SQLCompare is the best tool that I have used for finding differences between databases and getting them synced.
To keep the databases synced up, you need to have several things in place:
1) You need policies about who can make changes to production. Generally this should only be the DBA (DBA team for larger orgs) and 1 or 2 backaps. The backups should only make changes when the DBA is out, or in an emergency. The backups should NOT be deploying on a regular basis. Set Database rights according to this policy.
2) A process and tools to manage deployment requests. Ideally you will have a development environment, a test environment, and a production environment. Developers should do initial development in the dev environment, and have changes pushed to test and production as appropriate. You will need some way of letting the DBA know when to push changes. I would NOT recommend a process where you holler to the next cube. Large orgs may have a change control committee and changes only get made once a month. Smaller companies may just have the developer request testing, and after testing is passed a request for deployment to production. One smaller company I worked for used Problem Tracker for these requests.
Use whatever works in your situation and budget, just have a process, and have tools that work for that process.
3) You said that sometimes objects only need to go to a handful of databases. With only 18 databases, probably on one server, I would recommend making each Databse match objects exactly. Only 5 DBs need usp_DoSomething? So what? Put it in every databse. This will be much easier to manage. We did it this way on a 6 server system with around 250-300 DBs. There were exceptions, but they were grouped. Databases on server C got this extra set of objects. Databases on Server L got this other set.
4) You said that sometimes the DBA forgets to deploy change scripts to all the DBs. This tells me that s/he needs tools for deploying changes. S/He is probably taking a SQL script, opening it in in Query Analyzer or Manegement Studio (or whatever you use) and manually going to each database and executing the SQL. This is not a good long term (or short term) solution. Red Gate (makers of SQLCompare above) have many great tools. MultiScript looks like it may work for deployment purposes. I worked with a DBA that wrote is own tool in SQL Server 2000 using O-SQl. It would take an SQL file and execute it on each database on the server. He had to execute it on each server, but it beat executing on each DB. I also helped write a VB.net tool that would do the same thing, except it would also go through a list of server, so it only had to be executed once.
5) Source Control. My current team doesn't use source control, and I don't have enough time to tell you how many problems this causes. If you don't have some kind of source control system, get one.