On Arbor Day, each child would plant a tree. The smell of cut grass and the heat reflecting off the dust in the open field created vivid memories of life and replenishment. The watering cans left a dark mark for each new twig on the hillside, one for every child.
In an act of practical symbolism, children gave new life; the very forests that would fill their own adult world. A casual drive through American towns and cities today reveals these patches of woods, of varying ages, some already defined as “old growth.”
Sadly, these woods stand as remnants of a forgotten past. Largely no longer renewed, tall trees and shady grounds represent a time when a desire to serve, to grow and to nurture our young stood fast. Today, as this is written, congress debates, with the threat of a veto, whether children without access to health care will be insured in the CHIP (Children’s Health Insurance Program). Maddeningly, whether oral health care will be included, the CHIP program remains uncertain as the amount of appropriation devoted to CHIP fails to remain whole against competing needs.
As adults and surgeons we have not just an obligation, but a desire to see new life take root and to flourish in good health. Nowhere can OMS do this better than by tending to the oral and maxillofacial health needs of children.
The most unmet health need in America’s children is oral health care. It is 4 times more likely that a child will not have a dental health care need met than to be denied medical care (Fig 1).1 This correlates exactly with the ability to pay for care. While 45 million Americans are without health insurance, 160 million, nearly 4 times that number, are without dental insurance.
While individuals cannot make national policy, each of us can act to improve the status of children. The America’s Promise Alliance, an organization founded by Colin Powell in 1997, provides a template for individual action to help children towards better lives.2 In 2001, America’s Promise Alliance was given an award by George W. Bush for oral health programs in Kentucky. That program, sponsored by the University of Kentucky, made an oral health commitment to children according to America’s Promise Alliance principles. Symbolized by the red wagon (Fig 2), America’s Promise Alliance recommends that all young people have access to “Five Promises”—or fundamental resources—to help them succeed in life. Alliance research has found that children who receive at least 4 of the Five Promises are much more likely than those who experience only 1 or zero Promises to succeed academically, socially, and civically. They are more likely to avoid violence, contribute to their communities, and achieve high grades in school. The Five Promises are:
1.Caring adults
2.Safe places
3.A healthy start
4.Effective education
5.Opportunities to help others.
Consider how oral and maxillofacial surgeons can participate through their clinical practices and community service in giving these essential resources to children.
Caring adults: Oral and maxillofacial surgeons can participate in free or reduced cost care through a variety of programs that benefit children including church programs, Salvation Army clinics, DDS (donated dental services), and programs that benefit the children of migrant workers, among others. Also, we can show we care by creating time in our practices for the care of children. Very young patients, often with advanced caries, may be time-consuming and not very financially rewarding, but they are in acute need of our expertise and care.
Safe places: Oral and maxillofacial surgeons must provide a safe and comfortable surgical experience for our youngest patients. An adult’s ability to cope with health care services will depend on those earliest experiences. If we relieve dental pain and provide good anxiolysis and a pain-free experience to children, we can mitigate risk of future chronic pain behaviors such as substance abuse. As adolescents and adults these children will comfortably accommodate to the dental experience and become lifelong accepting dental patients. Providing good pain and anxiety control now allows for comfortable and sustainable dental care in the future for children.
A healthy start: Participation in cleft and craniofacial surgery teams, pediatric trauma teams, children’s hospital medical staffs are some of the many ways oral and maxillofacial surgeons help children get a healthy start. Many OMS now are PALS (Pediatric Advanced Life Support) trained and able to provide ever more sophisticated surgical services to children. Fellowships in craniofacial surgery, ADA/CODA requirements for pediatric surgery, and anesthesia training in accredited OMS programs, pediatric continuing education programs, international pediatric surgical programs, and the Clinical Interest Group in pediatric oral and maxillofacial surgery are but a few of the OMS initiatives supporting a healthy start for children.
Effective education: Children (and their parents) need to understand their oral and maxillofacial health care needs including prevention, recognition of disease, and health care services. Take the opportunity to speak to children about oral health in their schools and other community settings. Some important topics young children need to hear from oral and maxillofacial surgeons include caries risk and prevention, sports safety, and the consequences of smoking. Older children will want to understand impacted teeth, and automotive (and ATV) safety.
Opportunities to help others: Children will only develop well when they understand how to serve others. Tell children about the opportunities they might have to help others as a health care professional, or best of all, an oral and maxillofacial surgeon. Find means to volunteer alongside children in health care settings such as hospitals and clinics. Their career decisions will depend upon the role models they observe. The chance to help another in need is perhaps the most meaningful OMS experience we can provide.
Each of us has daily opportunities to positively affect the lives of children. We can make our childrens’ lives better. Grab a wagon … and plant a tree.
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