Dentists Remember and Respond to a Child's Preventable Death

Dentists Remember and Respond to a Child's Preventable Death
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To the horror of us all, Deamonte Driver, a seventh grader from Prince George's County, Maryland, died of complications from an abscessed tooth on February 25, 2007. The outrage is that Deamonte's life could have been saved by routine dental visits and an $80 extraction. As a response to this needless death, a team of Black dentists have established the Deamonte Driver Dental Project which provides mobile dental services to prevent similar losses from happening in the future.

The inexcusable and unnecessary loss of Deamonte's life is a Dickensian story that started when he complained of a headache. His mother was unable to find a dentist to see him who would accept Medicaid patients, so she took her son to a hospital emergency room where he was given medicine for a headache, sinusitis and a dental abscess and sent home. He quickly got much sicker and was rushed to surgery, where it was discovered that the bacteria from his abscessed tooth had spread to his brain. Heroic efforts were made to save him including two major operations and eight weeks of additional care costing about $250,000--all too late.

Deamonte's story is not unique. Fewer than one in three of Maryland's 500,000 children who are Medicaid recipients received any dental services last year. This is due to the fact that only about 900 of the state's 5,500 dentists accept Medicaid patients because of the program's low reimbursement rate and bureaucratic red tape. Just arranging a dental appointment can be a major challenge for families that lack transportation or may be periodically homeless and have erratic telephone and mail service.

Soon after Deamonte's death, Black dentists Dr. Hazel J. Harper and Dr. Belinda Carver-Taylor brought together about 50 of their colleagues to determine how to prevent future calamities, and the Deamonte Driver Dental Project was born. Launched in November 2008, the project aims to "stamp out the epidemic of tooth decay by increasing access and providing early intervention." The project states its mission clearly: "We must transform a culture of crisis into a culture of prevention. Dental decay is a preventable disease. The ultimate goal is to create a successful, sustainable model program for other counties." The project is a school-based, grassroots effort that focuses on underserved children from low-income families in Prince George's County. It is sponsored by the Robert T. Freeman Dental Society Foundation, an association of Black dentists from Washington, D.C., and Maryland, with the involvement of local businesses and churches. The Foundation is a local chapter of the National Dental Association.

The Deamonte Driver Dental Project started by targeting nine Prince George's County elementary schools and relies on principals, school nurses and parent liaisons to identify children in need of help using criteria such as eligibility for free school lunches. Children are provided diagnostic, preventive and simple restorative dental services, like fillings, in a specially customized dental van that pulls up to school sites. In just four days in February 2009, the group screened 170 children at Seat Pleasant Elementary School. Each child received a report card to take home indicating needed follow-up dental services--either preventive, routine or emergency. The dentists found 32 children who required emergency services for problems like abscesses, acute gum disease and teeth rotted down to the nerve centers.

Principals and nurses are alerted to children who have emergency needs to ensure that parents get notified. For children who cannot be treated in the van, project coordinators have enlisted a network of 40 local dentists to serve them in their private offices. At least one of these dentists' offices is within a 10-minute radius of each school. Organizers believe that the project's growth and success depend on reaching out to include a multicultural team of health providers--dentists, hygienists and nurses.

The dental group has been using a rented vehicle, but with the support of Maryland Governor Martin O'Malley, the state's Office of Oral Health in the Department of Health and Mental Hygiene has committed $288,000 for the purchase of a new fully equipped dental office on wheels that will be delivered later this year. The Aetna Foundation also supports the Project with a $31,500 grant.

The project's overall objectives are to eliminate health disparities by expanding access to quality oral health care; increasing the number of providers in the dental safety net; growing the number of children connected to a "dental home" for continuity of care; establishing a "Children's Dental Hotline"; and identifying eligible children not currently enrolled in any government supported health coverage program.

What happened to a child as young as Deamonte in America is scandalous, but it's gratifying that a community led by admirable dentists turned its grief into action and organized the Deamonte Driver Dental Project. Deamonte's death also influenced Congress to mandate the inclusion of dental benefits into legislation reauthorizing and expanding the Children's Health Insurance Program (CHIP), which was signed into law by President Barack Obama on February 4, 2009. For more information about the Deamonte Driver Dental Project, go to deamontesdentalproject.org.

To learn more about the Children's Defense Fund's campaign to guarantee comprehensive health coverage for all children in 2009 visit www.childrensdefense.org/healthychild

Marian Wright Edelman, whose latest book is The Sea Is So Wide And My Boat Is So Small: Charting a Course for the Next Generation, is president of the Children's Defense Fund. For more information about the Children's Defense Fund, go to www.childrensdefense.org.

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