A couple of years ago I wrote a post called “The Silent Epidemic” about the lack of dental care for the poor.
There’s a perception that dental health is somehow a ‘luxury’. Not for the poor, it isn’t. We are judged more harshly by our appearance than most, and teeth are a big part of that. I grew up with a kid who’d had to have his teeth removed and replaced by a dental plate before he was 12. He was ostracized by other kids, seen as retarded by the school administration even though he was quite bright, and in general placed on a path that would ensure he never rose above his ‘natural place’.
It’s something we suffer in silence and nobody else is talking about it, either. Dental insurance exists but it’s prohibitively expensive even though most dental procedures are a lot cheaper than your standard medical procedure; health insurance will pay thousands of dollars for a tonsillectomy but refuse to pay a few hundred for a root canal. I don’t, in all honesty, know why.
Maybe it’s because only the poor need help paying for such things.
I remember wanting to mention at the time that poor dental care can sometimes mean death but I didn’t write that because I didn’t think anybody would believe me.
Twelve-year-old Deamonte Driver died of a toothache Sunday.
A routine, $80 tooth extraction might have saved him.
If his mother had been insured.
If his family had not lost its Medicaid.
If Medicaid dentists weren’t so hard to find.
If his mother hadn’t been focused on getting a dentist for his brother, who had six rotted teeth.
By the time Deamonte’s own aching tooth got any attention, the bacteria from the abscess had spread to his brain, doctors said. After two operations and more than six weeks of hospital care, the Prince George’s County boy died.
I want you to imagine, just for a moment, what it must have been like to live with an abscessed tooth for, what? months? Think back to the last time you had a tooth abscess. Remember the excruciating pain? The pain so bad you wanted to bang your head against a wall to make it stop? The pain thousands of milligrams of aspirin couldn’t touch? And you probably only had to deal with it for a few hours until you could get to your dentist. Can you imagine having to live with such pain day after day, week after week?
Now imagine you’re his mother and you have two sons and one of them is in even worse shape and you can’t afford the high prices dentists charge to help either one of them. Both are always – always – in pain and you can’t do anything about it because somebody mailed your Medicaid eligibility forms to the wrong address.
By September, several of DaShawn’s teeth had become abscessed. Driver began making calls about the boy’s coverage but grew frustrated. She turned to Norris, who was working with homeless families in Prince George’s.
Norris and her staff also ran into barriers: They said they made more than two dozen calls before reaching an official at the Driver family’s Medicaid provider and a state supervising nurse who helped them find a dentist.
On Oct. 5, DaShawn saw Arthur Fridley, who cleaned the boy’s teeth, took an X-ray and referred him to an oral surgeon. But the surgeon could not see him until Nov. 21, and that would be only for a consultation. Driver said she learned that DaShawn would need six teeth extracted and made an appointment for the earliest date available: Jan. 16.
But she had to cancel after learning Jan. 8 that the children had lost their Medicaid coverage a month earlier. She suspects that the paperwork to confirm their eligibility was mailed to the shelter in Adelphi, where they no longer live.
And while you’re screwing with the govt bureaucracy put into place by conservatives to make sure only the “deserving poor” get help (conservatives always assume the poor are ripping off the govt for services they don’t really need so they add layer-upon-layer of paperwork to a] make sure they aren’t and b] discourage as many as possible from applying), your second son, who, you think, only has one bad tooth, complains of a headache.
Two short months later, after two operations, he’s dead. (In the photo above, Deamonte Driver, sitting next to his mother, Alyce, shows the scars from incisions for his brain surgery. [By Linda Davidson -- The Washington Post])
She said doctors are still not sure what happened to her son. His death certificate listed two conditions associated with brain infections: “meningoencephalitis” and “subdural empyema.”
In spite of such modern innovations as the fluoridation of drinking water, tooth decay is still the single most common childhood disease nationwide, five times as common as asthma, experts say. Poor children are more than twice as likely to have cavities as their more affluent peers, research shows, but far less likely to get treatment.
Here’s a quote from the article in the Seattle Post-Intelligencer that sparked my original post two-and-a-half years ago:
Meanwhile, those who do have the private insurance accepted by mainstream dentists are sometimes getting more treatment than they need, experts say. Tooth-whitening, a $600-million-a-year industry, has become the fastest growing segment of dentists’ practice, according to a 2002 American Dental Association survey.
“We have one group of people that is way over-seen, and another that is not being seen at all,” said Dr. Peter Milgrom, director of the University of Washington’s Northwest and Alaska Center to Reduce Dental Disparities.
A common rule of thumb in the dental world is that 80 percent of cavities are found in 20 percent of the patients — people who tend to be poor, elderly and members of immigrant and minority groups. (emphasis added)
In the last 2 years, nothing has changed. Nothing. Except, maybe, that the problem has become even worse from the constant cuts in Medicare and Medicaid demanded by a Republican Congress and a president who is even now demanding more cuts to pay for his illegal war. Meanwhile, the lack of dental care often results in much larger Medicaid bills.
Serious and costly medical consequences are “not uncommon,” said Norman Tinanoff, chief of pediatric dentistry at the University of Maryland Dental School in Baltimore. For instance, Deamonte’s bill for two weeks at Children’s alone was expected to be between $200,000 and $250,000.
The hope that this situation might change is most likely forlorn.
“I certainly hope the state agencies responsible for making sure these children have dental care take note so that Deamonte didn’t die in vain,” said Laurie Norris, a lawyer for the Baltimore-based Public Justice Center who tried to help the Driver family.
Don’t hold your breath, Laurie. Deamonte was poor and black and nobody gives a shit. In a week his death will be forgotten even by the paltry few who knew about it, and the Democrats will have to fight a concerted battle against Bush and the Republicans just to keep “entitlement programs” like Medicaid from being cut even further. The modern GOP, run by “movement conservatives”, has no conscience. It sees welfare and entitlement programs as a “beast” and its purpose is to starve that beast.
And so the Gingrich/Norquist/Bush strategy of deliberately creating huge deficits in order to use the resulting budget squeeze to strangle social programs is coming to fruition….
They’re going to tell you they ‘have no choice’. They’re going to say ‘economic realities’ are forcing their hand. They’re going to say, ‘We’d like to but we can’t–there isn’t enough money.’
Bullshit. They did this deliberately. They’ve been planning to do it since Reagan’s first term almost 25 years ago. Nothing about it is ‘accidental’; nothing about it is a ‘response to economic conditions’. It was engineered from the beginning to do exactly what it’s doing….
Killing people. The poor, the black, the immigrant, the old. Deamonte’s death isn’t an “accident”. It’s the result of a deliberate Republican strategy of Social Darwinism wherein the strongest and meanest takes all and the weakest dies. Deamonte’s death is small change compared to the thousands of hungry and homeless, the tens of thousands who have been killed in Iraq, the hundreds of thousands of elderly who have died before their time, and the millions who have been downsized and laid off into near-poverty by a corporatocracy that only reads the bottom line of its stock portfolio and is outsourcing globally to find the cheapest workers and the weakest, most corrupt govts.
Near the end of a speech he made about the same time I wrote the original post, Bill Moyers put it this way:
I know, I know: this sounds very much like a call for class war. But the class war was declared a generation ago, in a powerful paperback polemic by William Simon, who was soon to be Secretary of the Treasury. He called on the financial and business class, in effect, to take back the power and privileges they had lost in the depression and new deal. They got the message, and soon they began a stealthy class war against the rest of society and the principles of our democracy. They set out to trash the social contract, to cut their workforces and wages, to scour the globe in search of cheap labor, and to shred the social safety net that was supposed to protect people from hardships beyond their control. Business Week put it bluntly at the time: “Some people will obviously have to do with less….it will be a bitter pill for many Americans to swallow the idea of doing with less so that big business can have more.”
The middle class and working poor are told that what’s happening to them is the consequence of Adam Smith’s “Invisible Hand.” This is a lie. What’s happening to them is the direct consequence of corporate activism, intellectual propaganda, the rise of a religious orthodoxy that in its hunger for government subsidies has made an idol of power, and a string of political decisions favoring the powerful and the privileged who bought the political system right out from under us. (emphasis added)
It’s important to remember that, as Ralph Nader has said over and over again, the Democrats are almost as beholden to these forces as the Republicans. There’s not much in the way of real change we can expect from them as long as our election system is bought and paid for with campaign contributions from corporations and the rich. There will have to be a lot more Deamontes before that system can even be dented, let alone dismantled.