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About First Smiles

First Smiles is a statewide initiative to address the "silent epidemic" of Early Childhood Caries (ECC) affecting children ages 0-5. It is the most prevalent chronic disease of early childhood and a major cause of school absenteeism. This program is dedicated to providing education and training for dental, medical and early childhood educators, as well as education to parents of young children, including those with disabilities and other special needs, on the prevention of ECC.

In 2004, The Dental Health Foundation (now the Center for Oral Health) and the California Dental Association Foundation, in a joint venture, were awarded a 4-year, $7 million grant to deliver the California Children and Families Commission's Oral Health Education and Training Project. The project's goals are to:

  • Educate 30,000 dental professionals and 10,000 medical professionals and
  • Deliver intensive training to 14,000 dental professionals and over 3,500 medical professionals statewide.

The education and training consists of the newest scientific information on dental disease prevention in children, prenatal to 5 years, including those with disabilities and other special needs.

Target Groups

Dental Professionals, including: non-specialty dentists, hygienists, assistants, and dental students.

Medical professionals, including: primary care physicians working with young children and pregnant women (pediatricians, family practice physicians and OB-GYNs), residents in the above specialties, and pediatric nurse practitioners.

Early Childhood educators, including: WIC, Head Start, and the California Childhood Health Program.

Why is this Project Important?

Tooth decay is the single most prevalent disease of childhood. About one-third of California's preschool children have untreated tooth decay.

It can cost $2,000-$5,000 to treat EACH CHILD with severe tooth decay.

Many of these children must be hospitalized for dental treatment.

Untreated tooth decay can cause pain and infection that can lead to problems with nutrition, growth, school readiness, and speech problems.

What can Health Professionals do?

  • Provide an oral health assessment for babies and young children.
  • Provide anticipatory guidance for parents on issues such as weaning, frequency of snacking, self-assessment at home and use of fluoride toothpaste for daily brushing.
  • Evaluate the need for systemic and topical fluoride supplementation and anti-bacterials like xylitol and chlorhexidine.
  • Provide a fluoride varnish treatment when appropriate, as fluoride can prevent and arrest early tooth decay.

Medical team members can refer children to the dentist as needed and dentists can make room in their practices for these referrals.

What can Early Childhood Educators do?

  • Educate parents on oral health issues such as the importance of primary teeth, first dental visit by first birthday, transmissable nature of cavity-causing bacteria, weaning, frequency of snacking, self-assessment at home, and use of fluoride toothpaste for daily brushing for the entire family.
  • Educate children about proper oral hygiene, importance of dental check-up, importance of teeth, how they can get cavities, and how to keep their teeth strong.
  • Recognize signs of early childhood caries and refer to dental providers.

Training Format

The education and training programs and services will be offered in local, regional and statewide settings as well as on-line. The Project will be offering trainings in a variety of formats, including:

  • One hour in-office visits
  • Two hour in-person training
  • Four hour in person training
  • Two hour webcasts
  • One and two hour on-demand training
  • On-line education materials
  • Modules for distance learning training

Advisory Groups

There are two groups that provide guidance and professional expertise in the field of oral health to this project. The Scientific Advisory Committee is comprised of leading oral health experts from public health, private practice and academia, represented by dentists, physicians (including pediatricians), dental hygienists, dental assistants, and persons from the special needs field. The Oversight Committee includes representatives from the First 5 County Commissions, Diversity Council, Special Needs Project, and the Scientific Advisory Committee.

Project Partners

Training Status as of December 2007

Target Audience Goal Reached To Date
Dentists 5,016 5,567
Dental Hygienists 2,902 2,734
Dental Assistants 5,719 3,831
Medical Physicians 2,700 3,025
Medical Residents 495 541
Nurse Practioners 200 396