Early education and child care professionals should include preventive practices in the curriculum. In addition, early educators have many opportunities to notice possible areas of decay on children’s teeth. Coupling prevention and early recognition of possible trouble with referral to an oral health professional can save significant suffering. Early decay looks like dull white bands on the smooth surface of the tooth at the gum line. It is caused by bacterial activity in the mouth. It is a form of infectious disease. Early decay may be reversible with fluoride treatment and removal of plaque that builds up on the teeth. If this early decay is not treated, it becomes yellow, brown or black spots. These spots are places where decay destroyed the tooth enamel. If you see chalky white spots or discoloration on a child's teeth, urge the child's family to take the child to a dentist as soon as possible.

ECELS and PA AAP’s Healthy Teeth, Healthy Children conducted an online survey for early care and education programs as part of the February 2014 Dental Health Month. The purpose of the survey was to learn how child care programs were teaching and practicing oral health.

Sing to the tune of (Row, Row, Row Your Boat)

Brush, brush, brush, your teeth,
Brush them nice and clean.
Brush the tops and bottoms too,
And floss them in between.

What reasons do teachers/caregivers give for not doing oral hygiene as part of the curriculum?

  • Just one more thing to add to the child care day.
  • I don’t have enough time.
  • I can’t get everything done as it is.
  • Parents brush the children’s teeth at home.

While these common responses are understandable, the best practice benefits make it worth the effort. Caring for Our Children, 3rd edition (CFOC3) defines the best-practice standards for early learning programs. CFOC3 Standard 3.1.5.1 states “Caregivers/teachers promote the habit of regular tooth brushing. All children with teeth should brush or have their teeth brushed at least once during the hours the child is in child care.” CFOC3 Standard 9.2.3.14 has additional details: All child care programs should have an oral health policy that includes information about fluoride content of water at the facility, contact information for each child’s dentist, a resource list for children without a dentist, daily tooth brushing or rinsing the mouth with water after eating, use of Sippy cups and bottles only at mealtimes during the day and not at naptimes, no serving of sweetened food products, promotion of healthful foods per the USDA Child Care and Adult Food Program, early identification of tooth decay, age-appropriate oral health education activities, and a plan for handling dental emergencies.

Dental disease is the most common chronic disease of early childhood. Cavities and decay in baby teeth can cause pain, inability to eat healthful foods and inability to learn. The decay can cause damage that is very expensive to repair. Poor oral health affects a child’s overall health and development leading to lifelong harmful consequences.

Cavities can be prevented, stopped and even reversed if they are caught and treated early. The acid made by germs in the mouth causes cavities. Regular brushing removes food that feeds the germs and reduces the number of germs that cause tooth decay. Consistent application of fluoride in toothpaste and drinking water helps harden the teeth against the acids that cause cavities.

Include Tooth-friendly snacks: Cheese, Baby Carrots, Apple Slices, Cucumbers, Nuts (for children 4 years of age or older), Yogurt, Whole Grain Cereals, Other fresh fruits and vegetables

Avoid Tooth-unfriendly snacks:Cookies, Candy, Crackers, Sticky Fruit Snacks, Juice and Juice Drinks, Sugary Cereals and other high sugar foods

For all children:

  • Brush teeth with a fluoride toothpaste: Use a smear for infants with teeth; for 2-5 year olds use a pea-sized amount; for older children and adults use a ribbon of toothpaste.
  • Provide healthy foods and limit sweet snacks and drinks. Read how much sugar is in a portion and the portion size on every product label.
  • Schedule regular dental check-ups starting by 12 months of age and every 6 months thereafter.

Forming good habits at a young age can help a child have healthy teeth for life.

Little People Day School of Columbia in South Central Pennsylvania has been dedicated to oral health care for their children for more than 30 years! The children brush their teeth twice a day as part of their daily curriculum. It is such a normal part of their routine that when someone suggested the center could change to brushing once a day, the center said “no.” So the children continue to faithfully brush their teeth after breakfast and after lunch. Congratulations Little People Day School of Columbia! You have earned special recognition from the South Central Regional Key, and Keystone STARS!

For more information about Oral Health, go to: The Washington Dental Service Foundation website at http://www.kidsoralhealth.org/

Caring for Our Children, 3rd Ed., “Oral Health in Child Care and Early Education”, a special collection of oral health standards for early care and education programs at www.cfoc.nrckids.org/StandardView/SpcCol/Oral-Health

Contributed by Anne Dodds, South Central Regional Key Child Care Health Consultant

This bright, highly graphic poster illustrates steps parents, teachers/caregivers can take to help children have healthy teeth. One side is printed in English and the other side is in Spanish. 5/2018

In 2015, the American Academy of Pediatrics (AAP) updated the schedule of services children should receive during well-child visits.* The new schedule includes oral health screening and that all children between 6 months and 5 years of age have their teeth painted with fluoride varnish** 2-4 times a year to prevent tooth decay.

Learn more about how to make the most of well child visits. Go to the 8/2015 article* on the AAP’s www.HealthyChildren.org website. This website is for parents and other caregivers. Articles are available in English or Spanish, in both written and oral format.
*https://www.healthychildren.org/English/family-life/health-management/Pages/Well-Child-Care-A-Check-Up-for-Success.aspx
**https://www.healthychildren.org/English/healthy-living/oral-health/Pages/Fluoride-Varnish-What-Parents-Need-to-Know.aspx

Photo and article content with permission of the American Academy of Pediatrics.oral health pg 4

While funding lasts, ECELS is offering a free module review for the 2013 updated Oral Health Self-Learning Module. Act now to receive one of the remaining free reviews. As with all ECELS Self-Learning Modules (SLM), ECELS T/TA staff will help users to successfully complete the SLM and earn professional development credit. This module includes new tools you can use in your program to support oral health.

The content of the Oral Health SLM includes online, interactive activities, a resource list, dental referral resources and activities teachers/caregivers can use. This self-learning module meets the STAR Level 2 Performance Standard for Health and Safety. Contact ECELS if you have questions at: This email address is being protected from spambots. You need JavaScript enabled to view it. or 800/243-2357.

To view the updated Oral Health SLM, click the link or go to www.ecels-healthychildcarepa.org. Select Professional Development/Training, and then Self-Learning Modules. Scroll through the alphabetical list to the Oral Health SLM.

Oral health and public health experts have updated the recommendations to prevent cavities (dental caries) for children less than 5 years of age. What’s new is a strong recommendation for the child’s pediatrician or dentist to apply fluoride varnish every 3 to 6 months, starting as soon as possible. Painting the teeth with fluoride varnish is easy. Good research shows that fluoride varnish reduces caries by as much as 59%. Painting fluoride varnish on the teeth protects the outside layer of tooth enamel for “baby teeth.” Baby teeth start forming before birth. Most finish developing during the first year of life. The formed teeth start to come up during the first year, and finish coming up by the time the child is three years old.

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