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It’s
2007. And a boy just died of tooth decay. He
didn’t live Virginia, but in Maryland. Yes,
there were circumstances. Sporadic homelessness.
Neglect. Bureaucracy. There always are
circumstances.
The
simple fact is that the bacteria that eats first
through the enamel of a tooth ended up in the
brain of a 12-year old. Deamonte Driver didn’t
just fall through a crack in the system, he
underwent brain surgery, fought to make it, then
died.
Dying
young has been a tragedy in every time of human
history. But it has become less common in the 300
years since mankind discovered and began to
understand bacteria. Dying of the simplest of
infections was once the norm, but less so since
public hygiene took hold and since 1928, when
Alexander Fleming first observed the antibiotic
power of penicillin mold. That’s the Harry Byrd
era for those keeping political time. As a result,
Virginia, like most states, points to its dramatic
increases in life expectancy over the last century
-- from 48 years to 75 years for men and from 51
to 80 years for women, according to the Virginia
Department of Health.
Dying
of a dental abscess has become almost unheard of
in the age of modern medicine and dentistry. More
than an ounce of prevention has been applied for
more than five decades through a drumbeat of
floss-brush-see the dentist regularly, and by the
fluoridation of public drinking water.
Fluoridation, some might remember, was once
denounced as a communist plot by the John Birch
Society and as a waste by lesser conservatives,
who argued that adults didn’t benefit as much
but got the prophylactic just the same.
Children
with family “circumstances” are supposed to
have their dental care covered in the Medicaid
State Children’s Health Insurance Program. But
in the investigations and commentary following the
death of Deamonte Driver of Prince George’s
County revealed that in Maryland, less than
one-third of the children eligible for Medicaid
dental care coverage actually get treatment.
Don’t
look away. Virginia, it turns out, is even worse:
Only 24.3 percent of children eligible for
Medicaid dental care coverage actually get
treatment.
Deamonte
Driver’s family, it turns out, had no health
insurance. The family had trouble finding dentists
who would take Medicaid patients and endure the
hassle and paperwork that government officials at
the federal and state levels keep building into
the system in the name of taxpayers. The
Driver’s Medicaid coverage apparently had lapsed
temporarily for bureaucratic reasons.
Circumstances.
In
Virginia, as in most states, the Department of
Health has a Division of Dental Health. That
division claims a major role in the collection,
analysis and reporting of oral disease data in
Virginia for over 50 years. Long term studies, the
division reports, show that the overall oral
health status of children in Virginia has
improved, but that the percentage of children with
their filling needs met has not significantly
improved. Additionally, studies continue to show
that decay is disproportionately distributed with
more than 80 percent of the decay in only 20
percent of the child population. Yet, dental care
is not one of the health performance measures of
VirginiaPerforms, the new accountability
initiative of Virginia government.
So
what can we do differently? Parents can be more
attentive. Children can brush regularly and avoid
sugar. Schools can rid their corridors of junk
food. Dentists can step up to expand their
practices with new models of service delivery that
seek out the under served. State data collection
and analysis remain critical. Public education is
essential. Population-based programs, such as the
school fluoride mouth rinse program, is good.
Encouraging medical research and providing
incentives and scholarships for medical and
healthcare professionals in dentistry are great.
But
how about less bureaucracy, not more, for dentists
and healthcare professionals who are ready to
serve people with circumstances? Deamonte
Driver’s brain surgery and treatment cost over
$200,000. A tooth extraction would have cost 70 or
80 bucks. The taxpayer saved neither life nor
money.
How
about more funds for attention and outreach and
treatment, such as the $2 million being considered
in Annapolis to expand Maryland’s program or the
$40 million nationwide that U.S. Senators Benjamin
Cardin, D-Md., and Jeff Bingamen, D-N.M., have
asked for in their just introduced Children’s
Dental Health Improvement Act? How about a
national campaign to give American children the
healthiest mouths and teeth in the world? Why not
throw in new commitments to nutrition, housing,
hygiene and medical care in general? Name the
campaign after Deamonte Driver.
And
a final note. Virginia ranks in the third tier,
28th to be exact, among the states in life
expectancy. Two decades from now, according to the
World Health Association, 12 countries will have a
life expectancy at birth higher than the United
States. Iceland, Italy, Japan, Sweden, Australia,
Canada, France, Greece, Netherlands, Singapore,
Spain and Switzerland will be ahead of us. It’s
2007. We need to do more. What are we waiting for?
--
March 5, 2007
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