USA - Miami-Dade County's pilot program for Medicaid dental is criticized for too low fees and too few dentists.

The Columbia report notes some progress -- with 23 percent of Medicaid kids in Miami-Dade having at least one dental visit in 2007, up from 16 percent in 2005, but still below the 29 percent in 2003, before the pilot project began.

............Still, the Patch Oral Health Initiative, a University of Miami project, has found that dental care among poor children in Miami-Dade is sadly lacking. The program, which provides fluoride varnish to protect teeth and does a preliminary examination of preschool kids, found that 58 percent needed to be seen in a dental office and 10 percent had ''emergency needs,'' as was the case with Johanna Jimenez.

Half with decayed teeth and a third with emergency situations did not get follow-up care, the Patch report said, because of a variety of problems.

'There is a pervasive sense that since these are `just baby teeth' there is no big problem with this,'' says Brian Guerdat of the Patch program. ``But pain is very real . . . which can cause children to have behavior problems at home and school, prefer soft foods easy to chew rather than healthier choices necessary for better growth/development.''

Miami-Dade, where 90 percent of the residents receive fluoridated water.