Accord to advance dental care for kids

The Baltimore Sun

Alyce Driver shed silent tears at a news conference yesterday to announce new pediatric dental programs aimed at preventing deaths such as her son Deamonte's, who died in February at the age of 12 after an unchecked tooth infection spread to his brain.

The Prince George's County woman has avoided attention since her son's death forced lawmakers here and in Washington to focus on improving dental care for children of poor families. But she attended the event at the University of Maryland Dental School in Baltimore to witness something positive come from her loss.

With Driver as their witness, officials with the dental school and UnitedHealth Group, a Medicaid provider, agreed to work together to train dentists in pediatric dentistry, hire a pediatric dental fellow to provide care to poor children full time and employ a case manager to ensure that Medicaid recipients, especially children, see a dentist regularly.

The managed-care organization will provide about $170,000 to the dental school to pay for such efforts, said Dr. Allen Finkelstein, chief dental officer of AmeriChoice, a UnitedHealth Group company. The managed-care entity serves Maryland residents under the name UnitedHealthcare Medicaid. More money could follow, said UnitedHealth Group officials.

"Ms. Driver is glad to know that good things are coming out of this," said Laurie J. Norris, an attorney with the Public Justice Center in Baltimore who worked with Driver before and after her son's death. "She agrees that no more children should die."

Deamonte was a healthy boy, but by the time he told his mother about a toothache that was causing his head to throb, he was seriously ill. An infection in one of the boy's teeth had spread to his brain and even surgery could not save him. He died Feb. 25.

Although Deamonte's case was rare and complicated by the fact that his mother had let his Medicaid coverage lapse, it spotlighted the need for improved access to dental care by thousands of poor and low-income children across the nation.

"We have to make sure that our children are healthy," said U.S. Rep. Elijah E. Cummings, a Maryland Democrat who has reached out to Driver in the aftermath of her son's death. Cummings also facilitated discussions between UnitedHealth and the University of Maryland Dental School.

In Congress, Cummings introduced "Deamonte's Law," which would increase dental services in community health centers and train more pediatric dentists. He has also worked to increase dental services through the Children's Health Insurance Program. That program was recently approved for reauthorization but is now under threat of veto by President Bush.

Locally, fewer than one in three children in Maryland's Medicaid program received any dental service in 2005, the latest year for which figures are available. Medicaid is a federal-state program that pays for health care for low-income families with children, as well as other individuals.

Driver, a single mother of four other boys, required help from Norris to find a dentist to see another son, DaShawn, who was also suffering from poor dental hygiene. Norris and others who tried to help Driver said that many dentists' offices told the mother that they could not see DaShawn because they were not accepting new Medicaid patients.

A review of the list of dentists provided to Medicaid beneficiaries in the state found that many of them had stopped accepting new patients, in some cases because dentists said they were not being sufficiently reimbursed.

A committee of dental experts and advocates for the poor is reviewing reimbursement levels and other issues that could affect access to dental care. The committee is expected to deliver a list of recommendations by the end of the month.

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