OPEN WIDE EARLY CARE KEY TO KEEPING KIDS' TEETH HEALTHY

Even dentists have a hard time getting their young children to brush their

teeth. Consider Stephen Berger, the Santa Rosa children's dentist who has made

a name for himself for his annual Halloween candy buy-back program.

''I have four kids of my own, and they all fought me tooth and nail over

brushing. But with persistence, they eventually turn around. There's no

filling in any of my kids yet,'' says Berger, whose pack ranges in age from 3

to 21.

It's a battle, Berger emphasizes, parents should wage, and win. The most

annoying excuse Berger hears from parents for not brushing a child's teeth, he

says, is ''I don't want to turn her off to it.''

While maybe half of our nation's kids don't have dental caries (the

dentists' word for cavities), and another 25 to 30 percent have a only few,

''the last 20 to 25 percent have really severe decay,'' says Berger, who

admits he may get a disproportionate number of severe cases.

In a single day, Berger has seen children aged 2, 3, and 4 who needed tooth

repair so extensive each had to have general anesthetic to get the work done.

Petaluma dentist Martin R. Steigner classifies only about 5 percent of his

patients as having severe decay, but says even if he only gets one severe case

in two weeks, that's ''way too often for me.''

The excess sugar children will consume over the next few days in honor of

an ancient Druidic holiday gone awry won't cause this level of decay all by

itself, but it won't help either.

''For 20 minutes after eating, the mouth's acid level is high enough to

dissolve tooth enamel,'' says a Halloween flier Frank Hodges gives his

patients. Over time, this gradual dissolution causes decay. The average

American eats two pounds of sugar a week, affording plenty of chances for

decay to get started, says Hodges, a Santa Rosa dentist and instructor at the

University of the Pacific School of Dentistry, San Francisco.

The dentists agree the main cause of decay in the mouths of very small

children -- termed ''bottlemouth'' -- is parents' failure to begin caring for

children's teeth soon enough, and their failure to realize that putting a

child to bed with a bottle of anything but water offers decay a choice

opportunity to move in.

''When the child goes to bed with a bottle, or nurses and falls asleep with

the parent, the milk or juice stays on top of the teeth and causes tremendous

tooth decay,'' Steigner explains. ''By the time the child is 2, he has so many

cavities it's really a problem to treat.''

Often, says Berger, parents don't even realize the child has cavities,

because with bottlemouth, the decay is usually in the back of the top teeth,

where even conscientious parents rarely look.

''Some have draining abscesses, and never complain of pain,'' Berger says.

However, he adds it's very common for the parent of such a child to tell him

later that the child suddenly resumed eating after dental repairs were

completed.

A cavity in a 2-year-old is worse than a comparable cavity in a

12-year-old. While the older child may object to dental work, which is

admittedly uncomfortable and unpleasant, babies and toddlers must often be

given general anesthetic just to have their teeth filled.

Children's dental surgery is ''three or four times the cost to repair

adults' teeth, and medical insurance usually won't pay for it,'' Berger says.

But paying through the nose rarely assuages parents' guilty consciences, he

adds.

One father cried when Berger told him his 3-year-old's teeth were badly

decayed and that she would require general anesthesia -- and that was before

he heard the cost estimate.

The dentists hope recently passed fluoridation legislation will eventually

cut their workload.

''I'm so glad it passed,'' says Steigner. ''California is the second-worst

state in the country in the number of cities with fluoridation. It's gotten to

be a political issue rather than a health issue. Fluorosis (an excess of

fluoride) is not a problem at the levels recommended. You can get too much,

but not from the public water supply. It's more likely if a kid sucks on a

tube of toothpaste all day long.''

Cities with fluoridated water ''have found that as a round number, children

have 50 percent fewer cavities,'' says Hodges.

''All of us who see children know that where water is fluoridated, you do

see fewer cavities in the permanent teeth. Most of the benefit is for the

forming permanent teeth,'' Hodges notes. ''In Sonoma County, kids have to take

pills (to get fluoride). The suggested period of time to take them is 6 months

to 12 years.''