Alliance Seeks to Expand Dental Care to Poor Kids

Alyce Driver, above, had trouble finding a dentist for son Deamonte, who died of an infection. Rep. Elijah Cummings, at left, hopes to prevent similar cases. (By Linda Davidson -- The Washington Post)
By Mariana Minaya
Washington Post Staff Writer
Thursday, August 9, 2007

The University of Maryland Dental School and an insurance company have partnered to provide low-income children with more access to dental care. The action comes six months after a 12-year-old Prince George's boy died from a tooth infection.

Under an agreement announced yesterday, UnitedHealth Group will give the school more than $170,000 annually to train dentists in pediatric care, provide a case manager to connect children to a dentist and educate pediatricians to look for signs of tooth problems.

"Children are suffering every day because we have systematically failed to provide them with the dental care they need," said Rep. Elijah E. Cummings (D-Md.) at a news conference yesterday.

Cummings, who helped craft the agreement between UnitedHealth and the dental school, had called on lawmakers to discuss barriers to adequate dental care for the poor after Deamonte Driver died of an infection that began with an abscessed tooth. The infection spread to his brain.

"Nothing we do will bring him back, but I am determined to ensure that from his death comes life," Cummings said yesterday.

Of Maryland's 5,500 dentists, only about 900 accept Medicaid patients, according to a former president of the state dental association. Those patients are often avoided because of the bureaucratic hurdles in treating them, as well as low reimbursement rates.

After a Capitol Hill hearing in May on obstacles to treatment, the dental school and UnitedHealth developed a plan that would add another full-time pediatric fellow to the school's staff of seven and provide $30,000 to establish a mini-pediatric dentistry clinic, where about 15 general-practice dentists will train in advanced pediatric care and treat patients in need. The school will also provide three-hour courses to teach physicians to identify cavities or other problems, dental school officials said. The case manager also will help patients deal with transportation, remind them about appointments and explain what they can expect when they visit the dentist.

They hope to reach about 100 physicians with their efforts, said Norman Tinanoff, chairman of the Department of Pediatric Dentistry at the dental school. Most doctors are extremely unfamiliar with dental problems.

"We have to train physicians to stop looking right to the throat," said Allen Finkelstein, chief dental officer of AmeriChoice, a UnitedHealth Group company. "They have to feel comfortable saying, 'When did you see the dentist last?'

"We have to start shifting back to the preventive model. That's where the problem is. . . . We have to teach these students to do the right things for the community."

Deamonte's mother, Alyce Driver, said she spent seven months trying to find a dentist for her younger son, DaShawn, whose dental problems initially seemed more pronounced than Deamonte's. Several of DaShawn's teeth became abscessed before Driver found a dentist who accepted Medicaid. The boy eventually had five teeth extracted and some cavities filled at the University of Maryland's pediatric dental clinic.

Beyond efforts at the local level, federal legislation to enhance pediatric dental care is in the works. A House version of the Children's Health Insurance Program would guarantee dental care for every child served by the program. Another bill called Deamonte's Law would establish two five-year, $5 million programs to train pediatric dentists and improve dental clinics at community health centers.

"In 2007, there is no reason for a child to have a toothache -- let alone die," Cummings said.

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