By Susan Levine
Washington Post Staff Writer
Thursday, February 8, 2007
Though it probably helped to have classmates from Harriet Tubman Elementary in the same predicament just a few feet away, Joan-Nicole Johnson was being brave on her own. The 8-year-old barely flinched as dentist Jim Feldman shot her gum with lidocaine so he could start fixing a cavity on a bottom molar. A permanent tooth, he told her.
"So you want to keep it," he explained as his diminutive patient nodded seriously.
Feldman usually works out of his Connecticut Avenue NW office. But last week, he and several dozen other dentists from the District and suburbs met more than 120 youngsters in the basement clinic of Howard University's dental school. There, they and faculty, graduate residents and dental students provided an entire morning of cleanings, fillings, sealants and extractions -- tens of thousands of dollars' worth of care, all free.
Coordinated by the D.C. Dental Society, it was the city's fifth year of participation in Give Kids a Smile Day. The national event is intended to highlight the acute need for dental diligence among low-income children. According to the National Institutes of Health, 80 percent of tooth decay is seen in a quarter of the children in this country, and most of them are from economically disadvantaged families.
A complexity of issues puts them at greater risk -- including diets that include too many sweets, sugary drinks and processed foods -- and keeps them from receiving regular care.
"Poverty of education, poverty of finances, there are a lot of reasons," said Eugene Giannini, dental society president. "We go into some of these schools, and I am amazed by some of the advanced decay. . . . You just see black holes, teeth rotted to the gum line."
Most children in the District's Medicaid program do not visit a dentist even intermittently, despite action in 2005 by the D.C. Council to expand access by increasing reimbursement rates and persuading more providers to participate. For these children, problems are often ignored or simply not detected until they have become painful. And then, as Giannini noted, "it's too late."
The District's Give Kids a Smile Day touches just a fraction of the need. Still, half a dozen schools have benefited impressively to date. Last year's cadre of volunteers gave, on average, nearly $600 in care per child to those seen from Raymond Elementary School in Northwest.
The dental society picked Harriet Tubman Elementary as its 2007 target months ago. It sent an organizing team to the school, on 13th Street NW, to meet with administrators and staff and then began planning the logistics and making fliers. Dentists came twice to make presentations to parents, counselors called individual homes to encourage participation and teachers talked in classes about the importance of keeping teeth shiny, clean and healthy. By the first cafeteria screening in December, the mobilization was well underway.
"This was just a godsend," said Principal Sharon Bovell, who knows the struggles of her students' families. More than 85 percent of Tubman's 434 students qualify for free or reduced-cost lunches. "A lot of my parents basically depend on the clinics for medicals of any kind."
More children this year than in the past needed only cleanings. Yet there were few lulls in Howard's clinic as wave after wave came in last Friday.
The operation was in a large room with so many rows of individual stations -- each with a long maroon chair, silver tray of instruments and other typical accoutrements -- that the scene resembled a busy workshop. A cheery one, too. Assigned to every station was a small team of dentists and assistants, who talked through their young patients' anxieties, empathized with their occasional tears and repeatedly offered smiles and congratulations for courage.
"Here comes the super light!" M.J. Waroich told 7-year-old LeCount Jones as she focused an intense blue beam to cure the composite in a newly-repaired cavity. Waroich, whose practice is on I Street NW, had identified more than half a dozen cavities in the first-grader's mouth, including one already down to the tooth nerve. She tackled what she could.
"I would have liked to do more," she said after finishing -- and after allowing LeCount to slide down off the chair, as promised. "I don't think he's ever seen a dentist."
Walking the rows with other Howard and dental society officials was the university's dental dean, Leo Rouse. "This is an amazing community effort," he said. He said he hopes the experience makes a lasting impression on the children and their families. "What people need to realize is that oral health care is a component of total health care."
Just a couple of feet away, in Jim Feldman's chair, Joan-Nicole was nearly done. Her cavity had been more extensive than the X-ray indicated. "Six months from now, this would have been a major, major toothache," Feldman said. Instead, it was a problem averted.
Minutes later, a new toothbrush in hand and relief on her face, she was on her way.