Twelve-year-old dies from infected tooth as result of being too poor to treat it

[The Man]

The Washington Post writes:

Twelve-year-old Deamonte Driver died of a toothache Sunday.
A routine, $80 tooth extraction might have saved him.

If his mother had been insured.

If his family had not lost its Medicaid.

If Medicaid dentists weren't so hard to find.

If his mother hadn't been focused on getting a dentist for his brother, who had six rotted teeth.

By the time Deamonte's own aching tooth got any attention, the bacteria from the abscess had spread to his brain, doctors said. After two operations and more than six weeks of hospital care, the Prince George's County boy died.

Deamonte's death and the ultimate cost of his care, which could total more than $250,000, underscore an often-overlooked concern in the debate over universal health coverage: dental care.

Some poor children have no dental coverage at all. Others travel three hours to find a dentist willing to take Medicaid patients and accept the incumbent paperwork. And some, including Deamonte's brother, get in for a tooth cleaning but have trouble securing an oral surgeon to fix deeper problems.

In spite of efforts to change the system, fewer than one in three children in Maryland's Medicaid program received any dental service at all in 2005, the latest year for which figures are available from the federal Centers for Medicare and Medicaid Services.

The figures were worse elsewhere in the region. In the District, 29.3 percent got treatment, and in Virginia, 24.3 percent were treated, although all three jurisdictions say they have done a better job reaching children in recent years.

"I certainly hope the state agencies responsible for making sure these children have dental care take note so that Deamonte didn't die in vain," said Laurie Norris, a lawyer for the Baltimore-based Public Justice Center who tried to help the Driver family. "They know there is a problem, and they have not devoted adequate resources to solving it."

Maryland officials emphasize that the delivery of basic care has improved greatly since 1997, when the state instituted a managed care program, and 1998, when legislation that provided more money and set standards for access to dental care for poor children was enacted.

About 900 of the state's 5,500 dentists accept Medicaid patients, said Arthur Fridley, last year's president of the Maryland State Dental Association. Referring patients to specialists can be particularly difficult.

Fewer than 16 percent of Maryland's Medicaid children received restorative services -- such as filling cavities -- in 2005, the most recent year for which figures are available.

For families such as the Drivers, the systemic problems are often compounded by personal obstacles: lack of transportation, bouts of homelessness and erratic telephone and mail service.

The Driver children have never received routine dental attention, said their mother, Alyce Driver. The bakery, construction and home health-care jobs she has held have not provided insurance. The children's Medicaid coverage had temporarily lapsed at the time Deamonte was hospitalized. And even with Medicaid's promise of dental care, the problem, she said, was finding it.

When Deamonte got sick, his mother had not realized that his tooth had been bothering him. Instead, she was focusing on his younger brother, 10-year-old DaShawn, who "complains about his teeth all the time," she said.

DaShawn saw a dentist a couple of years ago, but the dentist discontinued the treatments, she said, after the boy squirmed too much in the chair. Then the family went through a crisis and spent some time in an Adelphi homeless shelter. From there, three of Driver's sons went to stay with their grandparents in a two-bedroom mobile home in Clinton.

By September, several of DaShawn's teeth had become abscessed. Driver began making calls about the boy's coverage but grew frustrated. She turned to Norris, who was working with homeless families in Prince George's.

Norris and her staff also ran into barriers: They said they made more than two dozen calls before reaching an official at the Driver family's Medicaid provider and a state supervising nurse who helped them find a dentist.

On Oct. 5, DaShawn saw Arthur Fridley, who cleaned the boy's teeth, took an X-ray and referred him to an oral surgeon. But the surgeon could not see him until Nov. 21, and that would be only for a consultation. Driver said she learned that DaShawn would need six teeth extracted and made an appointment for the earliest date available: Jan. 16.

But she had to cancel after learning Jan. 8 that the children had lost their Medicaid coverage a month earlier. She suspects that the paperwork to confirm their eligibility was mailed to the shelter in Adelphi, where they no longer live.

It was on Jan. 11 that Deamonte came home from school complaining of a headache. At Southern Maryland Hospital Center, his mother said, he got medicine for a headache, sinusitis and a dental abscess. But the next day, he was much sicker.

Eventually, he was rushed to Children's Hospital, where he underwent emergency brain surgery. He began to have seizures and had a second operation. The problem tooth was extracted.

After more than two weeks of care at Children's Hospital, the Clinton seventh-grader began undergoing six weeks of additional medical treatment as well as physical and occupational therapy at another hospital. He seemed to be mending slowly, doing math problems and enjoying visits with his brothers and teachers from his school, the Foundation School in Largo.

On Saturday, their last day together, Deamonte refused to eat but otherwise appeared happy, his mother said. They played cards and watched a show on television, lying together in his hospital bed. But after she left him that evening, he called her.

"Make sure you pray before you go to sleep," he told her.

The next morning at about 6, she got another call, this time from the boy's grandmother. Deamonte was unresponsive. She rushed back to the hospital.

"When I got there, my baby was gone," recounted his mother.

She said doctors are still not sure what happened to her son. His death certificate listed two conditions associated with brain infections: "meningoencephalitis" and "subdural empyema."

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, experts say. 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," said 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 said. 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 said, eventually pays for itself, sparing children the pain and expense of a medical crisis.

Reimbursement rates for dentists remain low nationally, although Maryland, Virginia and the District have increased their rates in recent years.

Dentists also cite administrative frustrations dealing with the Medicaid bureaucracy and the difficulties of serving poor, often transient patients, a study by the state legislatures conference found.

"Whatever we've got is broke," Fridley said. "It has nothing to do with access to care for these children."

Stories like this one explain why I find it impossible to comprehend how anyone can be against universal health care unless they simply hate the poor.

Discuss.

[Ugly Casanova]

My sister has an abscess tooth. It's gross, she keeps showing it to me.

...and she wont get it pulled out.

[Jak]

Originally Posted by Sockat0r

My sister has an abscess tooth. It's gross, she keeps showing it to me.

...and she wont get it pulled out.

Neither would I, punched the dentist I did. You don't see me going and dying.

[Saint]

I had an abcess once. It was disgusting. When I got it pulled, they numbed it, then forgot about me. When they finally came to pull it the anesthesia had worn off. *shudder*

I am not against the idea of universal health care. Unfortunately, such an idea is easier said than done and has to be a part of a larger change, as far as I understand the issues. One problem is that with universal health care, everyone gets the same care, whether from a good or bad doctor.

Also, wouldn't this completely eradicate the option of a second opinion?

[The Man]

Universal health care wouldn't necessarily eliminate the option of private practices, depending on how it was implemented, and nearly all implementations would allow for second opinions. If the government just funneled more money into its health programs, the system could run more or less as it is now, except that everyone would be guaranteed treatment for serious health issues. Whether that's the best way to run things or not is entirely up for debate, but I think most of us can agree it'd work better than what we have now.

[Ugly Casanova]

My sister has had three abscess teeth. =/

[anintendo_evafan]

Originally Posted by The Man

Universal health care wouldn't necessarily eliminate the option of private practices, depending on how it was implemented, and nearly all implementations would allow for second opinions. If the government just funneled more money into its health programs, the system could run more or less as it is now, except that everyone would be guaranteed treatment for serious health issues. Whether that's the best way to run things or not is entirely up for debate, but I think most of us can agree it'd work better than what we have now.

Oddly enough I do agree with The Man. If we just poored more money into health research programs and health treatment programs we might not see a definite change in treatment. But health care would be more readily available to the masses.

Still though. This is yet another sad day in American History *sigh*.

[Ragnarok]

I am actually for a universal health care program. If we funneled as much money into defense spending as we did in health care the kid would still be around. Yet this problem also lies in poverty too.

[anintendo_evafan]

Yes if we invested all the hundreds of billions of dollars that we invest into the defense of our country, well alot more lives would be saved daily. But that will never happen. Remember, taking lives is more important than saving lives.

[Dave]

Originally Posted by The Man

The Washington Post writes: Stories like this one explain why I find it impossible to comprehend how anyone can be against universal health care unless they simply hate the poor

You nailed it

[anintendo_evafan]

That seems to be the only logical excuse.

[ECCENTRICHOCOBO]

I'm almost convinced the American government only wants there to be two kinds of people in this world--the ones who join the military to fight the leaders' wars, and the good civilians who spend money to maintain the economy...so that we can spend more money on military, of course! Everyone else is useless to them, I fear.

[Etheon]

Which is why everyone should live in good old Canada. Sure, we elected Stephen Harper, sure, our environment plan...well, we don't have a real one per se, but hey, we have health care!

[Jak]

Originally Posted by Freudian Slip

My sister has had three abscess teeth. =/

I only had 2, I think.

[Daryl Falchion]

This kind of **** never fails to piss me off. Why teeth aren't considered a part of the medical services covered (at least in places like Canada) is beyond me. It's still your health and, as shown, it can do serious harm and even cause death. It seems to me that this is one of the many flaws in the system and one that the government wouldn't be too eager to fix. *sighs*

[thekingoftheempire]

All of you are ****ing selfish.
Here I thought I was but damn.

[The Man]

Er. How the **** is anyone who's posted in this thread being selfish? Please refrain from making unprovoked attacks on other members in the future, especially in the debate forum.

[Tycoon]

This is one of the proofing factors that democrats are the way to go. I am tired of going to wars (and not caring for people like Deamonte), rather then caring for ourselves, like our neighbors up north.

[Ssj7Crono]

feel bad about the 12 year old. stuff like this shouldnt even happen. even if there isnt any universal health insurance at the moment at least any others should be affordable.

[thekingoftheempire]

Maybe I shouldn't went on the attack...but hey, thats me.
Anyway, what I meant is that no one in this thread cares what happen to that kid. Its meaningless to them.
All is that they care is that they don't want it to happen to them.