Dental reform act could save lives [Commentary]

12-year-old Deamonte Driver of Prince George's County came home from school in February 2007 with a headache, which had started as a toothache days before. His mother, who made ends meet with low paying jobs, searched for a dentist who would accept Medicaid and found nothing. At wits end, she brought her son to the emergency room, where he received medication for pain, a sinus infection and a dental abscess.

But Deamonte did not get better. The bacteria from his cavity spread to his brain. Two surgeries and weeks of intense care and therapy could not save him. Deamonte Driver died — for lack of a simple procedure early on to remove a tooth.


Since the passage of the Affordable Care Act, the topic of health care has become a part of our national dialogue, and much of the discussion has been insightful and constructive. As a country, we have begun to take a hard look at ways to slash our nation's health care costs, improve access to care, decrease health disparities and keep Americans healthy. But too often we overlook a critical part of health policy: oral health.

Deamonte's case serves as a jarring lesson on the state of oral health for many Americans, and a call to action. Too often we think of dental care as an optional service. In reality, it is crucial component of overall health — something Deamonte's death helped many to realize. In 2007, fewer than one in three children under the age of 20 in Maryland's Medicaid program received any dental service at all, with even lower rates of care in neighboring Virginia and D.C. In fact, only 37 percent of children on Medicaid nationally received any form of dental care.


We've made immense progress in the seven years since Deamonte's death. When Congress reauthorized the Children's Health Insurance Program (CHIP) in 2009, it made changes that positively impact access to dental care. In Maryland, 52 percent of children on Medicaid now receive dental services. Nationally, the number of children enrolled in these programs who got dental care in 2010 has jumped to 46 percent. These numbers are still too low, but certainly a sign of progress.

The Affordable Care Act now allows hundreds of thousands more children to receive critical medical and dental care right now. Many more children could access these services if Republican governors in some states reversed their decisions to block the expansion of Medicaid. Receiving Medicaid benefits, as the Affordable Care Act intended, would be life altering for those low-income families, and it's just one of the ways the law is helping Americans. The ACA is one of many important steps we've taken in recent years, but more must be done to ensure oral health for every American.

Passing the Comprehensive Dental Reform Act, H.R. 3120, would go a long way toward that goal. While we've extended coverage for dental services, we haven't yet addressed the lack of access to dentists and care facilities that many families face. According to the Health Resources and Services Administration, there are 4,600 areas designated as Dental Health Professional Shortage Areas, places where there is only one dentist per 5,000 people. H.R. 3120 would provide funding to improve access to dental care through health clinics, school-based services and other options for underserved populations. It would also extend comprehensive dental coverage to Americans on Medicare, Medicaid and VA Benefits; increase the number of oral health professionals in communities in need; and help support research and education to better integrate oral health with regular care.

The discussions we have started since the passage of the Affordable Care Act must continue. They must look more broadly at the way we approach health care in the U.S. They must also include a renewed attention to oral health, the important role it plays in leading a healthy life, and policies like those introduced in the Comprehensive Dental Reform Act.

We must do everything in our power to prevent needless tragedies like the death of Deamonte Driver and to confront the disparity of care that separates so many Americans. When we keep Americans healthy, we reduce our nation's health care costs, ensure a strong and vibrant workforce, and give everyone the tools they need to succeed.

Rep. Elijah E. Cummings, a Democratic congressman from Baltimore, is the author of the Comprehensive Dental Reform Act. His email is Rep.Cummings@Mail.House.Gov.  Dr. Norman Tinanoff is director of the Division of Pediatric Dentistry, within the Department of Orthodontics and Pediatric Dentistry at the University of Maryland School of Dentistry.

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