Our Children and Our Specialty: Oral and Maxillofacial Surgery’s Role in Pediatric Health Care

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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.

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• Figure 1. 

  The unmet health needs of America’s children.

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:

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  Red wagon.

Consider how oral and maxillofacial surgeons can participate through their clinical practices and community service in giving these essential resources to children.

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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References 

1. Newacheck PW, Hughes DC, Hung Y-Y, et al. The unmet health needs of America’s children. Pediatrics. 2000;105(suppl):989
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2. America’s Promise Alliance: http://www.americaspromise.org/APA.aspx. Accessed September 7, 2007
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