Empowering Children One Smile at a Time

Harvard School of Dental Medicine promotes oral health at Give Kids A Smile 2019

“Let me show you!” My four-year-old patient, Sam, reached to his brother with a pair of neon orange sunglasses, placing the glasses over his brother’s eyes. “And this.” The four-year-old took hold of the paper napkin, too, placing that over his brother’s shirt. “This keeps you clean.” Being only two, the napkin covered the whole of the younger brother’s torso.

“Thank you for your help!” I told Sam, folding the napkin in half to better fit my young patient.

Sam beamed, his gummy smile spanning ear-to-ear. “I did good at getting my teeth cleaned. Say ‘ah’ Erin.” His younger brother opened wide with just the single note of prompting. “Now it’s your turn!”

Every year, thousands of children like Sam and Erin receive their very first dental visits free of charge. For some children, these visits have been years delayed, infection covering their teeth. For the families who find Give Kids A Smile early, their children receive their first dental visits closer to the ideal age — the age of one or within six months of the eruption of the first baby tooth.

No matter the age of the patient, though, every child leaves Give Kids A Smile connected to a dental home.

Everyone receives the care they need.

What is Give Kids A Smile?

Give Kids A Smile (GKAS) is a program developed under the American Dental Association Foundation. It began in St. Louis, Missouri, in 2003 and has since spread across the United States. Two dentists in the Midwest saw a need, and the dental community rose to ensure that need was met, that children would have access to healthy smiles. Since recognizing this need in 2003, more than 5.5 million children have been cared for by over half a million volunteers under the GKAS umbrella. With information from the ADA Foundation, you can join in this GKAS family and be a part of meeting this need.

Important to the GKAS program is the concept of free care. Early childhood dental caries occurs in all racial and socioeconomic groups; however, it is most prevalent in low-income populations. Dental caries result from overgrowth of bacteria on the teeth, and a dental visit can not only remove that bacteria from a child’s teeth but provide families with tips to lower a child’s risk of developing future cavities.

National Children’s Oral Health month is held in February, so most GKAS programs across the nation coincide with this February time frame. In fact, only 9 days into the month, 1,523 GKAS events have occurred across the U.S., with 6,494 volunteering dentists, 58,494 non-dentist volunteers, and 347,714 children served. With the addition of today’s Give Kids A Smile at Harvard School of Dental Medicine, that number is about to jump by about 50 kids and so many volunteers.

What is the Dental Home?

Every child at Harvard School of Dental Medicine’s Give Kids A Smile event is connected to a possible dental home. While not every family chooses this dental home, the connection is made and the barrier of finding a dentist diminished.

This concept of a dental home carries with it opportunity for the child — opportunity for a lifetime of healthy smiles.

Dental caries are a common and chronic condition. They are five times more common than childhood asthma and seven times more common than hay fever in youth. Statistics from Pediatrics reveal that more than 40% of children have dental decay by kindergarten. According to the CDC, 18.6% of children age 5 to 19 have untreated dental caries.

Many families ask why we can’t simply extract the baby teeth, not realizing that cavities in baby teeth can affect the permanent teeth, the child’s bite, and the child’s growth and safety if the decay prevents proper nutrition or results in widespread infection. Decayed teeth can also affect a child’s developing self-esteem, as their teeth turn darker in color or are, one-by-one, extracted.

With a dental home, though, a child becomes part of a dental team, a team committed to caries prevention and oral health.

This team is often integrated in some way with the child’s medical team to provide cohesive health care addressing the mouth as part of whole-body health. A dental home offers a child and family with a place to return for regular dental care. If a question or emergency arises, the families have a number to call. Even if the child or family does not see a dental problem, the dental home is on the lookout, trained to assess a child’s oral development at all stages and provide guidance on how to prevent future decay. Achieving oral health is a team effort, requiring cooperation from both the dental provider and the patient and family; a dental home can provide the family with the resources and education they need to actively and effectively join in this team. And importantly, GKAS serves to connect famlies to this dental home.

What are some tips for maintaining oral health at home?

Sam and Erin, the boys I met at GKAS, had healthy mouths. Though we discussed behavior modifications to decrease their caries risk and demonstrated brushing technique to improve oral hygiene, they were cavity free and set for six months. However, even Sam and Erin’s parents grew empowered with information to help best care for their sons’ oral health. Some of the tips we discussed were:

1. Oral hygiene —

We advise parents to help brush the child’s teeth until the child can tie his/her own shoes. We discussed the importance of a toothpaste with fluoride, the Bass Technique for brushing, as described by the American Dental Association, and the importance of brushing in the morning and at night. We also discussed the value of flossing once the teeth begin to touch. These tips and more can be found at Healthy Children.

2. Diet —

Sam and Erin liked healthy foods with few sugary or carb-filled snacks throughout the day, which is exactly what the dentist prescribes! As far as drinks, juice should be limited only to meal time, and children should not be put to bed with a bottle (or should be given a bottle with water if the bottle is necessary). We also encourage drinking fluoridated tap water to help strengthen the teeth.

Mirissa D Price on 103.3 AMP with Julee Marra — January, 2019

3. Habits —

Kids like to suck their thumbs or a pacifier; it’s a developed pattern for many. By about four, though, we can work with our children to reward avoiding this behavior so that they are no longer using this habit when they are six and their permanent teeth are starting to erupt. Any sort of sucking habit or tongue thrust can displace the front teeth and lead to a need for braces in the future.

4. What to expect —

Still teething, young Erin could experience pain or excessive drooling, and his parents were able to see first-hand why, while also getting tips about how to sooth the gums. We discussed what to do in the case of an injury from falling or sports, and that dentists will begin evaluating their children for braces around age 6 or 7 in case they need early intervention. The most important thing now was to keep their teeth healthy until and far beyond that time!

Sam and Erin’s parents were doing as great a job at home as their children did in the dental chair, and just a few tips and adjustments — all garnered from a single GKAS visit and available from the American Academy of Pediatric Dentistry — could equip their children with a lifetime of oral health. For the children with caries who needed treatment or extractions, the GKAS visit did even more to help restore their mouths to a healthy state.

We came, we saw, we smiled!

About 20% of children will go without a dental visit this year. In that 20% are the children most vulnerable to decay — children of low socioeconomic background, children in areas with low access to a dentist, and children with families lacking access to the resources and information needed to best care for their child’s oral and overall health. As a helping profession, we see this statistic and know that this is not acceptable.

With Give Kids A Smile, we see this statistic and know, with the work of dedicated volunteers, this statistic can change.

Mirissa D. Price is a 2019 DMD Candidate at Harvard School of Dental Medicine and a rising pediatric dental resident at Boston Children’s Hospital. She serves as a Scholar of Dental Education at Harvard School of Dental Medicine and a Give Kids A Smile Leadership Ambassador. Mirissa’s research and outreach interests include social-emotional development in youth; addressing barriers and access to pediatric dental care; interprofessional collaboration; and dental education. As a child, doctors told Mirissa that she would live in a nursing home, confined to a wheelchair, crippled by pain. Instead, Mirissa uses her medical experiences to inspire others, living each day with a passion to spread pain-free smiles through her dental work, writing, improv comedy performances, and nonprofit work with children. You can stay up to date with Mirissa’s writing at mirissaprice.wordpress.com and follow @Mirissa_D_Price on Twitter or Facebook. You can even take home a few inspirations of your own, at Mirissa’s Etsy shop, A Smile Blooms.