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When Long Beach students smile, the teeth they sparkle aren't always pearly white. A survey released Monday reveals that tooth decay is a major problem among students in the Long Beach Unified School District. It is five times more common than asthma and can lead to speech problems, a lack of concentration due to the pain, a host of other illnesses brought on by the decay, and missed school days. A statewide survey, also out Monday, showed similar, although slightly better, results throughout California. During the 2004-2005 school year, dental health care professionals looked in the mouths of randomly selected kindergarten and third grade students throughout the state.

More than 21,000 students were screened. In Long Beach, 826 kindergartners and 816 third grade students took part at 12 schools. Of those screened in Long Beach, more than half of the kindergartners and seven out of 10 third graders had tooth decompose. In 28% of those cases, the decay was untreated. Additionally, 13% of kindergartners tested had never been to the dentist; that number dropped to 5% among the third graders. "This is data which pretty much confirms what we as practitioners in Long Beach already knew," said Santos Cortz, DDS, the lead investigator of Long Beach Smile. "There were not a whole lot of surprises." The reasons behind the prevalence of dental decay among children in Long Beach are varied, from misconceptions that baby teeth don't need treatment to lack of dental insurance, Cortz said.

The preventable disease is most common among minority and poor children because their families either don't have insurance or cannot afford the care even with Medical assistance. "The issue with patients on Medi-Cal is it's a state-funded program that is under funded," Cortz said, adding that in some communities money isn't the only factor. "Half the population among children in Long Beach are Latino and many have never been to the dentist. Their parents have never been to the dentist and those customs are not passed down." Signs of tooth decay can begin early. White spots on the teeth of kids point to decalcification of the tooth, often caused by milk excess in the mouth.

Left alone, these teeth can become grossly decayed, turning to a "soft gooey mush on the tooth," said Cortz, who also has been a pediatric dentist for 24 years and volunteers at the Children's Dental Health Clinic at Miller Children's Hospital. "There's a misconception that because baby teeth will fall out eventually, they do not need to be treated," Cortz said. "The baby teeth help guide the permanent teeth, and baby teeth do remain in the mouth until a child is 11 or 12."

Left untreated, tooth decay can be very painful for children and cause more health problems, Cortz said. The bacteria in the decay can leak into the blood stream and make a child more vulnerable to illness, he said. Making dental health part of a child's regular checkup would go a long way to preventing tooth decay in older children, Cortz said. Steps are being taken toward that goal; a county program plans to train physicians and dentists to talk to parents about oral heath care. "What we're trying to do is make physicians aware that before they get to the tonsils, there are teeth and gums too,' Cortz said.

"We need to make sure children are being assessed at the pediatrician and dental office." While the statistics of the survey point to a problem in Long Beach, Cortz said the city is in a better position than most cities to deal with it. There are programs currently in place that focus on childhood oral health. However, they do not have the resources to match the need, he said. The Long Beach Health and Human Services Department's Smile Bright program goes into schools and provides dental education to teachers, students and parents, as well as sealant treatments for children. Volunteer dentists also do screenings in the district and through the Miller Children's Dental Health Clinic.

"If I could put some goals down now, I would look at the issue of early education, and look at the issue of providing additional funding for the clinic," Cortz said. "I would enhance the Smile Bright program and bring more awareness to the public. These problems are solvable. We've just got to keep the fire going." office." While the statistics of the survey point to a problem in Long Beach, Cortz said the city is in a better position than most cities to deal with it. There are programs currently in place that focus on childhood oral health. However, they do not have the resources to match the need, he said. The Long Beach Health and Human Services Department's Smile Bright program goes into schools and provides dental education to teachers, students and parents, as well as sealant treatments for children.

Volunteer dentists also do screenings in the district and through the Miller Children's Dental Health Clinic. "If I could put some goals down now, I would look at the issue of early education, and look at the issue of providing additional funding for the clinic,'"Cortz said. "I would enhance the Smile Bright program and bring more awareness to the public. These problems are solvable. We've just got to keep the fire going."