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DETROIT - Black children from Detroit's poorest families have among the worst teeth of any group of children in the nation, according to a recent study by professors at the University of Michigan.
It's not uncommon for Detroit children as young as 1 or 2 years old to have numerous teeth rotten to their gums - even before all their baby teeth have come in, according to several pediatric dentists.
By age 5, more than half of Detroit's low-income, black children have cavities; another 35 percent are showing initial signs of dental decay. That's nearly twice the national average. Nationwide, about 28 percent of 5-year-olds have cavities.
There are many explanations for the statistics gathered by U-M dentistry professor Dr. Amid Ismail and his colleagues. They include not enough public education on how to practice good dental hygiene, too few pediatric dentists in the area, especially ones who will take Medicaid, and poor eating habits.
"One of the problems in our society is we have very easy access and social acceptance of soda pop, almost as a substitute for water," said Dr. James Stenger, chief of the dental department at Children's Hospital of Michigan in Detroit. "It's very highly acetic, and it's got very high levels of sugar. ... I see lots of kids in here who have almost all their teeth pulled out, and they're 3, 4 years old."
In Wayne County, Mich., there are only two places where parents can take children younger than 3 for free or Medicaid-covered dental work, according to the Tri-County Dental Health Council, a nonprofit group that runs a referral service and coordinates the work of volunteer dental professionals.
One is the Detroit Health Department, which runs a free pediatric dental clinic with one dentist. The other is Stenger's clinic at Children's Hospital, which accepts Medicaid and is now taking nonemergency appointments for April.
Low-income parents in nearby Oakland and Macomb counties don't have many more options. In Oakland, five pediatric dentists accept Medicaid, according to the Dental Health Council, though all have restrictions. One isn't taking new patients, for example. Another only sees patients with disabilities.
In Macomb, the council lists just two pediatric dentists who take Medicaid, and they won't take patients older than 4.
"I talk to people on a daily basis, moms and dads who have kids who are 1 and 2 years old and have five cavities," said Karen Trompeter, the council's executive director. "There's almost no place to take them."
And the problem is only getting worse. In the past few years, pediatric dental clinics at Henry Ford Hospital and the Detroit Institute for Children closed. Recent changes in the Michigan's Medicaid reimbursement policies haven't helped. This fall, Medicaid stopped covering dental expenses for many low-income adults. That means clinics that used to see older children along with adults on Medicaid have seen some of their business dry up.
University of Michigan's Ismail is working with the Detroit Health Department to reverse the downward spiral in the dental health of the city's poorest children. With nearly $8 million in grants from the federal government and other sources, he is offering free dental screenings and launching a public education campaign.
Ismail's efforts couldn't come soon enough for Caprice Manciel, a 3-year-old who recently had her four decayed upper front teeth pulled by Dr. Mona Ibrahim, the lone pediatric dentist at the Health Department. Caprice's teeth were rotted because she sucked on a bottle most of the day and during the night. Her mother, Monique Pearson, had taken Caprice to three other dentists. All refused to care for her. The procedure, which would have cost thousands of dollars, was free for Pearson.
"She was the baby and everyone babied her. They gave her her bottle," Pearson said. "Now that has really cost my daughter."
HOW TO PREVENT CAVITIES
-Don't let babies go to bed with a bottle.
-Don't let babies drink from bottles all day.
-Don't dip pacifiers in honey, syrup or anything sweet.
-Don't let your children drink pop.
-Limit your children's consumption of juice and other sugary foods.
-Clean your baby's teeth with a clean washcloth or soft small toothbrush after each feeding.
-Take your child to the dentist as soon as his or her first tooth appears and every six months thereafter.
-Floss and brush your children's teeth and tongue after breakfast and before bed starting at age 1. Hold the brush at a 45-degree angle to the teeth. Brush each tooth using continuous circular motions. Brush the front of all the child's teeth, then brush each tooth on the side facing the tongue, then on the biting surface.
-As children grow, they can brush their own teeth in the morning. But parents should continue to brush their children's teeth at night through age 8.
-Have your children rinse thoroughly with water after eating lunch or snacks.
Sources: Detroit Health Department, Children's Hospital of Michigan
(c) 2003, Detroit Free Press. Distributed by Knight Ridder/Tribune News Service.