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When 5-year-old Julie arrived at St. Joseph's Dental Clinic in Santa Rosa last year, her pain was visible. As Dr. Cheryl Willett, a pediatric dentist and director of the clinic, tells it, the swelling was so severe it was beginning to close her eye.

Julie (not her real name) was taken to the hospital where she spent five days being treated for multiple dental infections. In the end, 12 of her 20 baby teeth were extracted — all due to infection.

Unfortunately, clinic workers see severe cases like this once a month, sometimes weekly.

"If I asked you, &‘What is the number one childhood disease affecting U.S. children,' you might say asthma, obesity or even the common cold," Willett recently asked an audience at the Friedman Center in Santa Rosa. "But it's actually dental decay, and it's completely preventable."

Preventable, but pervasive nonetheless. Here are a few facts concerning this quiet crisis in Sonoma County, particularly among children:

<BL@199,12,11,10>A 2009 survey showed that 52 percent of Sonoma County third-graders had a history of dental decay, exceeding the state average.

<BL@199,12,11,10>The same study found that low-income kindergartners and third-graders had more than twice the level of untreated decay (21 percent versus 9 percent) as more affluent children. Nearly 7 percent of the children were found to be in need of "urgent" care.

<BL@199,12,11,10>There are now only 15 dentists who will accept Denti-Cal payments to treat low-income county residents, and six of them work at St. Joseph. <NO1>Overall, the county ranks in the bottom third — 44th out of 58 counties — in terms of dental health for kids.

<NO>

The problem is taking a toll on family pockets as well as in lost school time. More than 500,000 California children missed at least one day of school last year because of dental issues, costing school districts $29.7 million in revenue.

<NO1><NO><NO1><NO><NO1><NO>Moreover, the problem has grown worse as more families have lost dental health coverage in recent years or have seen their coverage scaled back, making it too expensive to get the specialty care they need.

Programs such as St. Joseph's Dental Clinic started in 1990 to confront this growing need among low-income children. They helped pick up the slack when school-based programs were decimated due to budget cuts. The clinic now treats more than 8,000 patients a year at its permanent site in southwest Santa Rosa and an additional 6,700 through its mobile dental unit which is driven to schools, churches, health fairs and other locations to educate families and treat children.

But in what has become symbolic of the challenges that face those dealing with this crisis, the mobile unit is no longer mobile. The costs of repairing the 11-year-old vehicle are prohibitively expensive, forcing staff to park the unit in a place where staff can still serve families but not to the extent they once did. Meanwhile, St. Joseph is trying to raise the $390,000 needed to buy a new mobile unit.

"In Sonoma County, the (dental problem) is something that we recognize as a major issue, and something we don't want to stand for anymore," said Dr. Mark Netherda, the county's interim public health officer.

On Tuesday, Netherda and other members of the Sonoma County Task Force on Oral Health will be updating the Board of Supervisors on the efforts, including the public-private partnerships that have been made to address this chronic problem even in this time of budget austerity.

In our editorial on Sunday, we will look at some of the solutions, including some of the task force's recommendations. But what's clear is that no solution is possible without greater community awareness and a broader commitment to stop allowing local children to live with this kind of pain.