LEARNIN' THE DRILL: HEAD UP. MOUTH OPEN. SPIT A SMART START TO ORAL HEALTH.

Byline: SUSAN ABRAM Staff Writer

NORTH HOLLYWOOD - At 4, Asia Morehead is already a dental care veteran and she knows the oral hygiene drill by heart: Sit still. Head up. Mouth open. Spit.

Thanks to five specially trained moms known as ``las promotoras'', or the promoters, Asia and dozens of her classmates at the Lowman Head Start program stand a good chance of having healthy smiles well into adulthood.

``We only had two criers today,`` said Martha Baguel, a Head Start mom and ``promotora`` who is a graduate of a 120-hour program sponsored by UCLA's Oral Health Promotion Program.

``The kids first come with fear, but then they feel comfortable with us because we're moms,`` Baguel said. ``Because of us, they look at dental care differently now. They are not afraid to go to a dentist.``

Winning the battle against tooth decay is about more than just a pretty smile. Some experts now say dental disease is the No. 1 health problem among California children, even worse than obesity and diabetes.

For some of the dozens of children enrolled in the Head Start program, Monday marked their first brush with dental care.

The ``promotoras`` transformed the North Hollywood classroom into a clinic, with dental files and sanitary bibs, sterile cotton applicators, gauze and boxes of toothbrushes. After a brief checkup for plaque and puffy gums, the children sat calmly around their play table to get their tiny teeth polished with tooth-decay-fighting fluoride.

And for the moms who trained to provide the service, there is the satisfaction of learning a new skill -- as well as reaching out to a community that might otherwise overlook dental care needs because of poverty and a lack of education.

In 2000, a first-ever surgeon general's report on oral health called dental and oral diseases in the United States a ``silent epidemic.``

The report found that while 44 million Americans lacked medical insurance, 108 million had no dental insurance, and uninsured children are 2.5 times less likely to receive dental care.

In California, almost two-thirds of the state's youngsters have dental disease by the time they reach third grade, making it the No. 1 health problem in children, according to a study released in February by the Dental Health Foundation.

The study also found that 4 percent of the children, or 138,000, are in pain or have untreated tooth infections. Researchers say children should have their first checkup at 2 years old, or even younger.

``We have all the tools to help in prevention but the problem is getting those tools to the children,`` said Dr. Nancy Reifel, an assistant researcher with the 2-year-old UCLA program that trained the moms. ``It would also take a change in the dental profession to add to this level of prevention.``

Funded by California's First Five initiative, the $25,000-a-month program provides dental care to more than 500 children ages 3 to 5, at nine Head Start classrooms in North Hollywood, Pacoima and San Fernando. Those children and each member of their families receive free toothbrushes and toothpaste every three months, and the results are positive, Reifel said. Instances of ``baby bottle`` tooth decay, for example, have decreased thanks to education, Reifel said.

The ``promotoras`` not only apply fluoride, but if needed, some cavity-fighting sealants. They also make referrals to local dentists who can treat bigger problems.

For the parents of the children who participate, the checkups also ease fears of dental visits.

``When I took her to the dentist for the first time, she already knew everything,`` said Elvira Gonzales of her 4-year-old daughter, Priscila. ``Now, she tries to teach me how to floss.``

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(1 -- 2 -- color) Above, mother of four and oral health ``promoter'' Lilian Lopez applies fluoride to the teeth of Hazmik Karapetyan, 4, at Lowman Head Start in North Hollywood on Monday, while dentist Dr. Nancy Reifel watches. Below, Julianna Ganan, 4, gets a fluoride treatment by another of the program's mothers trained to provide dental health care.

Tina Burch/Staff Photographer