Lailah Bench was not happy on a recent Tuesday morning, and for good reason: The 5-year-old was facing extensive oral surgery that would make an adult anxious.
And that's why she was at Laurel Regional Hospital.
Lailah had her dental work done at Laurel as part of a new program that allows pediatric dentists to use the hospital's operating room rather than their own offices for their younger, more high-risk patients and more complex cases. Doing so gives the dentists access to trained anesthesiologists and other hospital resources, which means they can do in one sitting what otherwise might involve multiple visits and a restless, often resistant young patient. And, they can do it more safely and painlessly as well.
Lailah's surgery was over in less than an hour, and her father said it went as well as the family had hoped.
"It was really quick and really easy," said Aaron Bench, of Olney. "It was all great. We had no issues."
For now, the only dental practice with privileges at Laurel Regional's new program is that of Dr. Jerome Casper, a pediatric dentist with offices in Olney and Gambrills.
Until he began using Laurel Regional last month, Casper had been seeing all of his more difficult cases at Shady Grove Adventist Hospital, in Rockville. But the waiting time for space there can be longer than six months, he said, and some of his patients can't wait that long.
"These are usually our more acute cases, and they need timely work," he said.
Since he began seeing his first patients at Laurel Regional in mid-February, Casper has treated 10 or 12, and he could not be more pleased.
"Laurel Hospital has been wonderful to us," he said. "The anesthesiologists and staff have been so wonderful to us and the young children. They're as good as any place we've been to before. I've been telling the staff, 'You could've fooled me that you weren't doing pediatric dental cases before, because it's been so seamless.' "
Dr. Trudy Hall, Laurel Regional's vice president of medical affairs, said the new program grew out of her close ties to the dental community. Her husband, Dr. Maurice Miles, is a dentist in Laurel and president of the Maryland State Board of Dental Examiners. Casper's wife, Jane Casper, is a dental hygienist and secretary of the board.
Together they helped awaken Hall to a shortage in Maryland of hospitals willing to help handle complex cases involving children or special-needs patients.
"There's a need for a safe, comprehensive environment for dentists to do these procedures," Hall said.
She said opening Laurel Regional's operating room to complex pediatric cases makes the service more accessible not only to families in Prince George's, but to those in Howard, Anne Arundel and other counties.
"All of our anesthesiologists are trained in pediatric life support," she noted. "We also have an on-call pediatrician 24 hours a day. … We're set up to be able to provide a much safer environment than a dentist's office."
Hot issue in Prince George's
Pediatric dental care has been a hot issue in Maryland — and especially in Prince George's County —since the 2007 death of a 12-year-old county resident, Deamonte Driver. Deamonte died after an infection from an untreated abscessed tooth spread to his brain. The family's Medicaid coverage had lapsed.
While the new pediatric dental care at Laurel Regional is not a direct result of that tragedy, Hall said the death focused attention statewide on the importance of pediatric dentistry.
"It's sad when something bad has to happen before the health care community or state lawmakers try to do what needs to be done," Hall said.
Frank McLaughlin, executive director of the Maryland State Dental Association, said state-mandated changes since the death that have made dental care more accessible to children go "hand-in-hand" with efforts such as the hospital program in Laurel.
Since the 2007 death, he said, "there's an emphasis in the state on all levels, government and private, on making children and parents aware of the importance of dentistry."
He said programs like Laurel's help the cause.
"I applaud the hospitals that schedule time for these procedures now," he said. "A lot of times you definitely need a hospital to get work done on children that needs to be done, so this is great that hospitals are opening their doors like this. … They're not making money off of this."
Opening the Laurel operating room to pediatric dentists was not a profit-driven decision, Hall said.
"To be honest, they're not a very profitable service line, like orthopedic or other general service lines," she said. "For us, it was just an ethical decision, the responsibility we have as a health care institution in Laurel to provide access for these kids."
Neither Hall nor McLaughlin were sure exactly how many hospitals in Maryland opened their operating rooms to dental cases. But they said more were needed and Laurel's is the first in Prince George's County.
Expansion expected
Hall said the dozen or so patients seen so far in Laurel should be just the start of something bigger. Hospital officials plan to expand the practice, she said, and already are in the process of adding two interested Laurel-based pediatric dentists to the list of those with privileges at Laurel Regional.
"We'll continue to grow as needed," Hall said. "We want to make sure it's running well first, then … we'll advertise to other dentists in the area and see if there's more interest."
Casper, meanwhile, said he expects to see patients at the hospital more than just one day a week, as he does now.
"Some of my fellow pediatric dentists want to have like a group, with a regular block of time, to use the hospital," he said. "I really think they see a need, and we definitely had a need for this."
Parents of children who've already used the service also see the need.
"This way was easier on her and easier on us," Aaron Bench said of his daughter's hospital surgery. "Instead of doing like 50 different visits, they got it all done here at once."
Kathy Anderson, whose 2-year-old granddaughter, Braelyn Gentry, had her teeth capped at the hospital the same day as Lailah's surgery, echoed that sentiment.
"I think it's easier on the child and the mom to get it all done at one time, to be safe," she said immediately after the surgery. "The dental office is more intimidating and you have multiple procedures. This was just a lot easier."