Why American Children Have Rotting Teeth

Dentists and emergency rooms are treating young patients with blackened teeth from decay, bacteria and many cavities since they can’t afford to go to the dentist for routine check-ups.

Congress held a hearing on children’s dental health in 2007 after a 12-year-old boy, Deamonte Driver, died when his tooth infection spread to his brain. His family was on Medicaid, but couldn’t find a dentist that would take Medicaid, and couldn’t afford to pay out of pocket.

Dentists don’t like to accept Medicaid patients because the Medicaid reimbursement rates are so low. Usually the cost of delivering the service is more than the reimbursement they receive. Also, Medicaid patients typically have transportation problems and thus higher rates of not showing up for scheduled appointments, which leads to another loss of income for the dentist.

But if children don’t go to the dentist, the infections can lead to root canals at an early age, heart disease, stroke, diabetes and osteoporosis.

The ER is the New Dentist’s Office

Since many dentists don’t accept Medicaid, those on it resort to going to the emergency room to get dental work. The Pew Center for the States did a study in February and discovered that preventable dental conditions were the main reason for more than 830,000 emergency room visits in the U.S. in 2009, which is up 16% from three years before.

But the ER doesn’t have trained dentists or dental hygienists on staff. All the ER staff can do is treat the patient for tooth pain through antibiotics, but they can’t help if the patient needs more extensive dental work.

The care given in the ER is ten times more expensive than going to a routine dental exam, but Medicaid pays for the ER visits, so it’s easier for those with Medicaid to get care than trying to go to a dentist’s office.

Many children end up in the ER with painful toothaches since parents don’t see the point in routine dental care for their kids. They think since baby teeth are going to fall out anyways children don’t need to visit the dentist.

But if baby teeth aren’t taken care of permanent teeth might not be aligned properly, may not even come in, and as the Deamonte Driver case above shows, tooth infections may even lead to death.

Dr. D’ Alfonso is an Austin dentist who works at the Lakeway Center for Cosmetic and Family Dentistry. He understands how many people have difficulties finding dental care and takes dental mission trips to help people in need in Mexico.