When starting school, kindergartners need to know their numbers, letters and how to use the bathroom. They need to be inoculated, provide a birth certificate and should be able to play well with others.

That can be a lot for a 5-year-old.

Now there’s more. With last year’s passage of Assembly Bill 1343, new kindergartners also must show they’ve been to a dentist.

As parents register children for kindergarten this year, included is a form that has to be signed by their dentist showing the child has had an oral exam in the past year.

“They have to have that proof of screening,” said Kathy Thompson, assistant superintendent of early childhood services for the Shasta County Office of Education.

The bill was passed to ensure that children were entering school healthy and to help the state gather statistics on children’s oral health, she said.

“It is quote-unquote required,” said Megan Johnson, who oversees the oral health program for the Shasta County Public Health Department.

However, children who haven’t had a dental exam or who have oral health issues aren’t barred from enrolling in school. On the dental exam form given to parents is a box they can check allowing them to opt out of the requirement.

“They have a chance to sign a waiver,” said Susan Nesberg, attendance clerk for Columbia Elementary School.

So far, she said, most of the parents who have registered kindergartners at her school this spring have had the exams performed.

“The majority of parents have done it,” she said. “It’s pretty straightforward.”

The concern among educators and parents is that the county’s relatively high poverty rate could make it hard for many parents to get their kids to a dentist.

In 2007, 27 percent of children in Shasta County had no dental insurance, according to a report by Children Now, a national organization that lobbies for public policy that prioritizes children.

“Access in Shasta County is a challenge,” Johnson said.

Children Now also reported that 17 percent of the county’s children have no insurance at all.

Johnson said the idea behind the bill was to help those families who wouldn’t normally take their children to a dentist get the attention they need.

Dental health “is something that gets pushed to the side,” Johnson said. “The whole purpose (of requiring the screening) is to help families whose children may not have visited a dentist.”

Johnson tells families to call around to area dentists to at least get on a waiting list for an exam and to check to see what services they offer.

“We have a lot of dentists in this area that accept Medi-Cal,” she said.

She said other dentists have sliding scales to work with families who can pay only a portion of the bill.

At Rother Elementary School, where a large percentage of the students qualify for free and reduced-price meals, officials work with parents to help them learn where their kids can be taken for exams.

“I really push for an exam,” said Nanci Leach, health clerk at the school.

The Enterprise Elementary School District, of which Rother is a part, created a handout for parents and guardians that helps explain the new requirement and provides resources to link them with Medi-Cal and Denti-Cal dentists in the area.

It also gives information on how to get in touch with other health resources like Healthy Families and public health. It then lists tips on how to keep a child’s mouth healthy.

Johnson hopes as more information is given to the public, more parents will see the importance of helping their children maintain healthy mouths and taking regular trips to a dentist.

For the past month, representatives from county public health have been visiting preschools to talk to kids about what’s good to eat, what isn’t and how to brush just right. Each child then receives a small, white plastic bag with a toothbrush, floss and toothpaste.

“Cavities are entirely preventable,” Johnson said. “Young kids don’t have to have them.”