Please continue on for your August coursework

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2 Stop! Notice Future classes offered by Snohomish Health District trainers will no longer be sent to your . Instead, monthly classes will be posted to our website for you to print or download. To access future classes: 1. Go to 2. Click on the Children and Families menu tab along the top of the page 3. Scroll down to Child Care Providers 4. Click on Trainings for Child Care Providers There you will see materials posted for all the classes that are available to take that month. No registration is necessary. Complete materials that you are interested in and return them by the deadline to the contact listed in the course materials for STARS credit. Thank you. Please continue on for your August coursework

3 Welcome Welcome to Snohomish Health District Healthy Communities distance learning course entitled: To receive credit for this course you must: Cavity Free Kids Read the text carefully and completely. Answer all test questions. Do not leave any unanswered. Complete the assignment thoughtfully and thoroughly. Do test and assignment individually. No copying or group work (note: it is acceptable to discuss the material as a group, but test/assignment must be done by yourself unless otherwise specified). Return the course evaluation Test, assignment and evaluation should be ed or postmarked on or before August 31 st, 2017 in order to receive credit. Late assignments cannot be accepted. Make copies of your test and assignments for your records. A certificate of completion will be sent to you via upon successful completion of this course. Please clearly print your name and an address on your test. Please remember to include your STARS ID number on your test in order to receive STARS credit. If you need a STARS ID number, visit for assistance. As always, these materials are yours to keep as a resource. Please feel free to contact Carrie Parker at any time with questions, concerns, or comments. Our office hours are T-F, 7am to 5:30 pm. Phone: cparker@snohd.org Mail copies of your test, assignment, and evaluation to: Snohomish Health District Attn: Carrie Parker, Healthy Communities 3020 Rucker Avenue, Ste. 300 Everett, WA OR Send electronic versions to: cparker@snohd.org

4 Course Learning Objectives Course Learning Objectives Upon review of the written resources, completing the independent assessment, and participating in class assignments/activities, participants will achieve the following: 1) Describe how oral health can impact a child s overall health and well being. 2) Demonstrate knowledge of proper response to dental emergencies. 3) List a minimum of four ways that child care providers can support oral health in children Core Competencies This course fulfills the following Core Competencies for Early Care and Education Professionals from Washington State Department of Early Learning: Content Area I: Child Growth and Development Level 1 f. Recognizes that children learn and develop through play. Level 3 a. Recognizes that interaction with people and the environment stimulates the child s brain function and therefore brain growth and development. g. Creates Environments and experiences that affirm and respect cultural, linguistic, ethnic, and socio-economic diversity. Content Area V: Health, Safety and Nutrition Level 2 a. Promotes good health and provides an environment that contributes to the prevention of illness. Level 3 c. Talks with and provides resource information to families about health. Nutrition Level 5 c. Advocates for policies and procedures that affect the nutritional welfare of the broader community. Scoring of test and assignments as follows: Section Points Possible True/False 20 Fill in the Blank/Short Answer 40 Choose the BEST answer 4 Choose ALL that apply 6 Assignment 30 Total Points 100 A passing score is 80 points.

5 Cavity Free Kids Why Oral Health is Important Oral health is part of your overall health; you can t be healthy without oral health. Tooth decay is the single most common chronic disease in children. It is five times more common than asthma. It is important to understand the importance of oral health, including ways to prevent tooth decay. Oral health means much more than healthy teeth. Oral health includes your teeth and gums, their supporting tissues, the hard and soft palate, mucosal lining of the mouth and throat, the tongue, lips, salivary glands, chewing muscles and the upper and lower jaws. Also included in oral health are parts of the nervous, immune, and vascular systems that help to nourish the oral tissues and provide connections to the brain and other body systems. Oral health is often taken for granted. We don t think about why we are able to smile, speak, chew, taste and show emotions through our facial expressions. These are all things that are affected by oral health and can be effected with lifelong problems when oral health is neglected. Eventually the lack of good oral health could start to affect how we eat and what foods we could eat. It could also begin to affect how we look, how we are able to communicate, and how we feel about ourselves. Baby Teeth Professional care is important in maintaining oral health. Once a baby s first tooth comes in around the first year, it is time for parents to schedule a dentist appointment. First dental visits help children get to know the dentist. The dentist and dental hygienist look at the teeth and address how to prevent problems. Prevention is much cheaper than treatment. A lot of people overlook the need to maintain healthy baby teeth. Baby teeth help children talk clearly and eat a variety of healthy foods. They also hold space for permanent teeth. If untreated, early tooth decay can impact nutrition, overall health and learning.

6 Tooth Decay Dental disease in children is a common, chronic problem and an infectious disease. The most common form of dental disease is tooth decay and cavities. Tooth decay is the destruction of tooth enamel. When you eat foods containing sugars or starches the bacteria that live in the mouth eat these foods and produce an acid. The bacteria, acids, food particles and saliva then form into dental plaque, which is a sticky film that coats your teeth. The acid is held tight against the tooth by this sticky plaque. Over time these acids will break down tooth enamel and cavities will form. The saliva in our mouth works to protect our teeth and rebuild enamel. Saliva is the body s first defense against unwanted bacteria and other irritants that cause tooth decay. More than 51 million school hours are lost each year to dental-related illness. Over half of 5-9 year olds have at least one cavity or filling. Cavities and tooth decay are one of the most common health problems around the world. They're especially common in children and young adults, but anyone who has teeth can get cavities, including infants and older adults. If cavities aren't treated, they get larger and the decay can become severe enough to cause serious toothache pain, infection, tooth loss and other complications. Prevention: There are many ways to prevent or minimize tooth decay. These are some simple prevention strategies from American Dental Association, American Academy of Pediatric Dentists and the American Academy of Pediatricians that many of us do already. Eat healthy foods Avoid frequent snacking (especially sticky foods) Wipe the gums with a soft cloth daily Help children use a small toothbrush as the teeth come in Brush after breakfast and before bedtime-use a smear of fluoride toothpaste when the teeth first erupt and graduate to a pea size amount by age three when the child can spit well Visit a dentist by age 1

7 Your Oral Health Counts! Babies are not born with tooth decay germs. A baby will receive germs from a caregiver or parent. Usually these germs are transferred from an adults mouth to a child s hand and then from their hand to their mouth. This is why it is important to make sure that the parent or caregiver s mouth is healthy as well. Tooth decay is also affected by the types of foods that are eaten and how often they are eaten. Fluoride Making sure children get the right amount of fluoride is a great way to improve their health and prevent tooth decay. You can get fluoride in water, toothpaste or rinses. Fluoride actually prevents cavities from starting or growing larger. It can even reverse small cavities before fillings are needed. There is such a thing as too much fluoride when teeth are still growing and this is called fluorosis. This can cause a change in color or texture of teeth. Supervise the use and storage of toothpaste. More than 80% of our homes in Snohomish County have drinking water with enough fluoride to protect teeth. The Snohomish Health District or your water district (water provider) can help you determine how much fluoride is in your water. Dental Emergencies A dental emergency may be very apparent if a child is experiencing mouth or tooth pain, swollen face and fever. Other dental emergencies include a knocked out permanent tooth, broken tooth, cut or bitten tongue, lip or cheek and broken braces. A toothache can sometimes be helped by rinsing the mouth with warm water or applying a cold compress. Broken teeth or a knocked out tooth need to be handled carefully. Any broken teeth fragments should be kept and brought to the dentist or emergency room. A knocked out tooth should be gently rinsed and placed in cool milk or water. Permanent teeth that have been knocked out can be replaced successfully if put back in place quickly, especially within two hours. A cut or bitten tongue, lip or cheek should be treated as an open wound. Apply pressure to the area to stop the bleeding and use a cold compress to reduce swelling.

8 In the case of a dental emergency, call the child s caregiver and offer to call the child s dentist to get accurate instructions for immediate care. If you have a dental emergency after hours, visit a hospital emergency room. What Child Care Providers Can Do Include the Child s Dentist on Your Health History Form This is just as important as knowing who their family doctor is. Not only do you want to know who the dentist is and have their contact number, but you want to ask for the child s dental history. Oral health is the gateway to overall health. Provide Parents Information Oral health resources should always be available to parents. Sometimes, child care providers will be one of the few resources that parents have and can trust for accurate health information. Let them know what the kids are learning about oral health and ideas for continuing the learning experience at home. They can help their child learn to brush their teeth safely and keep their teeth healthy. You can also talk to parents about the importance of dental visits. Also, keep parents aware of the other resources in the community. The Snohomish Health District has information and regular updates on dentists in the community who serve low-income populations or take medical coupons. You can find this information at by typing dental in the search bar and clicking on Dental Resource List. You can also get information by contacting the Snohomish Health District dental resource line at Develop Protocol for Emergency Dental Care If a dental emergency happens at your child care, it is important to remain calm and help sooth and reassure the child. Plan for emergencies and develop the steps to deal with each emergency ahead of time. If your staff is aware of your policies and procedures regarding dental emergencies, they will be better prepared to handle them. Make dental emergency care a part of first aid education.

9 Follow Infant Feeding Guidelines Drinking from bottles can cause tooth decay. Many of the liquids we put in bottles contain sugar, including formula and breast milk. When babies fall asleep while drinking from a bottle, the liquid pools around teeth and may begin to cause tooth decay. Develop a no bottles in bed policy and do not let children go to sleep with a bottle. Hold babies while feeding them. Not only is this comforting for them, but you will know if they fall asleep. Limit the amount of juice and other sugary liquids that babies receive, whenever possible, replace them with water. When babies are developmentally ready, offer them a cup of water, formula or diluted juice. Babies are developmentally ready when they can hold their heads up, swallow without gagging and have an interest in a cup. This happens around 6 months, so dentists recommend weaning from the bottle between months. For feeding, offer them a cup and age appropriate foods instead of a bottle. Avoid sippy cups that require sucking. Offer healthy Snacks and Meals Children usually need about 3 meals and 2-3 snacks to get them through the day. Follow the Washington state meal pattern to ensure children in child care are fed at appropriate times. Try to avoid grazing or eating little things all day. Each time we eat, acids can attack and break down our teeth, so we want them to have time to recover and repair and allow our saliva to help protect our teeth. Providing foods that help teeth stay healthy and strong is most important. Meals and snacks should provide a balance of nutrients through a variety of foods. In child care, most children will be served 2 meals and 1 or 2 snacks every day. Fruits and vegetables are a great meal or snack component, they do not stick to the teeth and when served often, children get an ample supply of vitamins, minerals, and fiber with very little sugar. Whole grain crackers and breads are good for teeth because they are less sticky than more highly processed and popular snack foods such as chips, crackers, sweet cakes, cookies and rolls. When these sticky snack foods are offered, serve them with an unsweetened dairy food, a meat or a meat alternative such as milk, cheese sticks, cottage cheese, sliced turkey, bean dip, nuts or seeds.

10 Dairy foods are the best source of the important mineral calcium and vitamin D. Both are necessary for the development of strong teeth and jaw bones. Other good sources of calcium are broccoli, tofu, and nuts. Ensure that children get 3-4 servings of dairy or other calcium rich foods every day. Taking kids outside everyday is another way to ensure they get enough vitamin D for good oral health. Provide Oral Health Education & Activities Helping kids understand about oral health early on will help make it important to them throughout their entire life. Add oral health words to your vocabulary lessons. Demonstrate the difference between sticky foods and foods that clean teeth: Have them eat an Oreo cookie and look inside their mouths using a mirror. Then give them apple slices to eat. The apples will help remove the sticky cookie from their teeth! Read books about good foods, keeping bodies strong and healthy, and taking care of teeth. Book Suggestions: The Berenstain Bears Visit the Dentist By Stan and Jan Berenstain Blue s Checkup By Sarah Albee and Ian Chernichaw Brush Your Teeth Please By Leslie McGuire and Jean Pidgeon How Many Teeth? By Paul Showers and True Kelley Little Bear Brushes His Teeth By Jutta Langreuter and Vera Subat What to Expect When You Go to the Dentist By Heidi Murkoff

11 Create oral health art or mobiles to display around your child care rooms. Visit a dentist for a tour. Most local dentists are happy to give small groups of children short tours of their office. Ask a dentist to donate a few dental supplies: masks, mirrors, bibs, rubber gloves, etc. Arrange a dentist s corner or container of dental supplies so children can pretend going to visit the dentist. Display oral health posters around your home or center. Ask children to bring a photo of them brushing their teeth to make an oral health bulletin board. Establish a Brushing Program Keeping teeth healthy at your childcare can help to avoid problems as well. Develop a brushing program and make sure both parents and kids understand why you want the children to brush regularly and how to brush effectively. First address tooth brush safety. Let children know that they cannot share toothbrushes and that brushes should dry separately in a tooth brush holder. Talk to the children about how germs can spread if the toothbrushes touch each other. Purchase a toothbrush holder that keeps the brushes separate or make one out of empty 2 liter bottles or Legos! Just make sure it is nonabsorbent and washable. You will also need to label toothbrushes or assign children their own color so that they know which toothbrush belongs to them.

12 It is best for children s teeth to use a soft bristle toothbrush. Educate kids through fun activities. Use puppets to demonstrate how to brush and how some foods stick to teeth. Practice brushing in a group with dry tooth brushes. Show children how to brush, then have them follow along with you. Brush the front of the teeth using a back and forth movement (circular movement is difficult for children under 6). Place the bristles of the toothbrush at a 45- degree angle along the gums in front and then in back of the teeth. Brush the backside of the teeth by holding the brush vertically inside the mouth and brush in whatever motion is easiest for the child. Finally, brush the tongue and roof of the mouth.it tickles. When it comes time to actually brush the teeth, use only a pea size amount of toothpaste. Always supervise the use of toothpaste. Provide hand and verbal assists according to development and need. Brush your teeth with the children to remind them visually of what to do. Teach children not to swallow fluoride toothpaste. It may taste good to them, but it is not good for them to swallow. In Closing From birth to adulthood, it is important to keep our mouths healthy. Oral health is not just about keeping our teeth clean. Many parts of our body are affected by oral health; teeth, gums, lips, tongue, jaw and facial bones, etc. There are even connections to our nervous and immune system. Good oral health helps us to eat, form words, communicate and smile. It helps meet some of the most basic needs that we have. There are many simple things we can do to keep our mouths healthy. Brush our teeth, use fluoride, eat healthy foods and visit the dentist regularly. All of these will help to reduce the germs that can cause tooth decay and prevent long term problems. Incorporate this information into projects, activities, and curriculums to show both children and parents how important and fun oral health can be.

13 Resources American Dental Association Are you in a Tooth Pickle? Virginia Department of Health Milk Matters Booklet Department of Health and Human Services National Institutes of Health Oral Health in America: A Report of the Surgeon General Department of Health and Human Services Taking Care of Your Child s Baby Teeth Healthy Mothers, Healthy Babies Time For A Cup Washington State Department of Health Washington Dental Services Foundation