ANNAPOLIS – Children across the nation will get free dental care today, but youngsters in rural Maryland are being left behind.
In Maryland, 47 dental care providers are participating in the nationwide Give Kids A Smile initiative, which provides free basic dental care to under-insured children, and aims to call attention to the issue of child dental disease.
Rural regions statewide have higher levels of oral disease and decay, yet only one practice is participating on the Eastern Shore, and just two in Western Maryland. In the rest of Maryland, 19 practices are participating, including three each in Baltimore, Columbia and Rockville.
More than half of school-age children living on the Eastern Shore suffer untreated child dental decay, worst in the state, according to a Survey of the Oral Health Status of Maryland School Children, conducted in 2000 to 2001.
Access to affordable dental care has been an ongoing issue in the state, as dentists migrate from the rural areas to more lucrative suburban and urban areas.
Dwindling volunteers in rural areas makes it hard to accommodate patients who rely on donated services, said Lillian Marsh, director of the National Foundation of Dentistry for the Handicapped.
The foundation provided more than $530,000 in free treatment throughout last year to disabled patients on fixed incomes. It has five people on its waiting list in Kent County, where just one of four dentists in the county volunteers.
This is typical of the rural areas, said Marsh. Rural Maryland has spotty dental coverage, but Marsh said there wouldn’t be a problem providing donated care if more dentists would help.
Eastern Shore dentists have a different view:
About five years ago, area dentists volunteered to treat the school system’s worst cases – children who couldn’t afford care and needed it most, said Dr. Robert D. Jones.
The program purposefully avoided the bureaucratic Medicare system.
It flopped. Parents didn’t sign up and those who did missed appointments.
Dentists abandoned the program when the state switched to managed care coverage under HealthChoice in 1997, Jones said. However payments under that program never got high enough to cover dentists’ overhead costs, he said.
“Other states have taken the same amount of money that was allocated in Maryland, and gotten wonderful results,” he said.
In 2000, the General Assembly enacted the Maryland Dent-Care Loan Assistance Repayment Program, providing dentists up to $70,000 in loan repayment assistance over three years if they meet a quota of Maryland Medical Assistance Program patients during the period.
The Dent-Care program supports 15 doctors serving the Medicaid population in Maryland, with two on the Eastern Shore and one in Garrett County.
Still, the state ranked 44th nationwide, with only 18.9 percent of Medicaid children receiving any dental care in 2001, according to the latest data available from the ADA.
That’s up from Maryland’s dead last ranking in 2000, when only 10.9 percent of Medicaid eligible children got care.
Dentist Melanie M. Burke Delaney is a volunteer for Give Kids A Smile. Her office will serve 13 children from Head Start and pre-schools in the Baltimore area, where 48 percent of school-age children suffered untreated tooth decay in 2000 to 2001.
Burke Delaney has volunteered screening children since the early 1990s, but says that many times notifying parents that children need services is not enough.
“I would see things that needed correcting . . . and then I’d go back, and the same kids would have the same (untreated) problems,” she said. “The reason I was so enthusiastic about Give Kids A Smile is that not only do I get to give the exam, I also get to perform the treatments.”