KING COUNTY, WASHINGTON - Recently, an important health care study came out of Olympia. Issued by Gov. Gary Locke, "The Report on Oral Health Access in Benton and Franklin Counties" is the first phase of a comprehensive survey on our state's oral health status.

This initial research focuses on Benton and Franklin counties, where dental disease is at epidemic proportions among children of limited income. The complete statewide report, as well as a surgeon general's report on our nation's oral health status, are anticipated in June.

The research effort is a wake-up call. What many of us take for granted -- access to routine preventive dental care -- has public health advocates concerned and engaged. The oral health access issues identified in Benton and Franklin counties are symptoms of a larger statewide problem. According to research sponsored by the Washington Dental Service Foundation, an estimated 275,000 children in our state -- especially those from low-income and minority families -- go without needed dental care each year.

Although dental disease crosses all population groups, it is the young, elderly and socially disadvantaged -- including the working poor -- who are most at-risk, and the access issues are complex. There are people within this high-risk group who have no dental insurance and others who don't use the benefits they have. The elderly, typically underinsured and suffering from nutritional problems that exacerbate oral health problems, often have transportation issues as well that keep them from adequate dental care.

In King County alone, only 30 percent of the children with Medicaid benefits went to a dentist last year. Along with access issues, community health advocates in many parts of Washington are contending within actual shortage of dentists.

This news is especially disheartening at a time when oral health exams are increasingly viewed by the medical and public health communities as important components of overall primary health care. A dental checkup can screen for AIDS, diabetes, stress and other health problems.

Through scientifically valid research, we know that the mouth is a sentinel indicator for general health concerns and that dental disease can make us sick elsewhere in our bodies. Studies show gum disease can result in premature births and that infection in children's mouths can lead to failure-to-thrive. Furthermore, certain heart conditions and types of stroke are being linked to bacteria in the mouth.

It's time to shore up Washington's dental-care safety net. Fortunately, some effective community partnerships are already in place, but there's much work ahead.

With fluoridated water systems and new dental technologies, such as tooth sealants, we have the potential to significantly reduce tooth decay among children. In Seattle and King County, public health and nonprofit community dental clinics are collaborating to increase access to dental care for at-risk and underserved populations. Together we provide oral health screening, intervention and other preventive programs (e.g., dental sealants) through the schools, homeless shelters and federal programs like WIC (woman, infants and children) nutritional program.

We need more community partnerships such as the Washington Dental Service Foundation's Cavity Free Kids pilot program addressing the pediatric oral health crisis in Adams, Benton, Franklin, and Yakima counties. Now in its second year, this innovative program is allocating $1.5 million over a three-year period to prevent dental caries in children through education, improved access and community development.

In the spirit of improving our community wellness, we need to pay close attention to these important studies on oral health and redouble our efforts to make oral health an integral part of our public health agenda. If we ignore this, more than our smiles may be at risk.