For Want of a Dentist (Uninsured boy dies of toothache in DC)

[UrbScotty]

http://www.washingtonpost.com/wp-dyn/content/article/2007/02/27/AR2007022702116.html">Absolutely ridiculous.

<snip>

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.

<snip>

[Waya]

1. Outrageous........

:mad:

[Quantess]

2. Just like in the "good old days"

Egyptians sometimes died of complications from tooth decay, partly because they ate sweets and didn't brush. I was stunned when I first learned that people used to die from tooth decay! Well, now we can embrace a return to the good old fashioned ways of the cradle of civilization. Just like in B.C and biblical times. Hallelujah!

[AZBlue]

3. I read this article and two things bothered me:

One was the needless death of this poor young boy and the pain that his family is now in. My heart goes out to them all.

Second is the focus on children only as needed dental and generally better health care. Let's face it, this is a crisis that affects seniors, adults and children alike. Each age group has a different set of needs and concerns when it comes to dental care, but each is just as important and, in cases like this, dangerous. We need to remember that not only children in this country are suffereing as a lack of health care - adults and seniors need it just as much.

[qanda]

4. You are exactly right

Kids are not the only ones who need dental care. In fact, kids are much more likely to receive dental coverage as a part of Medicaid than adults. I believe it is mandated by the Federal government that dental be covered for children who are receiving Medicaid and there is no such mandate for adults. It would be interesting to see the numbers of adults who are dying from poor dental care.

[SemperEadem]

16. the problem is not the medicaid

the problem are the doctors/dentists who will not take it for payment.

[uppityperson]

17. Exactly, It is getting really hard to find a dentist who will take it.

They are becoming fewer as time goes on, especially for older kids since they get paid so little.

[politicat]

25. There aren't numbers, per se, but a good indictator is 20-40 heart probs.

The big nasty complication of an abscess is pericarditis, an inflammation of the sac around the heart. It kills fast, and a lot of times, when a young person drops dead of a heart attack that's not drug/steroid related, it links back to gum disease. There's a lot of evidence coming out on it now; oral infections apparently get into the rest of the body pretty easily (NYT article here: http://www.nytimes.com/specials/women/warchive/980217_1362.html) It also looks like a period of poor dental care (which a lot of us, especially women) go through after college and before really "making it" or while we have young children underfoot that is later taken care of by catching up is still a risk factor because damage gets done and can't be repaired.

[uncle ray]

5. the thinking is

that we can start providing for children, because they have no power over their situation, then once we are taking care of our children we can expand coverage to other groups. single payer health care won't happen overnight, our best hope is to get there in small steps.

FWIW i was one of those children who slipped through the cracks, my parents earned too much to take advantage of any help, but were put off by the cost when the dentist said i NEEDED braces to fix my extremely crooked teeth, so they never took me again. they straightened out on their own over the years, now as a relativley young adult i have nice straight plastic teeth.

[NashVegas]

32. That's Such a Shame

I was in a similar situation, but was fortunate to be in a school system that cared enough about its students to make it a real issue with my family, so I got the braces.

It's something we shouldn't have to think about, but there is real prejudice placed on people in social situations and in job interviews when it comes to how messed up someone's teeth are. We (the US) are obsessed with it. The slightest gap and we automatically think, 'redneck.'

[Cronus Protagonist]

14. Yes, this is a much bigger problem

Everyone needs water, everyone needs food, everyone needs shelter, everyone needs dental care and everyone needs health care. These are the basic cornerstones of any civilized society. We provide free water, less so free food, less so shelter, and least of all are health and dental care.

We as a country can spend literally billions of dollars to kill people on the other side of the world, but we can't afford to fill a child's tooth before it abscesses. I know a poor kid first hand who had a similar problem, but myself and a friend intervened and my friend paid for the dental work. He lost his tooth, but we got it before it abscessed, although it was infected and he required a course of antibiotics, but he didn't lose anything else.

Myself, I had to put off going to the dentist for almost ten years due to lack of money, and eventually I had to go into debt over $10,000 to get all my lower and two upper molars crowned. My final choice was debt or toothless. I chose debt. In this, one of the richest countries in the world, why is this a common dilemma for its people, particularly when we can apparently afford to wage elective wars at great cost with little to no benefit to the country?

How fucked up is that?

[SemperEadem]

15. health care is directly tied to 'right to life' and no republican should be allowed

any space from that fact when they beat their chests about being a 'pro life candidate'. They should be asked "whose life?" and "how much are you prepared to tax in order to assure quality of life"?

[AZBlue]

20. They stop caring about life at the moment of birth.

It's absurd.

[Not a robought]

24. Until that life makes their first million

then they start caring again.

[LibDemAlways]

6. There is a new law in California that

children will not be admitted to school without proof of a dental exam. When I was in the dentist's offce with my daughter last week, another mother wondered aloud if there was a program to assist low income families with paying for that necessary exam. I attempted to find the information on the web and it's not easy. I did find one link to a site that provides a list of clinics. I'm wondering if parents will be given the name of a local clinic along with the dental exam info. when they receive the school admssion packet

Unfortunately, there's an "opt out" provision for parents who don't get it done. For people who simply cannot afford it, that will probably become the easy default option.

[Quantess]

7. "...children will not be admitted to school without proof of a dental exam."

Perfect solution! That means children who haven't had dental care don't have to go to school, either! :wtf:

[nolabels]

9. Nobody wants to get cooties from people with icky chompers

I think it is a good law and especially for those people who want to stay home and eat candy :sarcasm:

[Quantess]

10. Right? I understand why vaccinations are required for school.

Vaccines are required so that preventable, communicable diseases are discouraged from spreading. But, how does that apply to dental care? CA's new law makes no sense to me.

There's probably a handful of kids who consider themselves lucky. They get to avoid the dentist AND school.

[nolabels]

13. Preventive dental and health care should be mandatory really

Our government is too busy feathering the nest of corporations to care about the publics health. They even make laws more amenable to candy makers to help them sell more of the product. I have to put blinders going into the neighborhood supermarket because of knowing how all the adulteration that goes on for most food.

We are all worth more dying a slow death by corporations than living a healthy life.

[LeftHander]

8. "Universal heathcare would cost too much..."

Jackass republicans cannot see beyond a simple bill.

$250,000 spent in attempts to save this boys life would of allowed 500 others to visit a dentist.

the real issue is people are making money, lots of money off of this sick country...

[Megahurtz]

11. Ha Ha! In "the Richest Country in the World"!

:sarcasm:

What a fucking joke this Country is. I am humiliated to be here.

[dennis00]

12. University Dental Schools

are much less expensive than private dentists. They are in business to teach, not to make money. It seems like some kind of Federal arrangement could be worked out to give low income families access to good medical care at a dental school. My work was done at USC years ago for less than 1/4th the cost of a dentist. The students are already certified dentists, doctors, so you won't get a first year newbie working on your chops.

[politicat]

26. Not enough of them, though....

I went through something similar with a friend in November -- she had a nasty bone infection that resulted from a botched wisdom tooth extraction that was an emergency thing, because she has no insurance and may break the poverty level in a good year. Getting her into the University dental school program took a lot of work because they're can really only take about 300 clients a year and they were full. (The fact that she was an odd case helped a lot.) If the University of Colorado can only take 300 a year (and it's not a small program), there's no way that the university system can cover everyone who needs care.

Dental care needs to be covered under medical care. Period.

[MadMaddie]

18. Maryland boy, 12, dies after bacteria from tooth spread to his brain

http://www.msnbc.msn.com/id/17372104/

So the Neocons would have you believe that cutting welfare and pushing the poor into more poverty will help the poor pull themselves up by their bootstraps.

All children in America must be provided health care and dental care. The mother of this child worked but none of her employers provided health or dental insurance...out of 2200 dentist in Maryland only 700 take Medicaid....no car and only public transporation...and the choice of working or taking the child to an appointment...

This is * cabals US...American children dying because of a preventable disiese....

[TroglodyteScholar]

19. dupe

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=102x2749843

[redqueen]

21. We need single-payer coverage...

that's all there is to it.

[mainegreen]

22. A friend of mine from Siberia almost died from something like this.

Dental care over there was not too good. The infection was slow, but eventually spread to his heart. He had strokes, open heart surgery and is damned lucky to be alive.

No dentistry or bad dentistry can and does kill.

[haele]

23. Why is "dental" care considered different than "medical" care?

It seems as if society thinks that what goes on with teeth is not a medical issue. What is this? - "if you aren't born with it, it ain't important"? If someone has diabetes due to poor health habits, they're treated the same as someone with diabetes due to genetics. Healthy teeth - and by extension, healthy gums - are just as much a product of genetics as is diabetes or heart issues. It's not just cosmetic to insure that people have a full set of healthy teeth. Plaque, bacteria, inflamed nerves and chronic pain in the mouth have been linked to all sorts of chronic and fatal syndromes in the rest of the body.

Why would any competent medical authority consider problems with teeth any different than problems with, say, bones and their connective tissues?

/personal rant -

I have chronic weak teeth and bones due to a work-related chemical exposure a few years back, and while I can be covered by workman's comp for any future bone or respiratory issues, I'm not covered for "any future dental issues". If I had lost my teeth within 6 months of the exposure, they might have covered it, but 8 years (and three employers, two of whom did not provide dental plans) later, they tell me "we can't be sure that it's the chemical or poor hygiene".

I've found out the hard way what separate medical and dental plans ends up costing the average family. The dental plan may only cost a fraction of the medical plan, but a separate dental plan never covers enough if you have more than a cleaning and perhaps one cavity a year. If the medical plan included the dental, the family may pay about $10 to $12 a month more per person on the medical and the minimal co-pay for the dental visits, but in the long run, it would cost less to both the insurance in administration and patient in visits.

I don't understand why non-cosmetic dental would not be covered the same as non-cosmetic medical - I pay a $15 co-pay for medical and they pay 80% of all tests, inpatient procedures and labs, so I never really see more than perhaps $200 for a major procedure, yet should I have two cavities and need a root canal and it's attendant post and crown, I'm paying $700 after the $1200 "limit" of covered dental care is reached - this is what happened with the kidlet this year. She had an urgent care visit/emergency room visit that was billed for over $10K - of which we only had to pay $300 - $200 for the hospital visit and $15 for each of the doctors that saw her.

It seems that it would be far more cost effective to everyone; insurance co., dentist, and consumer that non-cosmetic (i.e. "medical") dental procedures be covered in the same insurance policy as the rest of the other medical procedures - heck, the family Optometrist, my OB/GYN, my kid's Pediatrician, my husband's Rhumitologist, Cardiologist, and certified physical therapist - all of them specialists who are covered equally under my medical plan. So why isn't my dentist under my medical plan, too? Isn't my dentist a doctor, too? Didn't he or she also go to medical school?

Right now, I am being faced with a choice - 6 root canals due to stress fractures in the tooth surface of all my molars or a session of yanking finishing off with a partial bridge. Neither of which I can afford to pay for until the root canals for both the kidlet and the hubby are paid for - which won't be until, say, June? July?

Tell me why this situation should be considered non-medical - why am I faced with waiting on how to choose between "saving my teeth" with a set of root canal procedures for over a $5K, or yanking out the 6 for $200 with an additional $4K for the bridge? The bacteria and plaque build up in my still untreated teeth is just as dangerous and almost as critical as a bacteria and plaque build up in, say a smashed, untreated finger. All of this cost after I pass the $1.2K that my "dental plan" grants me for coverage over the year.

I'm a f'n project manager; mid-level professional. With this economy, I don't seem to be paid very much any more, but I still have responsibilities to my employer. I can't just have all my teeth yanked and still be able to "do my job" and be taken seriously. The mumble factor itself is a huge disability when attempting to communicate with customers and co-workers.

Even with the provided dental plan, I can't afford real dental care until it gets to emergency room visit level of pain. I have to save up a good $1000 up front and will still be paying $100 - $200 a month just to pay off the work that needs to be done, and that's if I want it done at once. If I'm willing to wait 7 years, I can get each tooth done one at a time and live with the pain and the chance of developing a serious medical condition due to the plaque or a possible septic infection in a cracked tooth.
Whereas I can go in to my OB/GYN and get a pap-smear, a polyp biopsy and all attendant lab work done for around $120 total. And if they do find a problem like cancer, I can get treated right then and there for about $150 a session and under $100 a month for the perscriptions I will need during the 4 to 6 month period. And follow-up visits would only be $15 to $30 a visit.

That's just unacceptable.

//end Rant

Haele

[AX10]

27. This is 21st Century America?

:wtf:

[northzax]

28. MARYLAND

not DC. come on.

[GoddessOfGuinness]

29. Childrens Hospital, where the boy died, is in DC...

But the family is currently living in the MD suburbs.

This story is heartbreaking...

[northzax]

30. but his lack of dental treatment

the thing that caused the problem, was Maryland. his end-stage treatment was paid for in DC. We have enough problems without being blamed for bad health care in the exurbs. Of course he came to Children's it is one of the top two or three children's hospitals in the country.

sorry, I am a bit sensitive to criticism. worth noting that in DC, he would have had access to the emergency dental care that would have prevented all of this in the first place.

[GoddessOfGuinness]

31. Understandable...

I live in Prince Georges County. Before Ehrlich, we were on the right track with regard to ensuring the good health of children, if not the rest of the population. I hope O'Malley gets us back on track.

Unfortunately, the quality of social services in Prince Georges County has suffered ever since Ray-gun. These are the people that would not only be able to help poor families get through the necessary paperwork, but would push for a simpler, more streamlined process via the government.