A well child includes a healthy smile

Typically, when a doctor encourages a child to “open wide and say ‘ah,’ ” only the tonsils and throat are getting the once-over. But a pilot program that begins today aims to get pediatricians to examine those baby teeth as well.

Under the program, Group Health doctors and some clinical staff are partnering with Washington Dental Service to provide free dental exams at well-child visits for all patients aged 6 months to 3 years. The doctors will learn how to spot early signs of tooth decay, which is the most common chronic childhood disease. At the checkups, doctors or nurses will also apply fluoride varnish, teach parents about dental health and refer children to follow-up care with area dentists.

“Children between the ages of zero and 3 have had very limited access to dental care,” said Dr. Ronald Inge, vice president and dental director of Washington Dental Service in Seattle, a dental insurer. “We were looking for other areas of access. Well-baby checks are the most common time that children are examined.”

So, a couple of Group Health pediatricians, along with nurses and other staff, spent Wednesday morning at the Lidgerwood Medical Center learning how to incorporate a brief dental exam into their regular checkups.

“If you want to make a change, you’ve got to get the kids very early,” Spokane pediatric dentist Dale Ruemping told the group, adding that he sees four or five children in the operating room each week with advanced tooth decay.

The pilot program begins at the Lidgerwood Group Health clinic. It expands to Riverfront Medical Center next month and will be rolled out at four Group Health clinics in the Seattle area by year’s end. It will be evaluated, and possibly expanded, at the end of three years, according to Group Health officials.

The exams will be provided at no extra cost to parents. Washington Dental Service will cover the cost for its subscribers who are also Group Health members. Medicaid will pay for dental checkups for those it covers. Anyone who falls through the cracks will be covered by the Washington Dental Service Foundation, which is setting aside a total of $150,000 over three years for the program, said Sean Pickard, manager of government and public relations for the group.

The in-office dental exams, Ruemping said Wednesday, should take less than a minute.

Still, those well-child visits are jam-packed with information, immunizations, parent questions and the usual checkup. Adding one more thing to check could bog things down, said Dr. William Greene, a pediatrician at Lidgerwood who will be one of the first in the program.

But, Greene said, “Nurses will be involved with a lot of the work.”

And Dr. Robert Piston, the other Lidgerwood pediatrician in the pilot program, said dental health is so critical, it’s worth finding the time.

“This is a great idea,” Piston said. “Lots of children don’t see a dentist when they’re young but they do see the doctor.”

Greene and Piston rolled up their sleeves and donned latex gloves Wednesday as a few kids toddled into the Lidgerwood conference room.

Ruemping showed them how to get the youngsters to lean back and open wide, while a nurse swabbed sticky fluoride varnish all over their teeth.

“Yummy,” proclaimed 3-year-old Connor Duncan of Spokane not long after getting his fluoride treatment.

Duncan didn’t make a peep and even smiled at the end after Ruemping said, “We’re going to paint some Spider-Man sauce on Spidey’s teeth here.”

Dentists not involved in the partnership applauded the idea. But they stressed the importance of regular trips to the dentist, too.

“We get some of our best help from our friends that are in the pediatric world,” said Dr. Chris Herzog, a pediatric dentist with The Children’s Choice in Spokane. “Our biggest concern is that we don’t want parents to feel like the pediatrician just did their dental visit, and then the kid is good.”