A Brooksville woman was charged with child abuse this morning following complaints that she didn't properly take care of her son's dental health needs.

Vanessa Wright, 30, was transported to the Hernando County Jail after authorities claim that on four separate occasions she didn't follow through with dental treatment for her 5-6 year-old son, resulting in a hospital trip in July to All Children's Hospital in Tampa to treat infection. The Florida Department of Children and Families is also investigating the matter.

According to sheriff's reports, Wright originally took the child to the Hernando County Health Department in October 2008 to treat his teeth. After not following through with treatment, she took him for treatment in February 2009 to Cobbe Dental & Orthodontics in Spring Hill where the boy was given the same diagnosis. Again, treatment allegedly wasn't followed through.

Following the July hospital visit, the boy was again referred to Cobbe Dental in August, however Wright again allegedly didn't follow through with treatment.

Wright reportedly had Medicaid that would've covered the cost for the dental treatment at no cost to her.

Bond was set for Wright at $10,000.

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Comment

First question: When does it become neglect? 

When the child suffers pain? When infection is present?  When the child gets his/her fifth cavity? ...First cavity?

Since the child may be too young to be held responsible, then ANY damage of the enamel on ANY of the teeth really should be considered as neglect by the parent(s), should it not? Or should we wait until decay gets so bad that it burrows into the nerve chamber in order to consider it neglect? At what point do we actually declare it a crime?  Interesting considerations, no?

Second question: Who is responsible? 

Don't the dentists or hygienists, as the 'professionals,' have an obligation to nip the issue in the bud by taking the parent and child aside after the exam to drive home the danger at the first sign of decay - to teach the proper hygienic procedure and dietary regimen for keeping the teeth healthy? One could argue that they would.

The professionals know full well that, at the first sign of decay, there is a dangerous situation and trend developing which will not improve if things don't change with the child's hygiene and parents' oversight. So, who should be the scape-goat? I know that the parent doesn't want to pay extra for a serious lesson in hygiene and that is why you won't find a 'Home-Hygiene Specialist' on the payroll at most dental offices. No doubt, they will have a 'financial specialist' to handle insurance reimbursement or out-of-pocket payment arrangements. We are often expected to be referred to endodontic specialists for root canals or periodontal specialists for a little more focused work on gum diseases, but never for education beyond a strong admonition by the dentist or hygienist in the exam room.  But they aren't really trained to do that.  They are trained to repair teeth.

However, if there is a situation developing in the child's mouth, the professionals KNOW that further rot and decay is sure to develop unless better hygiene habits are adopted... Doesn't some of the responsibility, then, fall on the shoulders of the profession? (I know... "We TELL the patients, but they don't listen...!")

Perhaps the insurance companies should adopt true hygiene education programs conducted by the profession so they could be reimbursed for that extra time with the patient. The effectiveness of the program would certainly be easy to track, wouldn't you agree? But then, if the patients were all that successful in keeping their teeth healthy, it would probably affect the professionals' bottom lines.

In this particular case involving Vanessa Wright, a Medicaid recipient, perhaps the federal, state and local governments should share in the responsibility for providing such a poorly run program, where one is hard-pressed to find a professional who will even accept Medicaid subscribers. Why? Because Medicaid is one of the absolute worst insurers when it comes to number of denied claims, the length of time that the professional must wait for re-reimbursement (up to 5 months in many cases), and the paltry amount actually paid out on a claim. (Physician's Practice Magazine, June, 2009) Many, many professionals simply will not accept the Medicaid patient for those reasons.  (Of course, the PC spin says it is the private insurance companies.  Well, ask the doctor if you want the truth.)

So wouldn't our government bureaucrats, running such an undesirable program, have some culpability for circumstantially limiting access to more professionals? For not incorporating an educational program for both the parent and child, whereby the professional could be properly reimbursed for such a program? For not providing an effective and motivational hygienic and nutritional program for the professional, the parent and the child, aside from a 'treatment plan' designed to address only the symptoms?

Yet, these are the same bureaucrats who will look down their noses at, and bring charges against a parent for the child's decaying teeth.  Do they truly understand the seriousness of the problem after watching all those happy and healthy looking seniors on TV giddy over their denture adhesives -- like dentures are nothing more than an inconvenient, yet normal part of life?  How important could natural teeth really be, then??

Ultimately, I might agree that since the parents have the most access to the children, they have the most responsibility in the matter. Yet, is every parent equal in his or her knowledge in the matter? If the profession, supported by the government in this case, lacks an effective and motivational prevention-centered program which can be effectively conveyed to the parent and the child - shouldn't they also share in that responsibility? 'We the people' are certainly paying through the nose for the effects of poor lifestyle -- we certainly are quick to complain about smokers and the obese for driving up health care costs -- wouldn't you be a little happier knowing that some of that chunk, sliced out of your every paycheck, be going toward a more educational approach to better oral health, rather than treating symptoms of one disease, as Dr. Nara puts it, "...they could be CURING all along?" One must ask, "Why the absence of such a program? Why the lack of culpability on the part of the profession (including the Florida and American Dental Associations, in this case) and the government (or private) insurance providers?"

That brings us right down to 'We, the people.' 

We are very quick to scream about the injustices done to us or pointing the finger at the 'ignorant' individual going to jail for neglect (assuming, of course that it was neglect, in this case, and not some other reason), yet we fail to do anything more than flip or click to the next, more interesting story about Tiger Woods' affair, or which celebrity looks good in a bathing suit this year. Our social values are sinking to new lows and we feel little, if any, responsibility and TAKE little, if any, action regarding the decay of our society other than to shoot email out to our lists, forwarding jokes and cutesy good-luck angel stories... Yet, we have the nerve to shake our fingers at those 'found' guilty of their own ignorance while we depend on Big Brother to solve all of our problems... then whine because he does such a lousy job at it. At the same time, we park and raise our children in front of wider and wider television screens spewing worthless mental nutrition akin to 20 years of living on mental hot dogs, chocolate chip cookies and carbonated sugar-laden beverages. I suppose this will continue until we all accept and assume the proper responsibility that we have shucked off on 'the profession' or 'the government' or '(plug in whatever fits).'

You might say, "Yes, but in this case, the mother, Vanessa Wright, failed to follow up on a specific treatment plan prescribed by the dentist! That's different! She was supposed to take her kid back to the dentist for treatment! It isn't about 'hygiene... "' BULL! It has everything to do with hygiene and nutrition and observation and so on. Mainly, it has to do with education, in my view. When that poor kid's teeth get all fixed up, does that solve the problem? Sure it does...

...until he walks out of the dental office.

Vanessa is in the government 'caretaker' program, for goodness sakes! How could things have gotten so bad with this child in the first place? We are on the eve of handing it ALL over to the federal government to take care of so everyone can have equal access to medical treatment. What about education in addition to treatment? Is that in any of the proposals? I remember the hygienist coming to my grade school once or twice a year to instruct us in proper oral hygiene. Today, our children know more about condoms than tooth brushes. Times change, I suppose.

Well, I've given you my thoughts. What are yours? Would you mind taking a moment and completing a short survey on the issue?

Thank you,

Tom

Answers to these questions are anonymous