Four years ago this February, Prince George’s County, Md. was devastated when 12-year-old Deamonte Driver died after complications from a tooth abscess.

His mother Alyce, who worked at low-paying jobs, had unsuccessfully searched for a dentist to treat Deamonte’s toothache who would accept Medicaid. Alyce took Deamonte to a hospital emergency room, where he was given medicine for a headache, sinusitis, and a dental abscess and sent home. His condition worsened, and he was back at the hospital being rushed to surgery, where it was discovered that bacteria from his abscessed tooth had spread to his brain.

Too late

Heroic efforts were made to save him, including two operations and eight weeks of additional care and therapy totaling about $250,000 – all too late. Deamonte died on February 25, 2007 – when his life could have been saved by a routine dental visit and an $80 tooth extraction.

Tooth decay is the single most common chronic childhood disease – five times more common than asthma and seven times more common than hay fever.  Dental care is an often overlooked but critical component of comprehensive health care for children.  Pain and suffering due to untreated dental disease can lead to problems in speaking, eating, and learning.  For children caught without dental coverage, dental problems can quickly become more than "just" a toothache.

Research shows children who lack basic dental care miss more days of school and see their overall health suffer. According to the Children’s Dental Health Project, "The oral health of children has a significant and lasting impact on the productivity of our existing and future employees and leaders... Untreated tooth decay is progressive and can be devastating to children’s long-term health, educational achievements, self-image, and overall success." In extreme cases lack of dental care can even lead to fatal complications.

Excluded from insurance

Despite its importance, dental coverage is largely excluded from many private insurance plans, and pediatric dentists can be difficult to find.  For every child without health insurance, there are 2.6 children without dental coverage.  Uninsured children are 2.5 times less likely than children with insurance (public or private) to receive dental care.

Since Deamonte’s death, Congress has recognized dental coverage as an important component of comprehensive care for children, enacting major policy changes to improve dental coverage for children.  In 2009, the reauthorization of the Children’s Health Insurance Program (CHIP) required states to provide dental coverage to enrolled children, and gave states the option to provide dental benefits to certain children who do not qualify for full CHIP coverage.

In 2010, the health reform bill required that all insurance plans to be offered through new health insurance exchanges starting in 2014 include oral care for children, and prohibited these insurers from charging out of pocket expenses for preventive pediatric oral health services.  Other provisions will help train more dental health providers.

A new report by the Children’s Dental Campaign of the Pew Center on the States calculates that more than 31 million Americans are "unserved" – meaning they live in areas where they can’t find a dentist in or near their community.  In seven states, more than 20 percent of the population can’t find a dentist.

Now a model

Maryland has become a model for reform. One innovative solution is mobile dental clinics staffed by volunteer dentists, and in November the Deamonte Driver Dental Project Mobile Unit, a large van now equipped as a three-chair children’s dental clinic, made its first stop by spending the day at Deamonte’s old school.

These victories are all part of the solution still needed to make sure all children receive the dental health care they need to survive and thrive.

Marian Wright Edelman is president and founder of the Children’s Defense Fund (www.childrensdefense.org).