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Lying on a table awaiting her dental exam at Dr. Heather Wise's office, Selena Badillo is all smiles. The 9-year-old Adair County resident has been to the dentist before, as evidenced by the fillings or "silver stars" on a few of her teeth, and she seems eager for her examination.

Not all Kentucky children are as acquainted with a dentist's office as Selena, however. Some children have never been to see a dentist.

But that could soon change. House Bill 186, sponsored by Rep. Tom Burch, D-Louisville, would make a dental exam mandatory for new students enrolling in elementary or secondary school.

"This is something that has definitely needed to be put into place for awhile," said Dr. Randy Smoot, a Campbellsville dentist.

Though this isn't the bill's first trip around Frankfort, it is gaining more support this year, said Campbellsville dentist Dr. Marlene Richardson.

"This is possibly the closest we've come to getting it passed."

The sticking point in the past was funding.

"Funding is the biggest issue," Richardson said. "Some parents can't afford the dental exam. I feel like the KDA can work through that."

Richardson, who is chair of the Kentucky Dental Association's executive board, said the association is working on the details of a program that would have dentists giving dental exams in the schools for those who can't afford to pay.

For those who don't have dental insurance, Campbellsville dentist Dr. Frank Metzmeier said there is help.

"The majority of children who have [oral health] problems are eligible for medical assistance."

Taylor County Schools Director of Pupil Personnel Angela Wheat believes the bill is a good idea, but she hopes help will be offered to those who can't afford the exam.

"It's a great idea, but it could be cost prohibitive."

Campbellsville Independent Director of Pupil Personnel Jeff Richardson believes the bill would improve school attendance.

"Dental hygiene leads to a lot of absenteeism. If they get started [going to the dentist] early, it becomes habit-forming."

With physicals and eye exams already required for new students, Jeff Richardson said, it only makes sense for students' teeth to be checked too.

"We want it passed. We want everything checked from top to bottom."

According to the 2001 Kentucky Children's Oral Health survey, about 20 percent of children hadn't gone to the dentist in more than a year, while 3.5 percent had never been. Nearly 30 percent of Kentucky children had some form of untreated tooth decay.

More than 5,600 third- and sixth-grade school children and 572 preschool children across the state received a dental screening as part of the survey.

Tooth decay leads to pain, loss of appetite and absenteeism, Smoot said. Early detection would not only prevent these symptoms, it can also help avoid the need for more expensive procedures.

Nearly half of Smoot's new pediatric patients have some form of tooth decay. Tooth decay is fairly common among young children, he said, often because parents aren't aware of it until it becomes infectious.

Wise sees much of the same problem in her practice, which is exclusively for children.

"We do see some with problems," she said. "We've seen some new patients who have never seen a dentist."

HB 186 is a key preventative measure, according to Metzmeier, who said it would have a positive impact on oral health and school attendance.

"One of the major causes for students missing school is tooth ache," Metzmeier said. "The idea for the bill, as it stands right now, is to get these children exams before they start school. It will prevent a lot of absenteeism."

Such a measure is needed now more than ever, Metzmeier said.

Oral health is on the decline, he said, due, in part, to the increased consumption of bottled water. Bottled water doesn't have fluoride, he said, as does tap water. Fluoride helps prevent cavities.

After fluoride was added to public water supplies in the 1950s, the U.S. saw a 60 percent reduction in tooth decay, Metzmeier said.

"Now, with more children drinking bottled water and soft drinks, we've seen an up tick in the amount of tooth decay."

Wise said the bill is a great idea, but "We still have to have continuity of care. We have to encourage regular routine visits."

In the end, the benefits of dental exams should prevail, Metzmeier said.

"It's a real problem. It's a real attendance factor. We really just don't want little ones hurting in school all day."

- Staff Writer James Roberts can be reached at 465-8111 Ext. 226 or by e-mail at writer@cknj.com.