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More Than a Toothache

The Congress of America will hold a hearing on a neglected yet, crucial issue -dental care insurance in children.

In America, one in three children do not have access to dental care insurance. The number of them is astounding- 25 million. As for Medicaid, with the poorest children this is of no use, as dentists often do not accept Medicaid, due to its low reimbursement rates.

Lack of dental insurance, especially for children is no secondary issue. Take the case of Deamonte Driver, a boy aged 12 years. The young teen suffered a tooth decay with fatal consequences. Being too poor, Deamontes mother could not find a dentist to treat her son, even with the help of a lawyer. He died as the bacteria from his infected tooth spread to his brain.

In 2000, the surgeon general of US reported that tooth decay was the most chronic ailment for children and that poor children were most at risk.

In spite of such modern innovations as the fluoridation of drinking water, tooth decay is still the single most common childhood disease nationwide, five times as common as asthma. Poor children are more than twice as likely to have cavities as their more affluent peers, research shows, but far less likely to get treatment.

Serious and costly medical consequences are "not uncommon, according to Norman Tinanoff, chief of pediatric dentistry at the University of Maryland Dental School in Baltimore. For instance, Deamonte's bill for two weeks at Children's alone was expected to be between $200,000 and $250,000.

The federal government requires states to provide oral health services to children through Medicaid programs, but the shortage of dentists who will treat indigent patients remains a major barrier to care, according to the National Conference of State Legislatures.

Access is worst in rural areas, where some families travel hours for dental care, Tinanoff says. In the Maryland General Assembly this year, lawmakers are considering a bill that would set aside $2 million a year for the next three years to expand public clinics where dental care remains a rarity for the poor.

Providing such access, Tinanoff and others say, eventually pays for itself, sparing children the pain and expense of a medical crisis.


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