Preventing Decay, Preventing Tragedy

Sunday, March 18, 2007

Twelve-year-old Deamonte Driver died last month from an abscessed tooth. The Prince George's County boy's passing is an astonishing reminder that our country is far from a land of equal opportunity when it comes to health care.

According to the Children's Health Dental Project, 4 million children are born each year in the United States. More than a quarter of them will have cavities by the time they are toddlers, and more than half will have cavities by the time they reach second grade. Tooth decay remains America's most prevalent chronic childhood disease. It is five times more common than asthma, and can be just as debilitating and fatal -- as Deamonte's death has shown.

Not all children are at equal risk. Children in poverty are twice as likely as their wealthier peers to develop cavities -- and when they do, they develop twice as many cavities. In addition, children in poverty are more than twice as likely to suffer toothaches but less than half as likely to obtain dental care. Why? Because most dentists will not accept their government-sponsored insurance, and alternative treatment sites -- such as health centers, hospitals and dental schools -- are scarce and overburdened.

Some people blame the parents. But research shows that most poor parents strive to obtain proper care for their children. In fact, in the rare instances in which states have fostered successful dental programs, the number of poor parents obtaining care for their children has increased dramatically, becoming almost on par with families that have private dental insurance.

One more fact: For every dollar spent through Medicaid on children's health care, just five cents go toward dental care. Comparing it proportionately, five times that amount is spent on the dental care of more affluent children. This disparity is striking.

But many low-income children don't have access even to minimal dental care. When Congress enacted the State Children's Health Insurance Program (SCHIP) 10 years ago to cover working-poor families, dental care was listed as an option. Oral health is not -- and should never be -- optional. Deamonte's death has shown us that dental care is integral to a child's health and well-being.

Perhaps the greatest tragedy of Deamonte's death is that tooth decay is easily preventable, and when it does occur it can be treated at low cost. Identifying the children most susceptible to dental problems -- and treating cavities as soon as they are detected -- is an investment we should be willing to make before another child's life is lost.

We in Congress should take action to ensure that all children have access to care. First we should require states to provide dental care through SCHIP, not only to children enrolled in the program but also to children whose families' private health coverage does not include dental care. We have an opportunity to do this when we reauthorize SCHIP later this year.

Equally important is ensuring there are enough oral health-care providers available to treat children across the country and that they are adequately compensated for their services. We have introduced legislation -- the Children's Dental Health Improvement Act -- that expands school-based dental sealant programs, encourages dental schools to train more residents, improves Medicaid and SCHIP payment rates to dentists, and provides incentives to dentists willing to work in underserved parts of the country.

America has never promised its children success, but it has always promised them opportunity. Children who suffer from untreated tooth decay are often denied this opportunity because of dental pain that limits their ability to eat, sleep, learn or, as in the case of Deamonte Driver, enjoy life itself.

-- Jeff Bingaman -- Benjamin L. Cardin

Washington

Jeff Bingaman (D) represents New Mexico and Benjamin L. Cardin (D) represents Maryland in the U.S. Senate.


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