The story began in 2006 when DaShawn, then 9 years old, began having severe toothaches and mouth pain.
He had to miss school because of the pain, and at other times, had to go to class with swollen cheeks. “It hurt
all the time unless I put pressure on it,” said DaShawn, who carried around old candy wrappers to bite down on
for that purpose.

The first dentist who agreed to see DaShawn under Medicaid did a consultation but refused to take him as
a patient because the youth was fidgety and “wiggled too much in the dentist’s chair,” said Alyce Driver.

She then sought help from the Public Justice Center in Baltimore, Maryland.47 The staff obtained a list of
primary care dentists who claimed to accept DaShawn’s Medicaid managed care plan. The first 26 providers
on the list turned them down. They eventually found a primary care dentist for DaShawn, who confirmed that
he had six severely diseased teeth that needed to be pulled, and advised his mother to take him to an oral
surgeon. Alyce Driver once again turned to the Public Justice Center, which in turn consulted the Department
of Health and Mental Hygiene, the local health department and the state’s Medicaid plan. They secured the
earliest available appointment with a contracted oral surgeon—six weeks later. After an initial consultation, an
appointment was set several weeks after that to begin the extractions. But when Alyce and DaShawn Driver
showed up for the rescheduled appointment, the surgeon’s staff told them they no longer accepted Medicaid
patients, Alyce Driver said.

It was at about this time that Deamonte—whose teeth appeared to Alyce Driver to be in much better shape than
DaShawn’s—became severely ill from an infection from an abscessed tooth that had spread to his brain. He was
hospitalized, underwent two brain surgeries and died six weeks later

The next oral surgeon the Drivers found for DaShawn a month later—again with the help of the Public Justice
Center’s staff and a team of case workers—immediately pulled one tooth and agreed that five others were badly
enough infected to require extraction. But the dentist insisted that DaShawn come back to have one tooth
taken out every month for five months, said Alyce Driver. “I said, ‘Wow, am I going to lose my other son, too?’”
she recalled. The University of Maryland Dental School clinic in Baltimore agreed to take DaShawn’s case, and
removed the rest of the diseased teeth promptly.

http://www.pewcenteronthestates.org/uploadedFiles/Cost_of_Delay_web.pdf

Low income children miss out on dental care | Voices of Central Pa:

"Tooth decay affects 48 percent of Pennsylvania children by the age of eight, even those who drink fluoridated water, according to the [Pennsylvania] Department of Public Welfare. By age 15, this increases to 50 percent. Thirty-three percent of low-income children have untreated tooth decay compared to only 10 percent of children in higher-income households.

Good dental health involves many factors, including diet and good brushing habits, but children also need to see a dentist regularly. American children routinely develop cavities and tooth mottling (fluorosis) [from too much fluoride]."

"In his practice Kelly said he commonly sees two-year olds with an average of 10 decayed teeth. Tooth decay in this age group is caused mostly by the sugars in soft drinks, juices and juice boxes, and by allowing children to go to bed with bottles."

From ADA News 1/27/2010

"Dr. Donald W. Marianos, a public health consultant, said that prevention of early childhood caries in this specific population [Native-American] has seen very limited or no improvement over the past 30 years, despite implementation of community water system fluoridation, fluoride rinses, dental sealants and oral health education."

"According to statistics presented at the symposium, ECC prevalence is about 400 percent higher in AI/AN children than for all U.S. races. In addition, ECC is often much more aggressive and destructive in AI/AN children. In some AI/AN communities, up to 50 percent of the children have such severe caries that they require full mouth restoration under general anesthesia—a rate about 50–100 times that in all other U.S. races. Severe ECC often leads to a lifetime of oral health problems."