According to a study by the American Dental Association, 90% of the Lakota people on the Rosebud Indian Reservation in South Dakota have chronic tooth decay or gum disease. This shocking statistic can be attributed to the reservation being located in one of the poorest counties in the US. Because most of the adults and children living on the reservation have never seen a dentist or learned about the importance of oral health, IUSD students are well received where they provide dental exams, x-rays, fillings, cleanings, extractions, prostheses, follow-up checkups, and education in preventative care. A distinct aspect of this trip includes treating patients from the tribal prison system, where students gain unique insight into health disparities experienced by socially disadvantaged populations right here in the US. Other activities students participate in include learning Native American history through cultural excursions to monuments and museums and participating in Native American customs.