In effort to improve dental health, city screens hundreds of children

Line up, open wide

October 23, 2007|By Nick Madigan | Nick Madigan,Sun reporter

"Show me your smile," the dentist, wielding a flashlight, said to the slightly apprehensive 3-year-old girl standing before her. "You brought your teeth with you?"

At that, the little girl grinned. Maybe this wasn't going to be so bad after all.

The dentist, Dr. Patricia L. Bell-McDuffie, director of oral health services for the Baltimore City Health Department, was one of several medical professionals who gathered this morning at an East Baltimore community center to inspect the mouths of about 300 children ages 3 and 4 and enrolled in Head Start programs.

"Now, Jackie, you need to do a better job of brushing those front teeth, OK?" Bell-McDuffie said gently to another girl. "Every night, before you go to bed."

Such elementary instructions were a staple of the session, part of an effort to improve dental care for low-income inner-city children in the wake of the death in February of a 12-year-old Maryland boy from a tooth infection that spread to his brain.

The screening was necessarily perfunctory, given the number of children, and involved no X-rays. But in most cases it was enough to determine whether a child had visible tooth decay, gum disease or other problems.

"I just saw a boy with two bombed-out teeth," Bell-McDuffie said, referring to a pair of primary second molars in the mouth of a 4-year-old that were so decayed they had large holes. "He was a severe case, but the majority of them have no obvious cavities."

The boy, who was accompanied by his grandmother and has health insurance - somewhat of a rarity in this group - was referred to the University of Maryland Dental School for treatment. He and other children were also given toothbrushes, toothpaste and educational materials.

When another 4-year-old, Tyrell Sinkler, was examined this morning, he was found to have a mouth almost full of fillings, and three or four teeth appeared to have been extracted. But, relatively speaking, those were good signs.

"The beauty of it is that he had treatment," said Dr. Clemencia Vargas, a member of the Department of Pediatric Dentistry at the University of Maryland Dental School. "In this population, 50 percent of the kids will have decay, and not necessarily with treatment."

The free exams at the Oliver Community Center on East Federal Street followed widespread outrage over the death of Deamonte Driver of Prince George's County on Feb. 25. His mother said at the time that she was unable to find a Medicaid dentist who would see him.

The death laid bare the problems with the state's Medicaid system, which can be difficult to navigate and has one of the worst reimbursement rates in the nation for basic dental procedures, according to a 2004 survey by the American Dental Association. Rep. Elijah E. Cummings, a Maryland Democrat, accused the Bush administration of failing to provide adequate dental care to poor children, and in May introduced "Deamonte's Law," which would increase dental services in community health centers and train more pediatric dentists.

"We must protect our children from this sort of needless suffering, and we must begin with the youngest of children," Cummings said this morning at the community center before the examinations got under way. "An untreated tooth infection is far scarier and uncomfortable than the routine care that can prevent it."

Dr. Harry Goodman, a dental school professor and supervisor of Head Start's dental health programs in a six-state region that includes Maryland and Delaware, said as he examined children today that "culturally sensitive" education is crucial if deaths like Deamonte's are to be avoided.

"Deamonte Driver was failed not only by not being able to get a dentist," Goodman said, "but because he didn't have the education or the attention to prevent tooth decay from happening in the first place."

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