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Deamonte's legacy

After Deamonte Driver, a 12-year-old Maryland boy, died from an untreated dental infection in 2007, it's hard to forget that an $80 tooth extraction could have saved his life. Never have the words "system failure" rung so true.

For more than 10 years, the U.S. surgeon general has recognized dental disease as a "silent epidemic" impacting low-income and minority children most severely. Maryland was no different. By 2006, more than one-third of all Maryland kindergarteners and third-graders had untreated decay in their primary teeth, but more than 70 percent of children in the state's Medicaid program had not seen a dentist in the past year.

All that changed after Deamonte Driver.

His tragedy spurred a comprehensive response. Maryland's federal legislators decried the situation and called for federal reforms to help bolster state Medicaid and public health dental programs. Gov. Martin O'Malley and Secretary of Health and Mental Hygiene John Colmers convened the Dental Action Committee — a statewide coalition of dental and medical health care providers, insurers, advocates, policymakers and academics — to study the oral health system.

The committee quickly realized there were several fundamental problems in our system of oral health care, hitting low-income and minority children the hardest, and it recommended a roadmap to address the disparities. The governor included many of these measures in his budget, and the Maryland General Assembly took action, modestly increasing Medicaid rates, simplifying the Medicaid system, providing for additional safety net dental clinics and approving a new public health dental hygienist work force to provide educational and preventive services in schools, Head Start, and similar settings.

The results are real. In the three years since the Deamonte Driver tragedy, Maryland has become a nationally recognized model for oral health care. According to a February 2010 report by The Pew Center on the States, Maryland was one of only six states to earn an "A" for its oral health programming.

We applaud state policymakers and health professionals for this tremendous progress. That is why the newly formed Maryland Dental Action Coalition, with support from the DentaQuest Foundation, recently recognized Maryland's leading oral health advocates with the Oral Health Hero Award for their contribution to making the state a national leader in oral health.

But the work can't stop there.

The Dental Action Committee also found that most people don't understand the importance of oral health, resulting in missed dental appointments and inadequate oral hygiene and dietary practices.

Only one-third of mothers thought oral health was important for their infants, according to a survey by the American Dental Association. The American Academy of Pediatric Dentistry also found that just 14 percent of parents realized that tooth decay in children can ultimately lead to the need for a root canal — even in infants.

With an estimated 1 out of 10 children reporting mouth pain from untreated dental decay, we have to do more to raise awareness. After all, what good is a top-notch oral health system if no one knows how to use it?

The good news is that oral health literacy campaigns can help. The ADA also found that 78 percent of parents would take their children to visit a pediatric dentist before their first birthday, if only they knew oral health care early in life would lead to improved oral health as their children developed. Getting that early care is critical for a child's overall development, since we know that children who have untreated dental disease face greater learning challenges, impaired nutrition and, in the case of Deamonte Driver, even death.

Now that we have the infrastructure, we need the public education. People must understand the importance of oral health, how to prevent oral disease and how to access dental services. With the help of new federal and private foundation funding, an oral health literacy campaign is being planned to empower the public to improve dental behavior and have a better idea of how to find dental services. The Maryland Dental Action Coalition is working hard to get the word out across the state.

We also have to consider the national state of oral health awareness. Important provisions in the national health care reform law require a national oral health prevention education campaign that focuses on reaching those who would benefit most, especially low-income and minority families. Now it's up to Congress to fund it. And we urge them to do so.

But as we consider the challenges ahead, we also encourage Marylanders to take this moment to appreciate how far we've come — how tragedy has been transformed into a legacy of commitment and cooperation to improve the lives of Maryland's children.

Jane Casper is a dental hygienist at Children's Dental Office in Baltimore and an advocate for access to dental care for children. She recently served as chair of the Maryland Dental Action Coalition. Her e-mail is jcasperrdh@gmail.com. Ralph Fuccillo is president of the DentaQuest Foundation, which is committed to optimal oral health for all Americans (www.dentaquestfoundation.org). His e-mail is ralph.fuccillo@dentaquestfoundation.org.

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