BEND, Ore. (AP) -- Dental health may not be getting any worse for Oregon children, but dentists say they see few signs that it is improving.

"I've seen a lot of it for a long time," said Dr. Cate Quas, a pediatric dentist in Bend who treats many Oregon Health Plan patients. "I see horrendous stuff in preschoolers."

Quas said she recently pulled 10 of a little boy's 20 teeth because the decay was so extensive. She said the boy told her he looked like an old man so she made him a retainer with prosthetic teeth.

"What happens is that families, they let the problem get too bad because they don't know where to go and they can't afford it. Of course it just snowballs and they end up with a toothache or an infection," said Vickie Matthews, coordinator of the Kemple Children's Clinic, which coordinates dental care for low-income children in Central Oregon.

"We have had some kids here with life-threatening infections," Matthews said.

According to a report released in November by the Oregon Department of Human Services, 56 percent of children ages 6 to 8 in Oregon have had dental caries, which is tooth decay that can lead to cavities.

Nationwide, 50 percent of children in the same age group have experienced dental caries, although the overall prevalence of tooth decay in older children is decreasing.

"Oregon has an oral disease burden. It's a silent epidemic," said Brett Hamilton, managing director of public and professional education for the Oregon Dental Association. "A lot of times people don't associate their mouth with their whole body or realize that their mouth is part of their overall health."

Quas blames too much milk or sugary drinks for much of the problem.

"The stuff you see in preschoolers is generally created when they are toddlers," she said. "It's not like between the ages of 2 and 5 the tooth decay becomes rampant."

Some parents give their children juice in sippy cups and let them carry the sugary drink around all day, or put them to bed with milk in their bottles, Quas said. Sugars in the fluids coat the teeth, giving bacteria a chance to take hold.

"The food pools on top of the teeth and the bacteria have a heyday," Quas said. "They have little parties all night long and eat into the teeth."

Instead, Quas and other dentists recommend giving children water in sippy cups or bottles instead of drinks that are high in sugar.

Often parents also don't realize that recommendations on dental care have changed, said Dr. Mike Shirtcliff, president and CEO of Northwest Dental Services in Redmond. The group of almost 300 Oregon dentists works to improve access to basic dental care in rural areas of the state.

"The mythology in dentistry is you don't treat pregnant women unless it is an emergency and you don't treat kids until they are 30 months old," Shirtcliff said.

But now the professional standard is to treat pregnant women, and babies should be seen before their first birthday. "We've been working hard to change the standard of care. It's going from old knowledge to new knowledge."

Shirtcliff's organization works to educate and encourage dentists to treat more patients with Oregon Health Plan coverage. Because the Oregon Health Plan does not reimburse at as high a rate as other types of insurance, he said, sometimes dentists are reluctant to participate.

In Central Oregon there are plenty of pediatric dentists, Shirtcliff said. But places like Douglas County, the Southern Oregon coast and areas of Eastern Oregon have a limited number of pediatric dentists to serve the population.

Dentists also recommend fluoridation of drinking water to prevent decay.

The Oregon Dental Association has been pushing the state Legislature for years to mandate that Oregon's drinking water be fluoridated, Hamilton said.

"There seems to be more and more decay," said Dr. Dean Nyquist, a Bend dentist who sees many young children with serious dental problems. "Especially in our area where we do not have fluoride in the water. It makes a big difference."

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