The Silent Epidemic, 2007

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.

Believe it.

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.

Deamonte Driver, sitting next to his mother, Alyce, shows the scars from incisions for his brain surgery. (By Linda Davidson -- The Washington Post)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.

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7 Responses

  1. I thought of you – right after I thought of my mom, who is a champion for dental care – when I read this post. Then Jeanne, who wrote about not being able to afford glasses in her youth. What is wrong with this fucking country?

  2. I am trying to reach Heath Foster. Have I done so?
    (If so, Heath, your politics are even further to the left than mine). — jeb

  3. Sorry, no. I’m not Heath Foster. Not in this life, anyway.

    As for the leftiness, what’s “left” about dental care? What’s “left” about acknowledging the Class War and its effects? Most people would call that “human”. Is “humanity” only a left-wing value?

  4. I take your point, and certainly agree with you that the “care” you write about should not have some political valence attached to it.

    As to whether or not “humanity is only a left-wing value,” I have no clue. You seem a bit edgy about terminology, which is fine. But, if you are going to subject the notion of “leftiness” to such scrutiny, you should consider whether your substitute term — “humanity” — holds up all that well.

    Are you really such a foundationalist that you believe all of us — those who care and those who don’t — can arrive at some common understanding (interpretation?) of humanity?

    All I really wanted to do was track down Heath. If you have any ideas in that regard, please let me know. Thanks.

  5. You seem a bit edgy about terminology…

    Quite true, tho I didn’t mean it to come out that way this time. I only meant, as you put it, that “’care’…should not have some political valence attached to it”. Maybe I’m touchy because it so often does, particularly with conservatives.

    It’s not that I mind that conservatives attach the words “left” or “liberal” to a social consciousness. I’m kind of proud of that, in a way. But it bothers me when people think of such things as either a political stance or a negative. Like when helping someone in trouble proves you’re a wimp or a bleeding heart or somebody so stupid they don’t understand the way the world is supposed to work.

    Are you really such a foundationalist that you believe all of us — those who care and those who don’t — can arrive at some common understanding (interpretation?) of humanity?

    I guess so. (The word “foundationalist” puzzles me. Not sure what you mean by it.) I do believe that, and I believe it because I’m old enough to remember when it was true. There was a time when the word “humanity” as I used it had a very clear definition agreed on by all but psychotics and sociopaths. To have or display “humanity” meant showing compassion, generosity, and benevolence to your fellow beings. No one ever argued about that, they only argued about how and when. It was not until the rise of neoconservatism in the late 70’s and early 80’s that the definition itself was first challenged and then turned on its head. Before that, even people who didn’t do it agreed with it.

    As for Heath, can’t help you. Don’t know him, don’t why you’d think I would. Have you tried whois?

  6. Thanks for your thoughtful reply. For the record, I am a plaintiffs’ attorney. My clients, most of whom are workers’ compensation and/or social security disability claimants, are the kinds of people you obviously care so much about.

    I am happy to have stumbled into your blog.

    Heath, by the way, is/was a reporter for the Seattle PI.

  7. I am a plaintiffs’ attorney. My clients…

    My congratulations and thank you. The work you do is neither popular nor terribly lucrative, but it’s awfully damned important to the people involved.

    Send me your email address. (Mine is on the sidebar: mick@mickarran.net) If you don’t mind. I’d like to be able to let people know what’s going on with workman’s comp and SSI – what kind of issues your clients face, what kind of tricks get played on them, what the rules are these days, what kind of discrimination they’re subjected to, that sort of thing. IOW, I’d like to be able to pick your brain from time to time.

    My audience isn’t large but it’s choice and growing. Maybe we can help each other. I’m offering Trenches as an outlet, if you’re interested. If your clients have stories to tell, I’d like to help them do it. If you have issues you think are being ignored or need more attention paid to them than the standard glossover, this is one place they will get it.

    Think it over. And pass it along if anyone else in your office or line o’ work is interested. They’re all welcome here, clients included.

    Heath, by the way, is/was a reporter for the Seattle PI.

    No shit! I read SPI every day online – it’s one of 5 dailies I never miss. It’s one of only 2 papers I know of that do decent coverage of workers’ issues (the other one is the Atlanta Journal-Constitution). I don’t recognize the name, but I must have read his stuff if he’s been active in the last 4 years. If I run into him, I’ll let you know.

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