Nine percent of children in Southeastern Pennsylvania have not seen a dentist in the last year, according to a survey of 13,000 households. Dentists say that lack of dental care could have lasting health implications.

The Household Health Survey, conducted by the Corporation for Public Health Management, found that more than 67,000 children in Southeastern Pennsylvania between the ages of 4 and 17 did not see a dentist in the previous year. The rates were the highest among poor and minority children.

The numbers are worrisome, said Bernard Dishler, president-elect of Pennsylvania Dental Association.

"The problem is that a small cavity becomes a big cavity becomes an abscess," he said. "It just is a snowball effect, so early treatment and early diagnosis is the most important part."

Dr. Andres Pinto who heads Penn Dental Medicine's Division of Community Oral Health said that the local survey findings mirror national trends in which minority and poor children are the most likely not to have access to dental care.

That lack of care can have grave results, Pinto said.

"Eighty percent of dental decay is concentrated on 20 percent of the pediatric population, and there is a lot of effect on missed school days, on behavior as well as performance in school," Pinto says. The children miss school or can't concentrate because they are in pain.

Experts say that dental schools at universities including Penn and Temple are playing a big role in making dental care more accessible to low-income patients. Later in life, poor oral and dental health can cause heart problems and other health issues.

The survey found that cost and lack of insurance were common barriers. Doctors say additionally parents still might have some misconceptions that teeth are not as important as a health concern as other issues.