Talking teeth


Talking teeth

In her eight years as a journalist with the Washington Post, Mary Otto wrote frequently about social issues of heartbreaking poverty and lack of access to health care.

But no story – or heartbreak – affected her quite like that of Deamonte Driver of Maryland.

Deamonte was the normally energetic 12-year-old boy who, in January 2007, came home from school one day complaining of a headache.

On his initial visit to the hospital, he was given medicine for the headache, sinusitis, and a dental abscess. He returned to school next day, but his condition worsened; the underlying problem had never been treated.

Twelve days and two brain surgeries later, Deamonte died. The bacteria from his infected tooth had spread, causing a fatal brain infection.

Otto was in Henrico Nov. 2 to address the Seventh Annual Virginia Oral Health Summit, a gathering of healthcare professionals and members of the Virginia Oral Health Coalition.

More than 200 members of the Coalition attended the meeting at The Westin Richmond – many of them fresh from reading Otto’s newly-published, Deamonte-inspired book: Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America.

‘It didn’t hit me’

In a Q & A session following her keynote speech, Otto described meeting Deamonte while he was hospitalized.

While she had read about the silent epidemic of dental disease in a 2000 report from the Surgeon General, she said she had not grasped the implications until that moment.

“It didn’t hit me – until I was in the hospital room with this boy,” she said. “By the time I met him, he’d had a couple of brain surgeries and was fighting for his life. But he was still trying to catch up on his math homework.”

A day or so after her visit with Deamonte, Otto called his mother to check with her before running the story – and was shocked to learn that the boy had succumbed.

Reaction to Otto’s Post story about Deamonte – who had died just a few miles from Capitol Hill – was swift, and often angry.

Maryland’s newly elected governor, Martin O’Malley, reportedly held up the Post headline in front of his cabinet and said, “What are we going to do about this?”

O’Malley appointed a dental action coalition, and Maryland ultimately overhauled its Medicaid dental system. On the national level, Deamonte’s death led to congressional hearings and heightened awareness of oral health access for Medicaid children across the country.

As Otto points out in her book, Deamonte’s plight was no isolated incident, but a national crisis. The same week that Deamonte died, a six-year-old in Mississippi died of a dental infection as well.

‘Searing’ stories

In Teeth, Otto traces the history of the dental profession and how it evolved into a system in which oral and medical health are largely separate, and dentistry is primarily a private industry serving those with the ability to pay.

Her opening chapter is devoted to the topic of beauty, and underscores the irony of a system that promotes expensive cosmetic procedures and “pageant smiles” for the “haves,” while one third of the “have-nots” are ashamed to smile – because a smile will reveal missing or unattractive teeth.

“We’re the country that made the Hollywood smile a status symbol to the world,” she told the crowd. “But so many people are unable to get even the most basic care.”

In Virginia, more than one-third (38 percent) of low-income citizens lack dental coverage. After Otto left the Post in 2008, she met some of these low-income Virginians as she traveled to dental clinics in underserved areas of the state.

With every clinic visit, she said, she met people who “seared” her. In Lee County, the person who seared her was a retired miner named Ernest.

Like many who are served by the clinics, Ernest had other health issues – but had put them aside to stand in a pre-dawn line hoping to get help for his urgent dental needs.

“He had a terribly swollen leg,” Otto said, noting that Ernest indicated he might end up losing the leg. It was an image Otto said she would never forget – “him standing on that diseased leg, waiting for oral care.”

Otto also cited the story of a young father in Ohio, Kyle Willis, who went to the emergency room for an aching wisdom tooth and was sent home with a prescription for painkillers and antibiotic.

“He couldn’t afford to get both prescriptions,” Otto said, “so he got the painkiller. And he died.”

Again and again, Otto documented cases in which routine dental care could have prevented death and disease. In Deamonte’s case, a routine $80 extraction might have saved him; yet the cost of his hospitalization amounted to more than a quarter million dollars.

As one pediatric dentist says in Teeth, “Tooth decay is virtually preventable, [yet] it remains the single most common chronic disease of childhood in the United States.”

Working for change

With events like the Summit, the Virginia Oral Health Coalition is working to change the dismal statistics and remove barriers to oral health care. In addition to educating future health care professionals and developing a Virginia Oral Health Report Card, the Innsbrook-based organization is creating regional alliances and advocating for legislative changes such as Medicaid expansion.

At the Summit, a member of the Virginia Dental Hygienists Association drew loud applause when she announced to Otto, “We have purchased your book, and are giving a copy to every Virginia legislator.”

Near the end of Otto’s book, she revisits the Deamonte Driver Dental Project mobile clinic that visits underserved areas of Maryland, bringing dental services to children who otherwise might go without.

The story of Deamonte Driver, Otto told the Westin audience, could be viewed as both a tragedy and a gift.

She quoted Maryland Congressman John Sarbanes, who once said that “Deamonte took us by the hand and escorted us through the health care system and pointed out all the places we could improve.”

“He led me, too,” Otto said of Deamonte.