The tooth fairy's revenge Quiet crisis: Maryland's low priority for oral health has far-reaching consequences.

September 16, 1996

IF YOU BREAK your leg, an emergency room will treat you. But suffer the excruciating pain of an abscessed tooth and unless you have adequate dental insurance or can afford to pay for care, you're out of luck. The most a hospital will offer you is a pain killer or two and maybe an antibiotic for the infection.

Dental care is a low priority in Maryland, and the state has the statistics to prove it. Although the state ranks 27th in the number of people who contract oral cancer, poor screening for the problem pushes Maryland to fourth in the country in the number of deaths.

As The Sun's Diana K. Sugg reported recently, the state's efforts to contain Medicaid costs have taken a cruel toll on teeth. For example, after the state cut off dental benefits for adult Medicaid recipients, there was a 21.8 percent increase in the number of these patients ending up in emergency rooms.

Every day thousands of Marylanders, including many children, suffer from dental problems and the resulting pain. Staffers in school health clinics say that untreated dental problems are a common reason for students to seek out their help. Imagine trying to concentrate on algebra with an aching tooth. Imagine, too, the added tension in a crowded home when parents already under stress are coping with a throbbing jaw.

Maryland's dental crisis has some obvious causes and some practical solutions. The soaring cost of Medicaid has created financial pressures to curtail benefits or, as in the case of adults, to cut them completely. As more Medicaid patients move into managed care, there is an opportunity to correct that, provided the state health department enforces the requirement that HMOs provide dental care for children -- and that it also encourages providers to offer coverage for adults.

Beyond that, there is clearly a need for better public education on dental health. Surveys have found that even families with dental insurance can be negligent in getting proper care. A state that has done as much as Maryland has done to discourage smoking can surely find a way to ensure that teeth get their due.

Pub Date: 9/16/96

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