoy sitting, but for Native Americans, it has historically been a particular place of pain.
"They tell stories of having really horrific pain during the procedures," said Swinomish Tribe Dental Director Rachael Hogan.
Before the tribe's modern clinic was built, Swinomish members lived horror stories of traveling dentists performing painful procedures in a doublewide trailer.
"Pretty much everything was about extractions and emergency care treatment," said Hogan. "There wasn't much thought given to how the treatment was provided. Now, I will have elders who will literally shake in the chair."
Those days created a culture of fear, distress and decay that spanned generations.
A Pew Charitable Trust study found that 2.4 million Native Americans have with tooth decay.
Sixty-eight percent of that population saw their problems go untreated as opposed to just 37% of the general public.
Among preschoolers, Native American tooth decay was four times higher than that of white people.
To clamp down on the problem the Swinomish Indian Tribal Community and Skagit Valley College are training what are called "dental therapists."
They're a new type of clinician who performs more complicated procedures than hygienists, like fillings while leaving the more advanced measures to actual dentists.
That brings more people into the profession -- specifically more Native American people.
Swinomish Dental Therapist Asiah Gonzalez says that means more people will get more care.
"Because I'm from here, that trust is already established. That bond is already there," she said. "I can relate to our cultural practices because I understand it."
Dental therapists visit the children's health clinic every week teaching them about the importance of eating right and getting good dental care.
The program is only the second to be accepted by the Commission on Dental Accreditation in the country.
Hogan says the goal is to create a new generation of dental professionals to change decades of distrust.
"It's really inspiring to see someone who looks like you, or who comes from a community like yours," she said. "It allows children that vision or hope for themselves."
The ghosts of the doublewide that sat just outside the clinic's windows are hopefully gone for good.
"We want people to see that this is just a place for them to receive health care and take good care of themselves," said Gonzalez.