Photo Credit: Rachel Garber

Ed. Note: Rachel Garber is a writer and photographer based in the San Francisco Bay Area.

Sesame Street was in San Francisco last week to catch some of the annual October sunshine that gets San Franciscans through its famously cold summers. On Oct. 16, students at ER Taylor Elementary chattered excitedly to each other on the blacktop, but not about the weather: They were talking about their teeth.

“I brush for three minutes—not two, just to be safe,” one 5^th grader bragged to his friends as his class waited to have their teeth examined by volunteer dentists. Their school participated in a three-day dental screening program Oct. 15-17 in San Francisco, as part of the American Dental Association’s (ADA) Give Kids a Smile initiative.

Some 2,000 San Francisco kids received screenings or dental education thanks to the collaboration between the ADA; the San Francisco Department of Public Health (SFDPH); the San Francisco Dental Society (SFDS); Colgate’s Bright, Smiles Bright Futures; the National Children’s Oral Health Foundation.  Sesame Workshop took part in these events through our Healthy Teeth, Healthy Me outreach initiative. The ADA distributed over 2,000 of the Healthy Teeth, Healthy Me kits to all of the participating children.

“If you look at Surgeon General’s reports on oral health in America, they outline a pretty grim picture,” said former ADA President, Dr. William Calnon. (Since 2000, the Surgeon General has referred to oral health as the “silent epidemic’ in this country.) Tooth decay is still one of the most frequent problems seen in young children and 50 million school hours are lost every year from dental-related issues.

Photo Credit: Rachel Garber

“For the most part, dental disease is preventable,” continued Dr. Calnon. “The sad thing is people don’t prevent it. Oral health in this country is severely in need of being addressed in a different way.”

With this in mind, organizations from last week’s events collaborated previously to further their own efforts in bringing preventative care directly to young children.

“Since we started our Kindergarten screening program with the Department of Public Health in 2000,” said Deborah Elam, Executive Director of the SFDS, “we’ve seen a significant improvement in Elementary schools overall. We have more work to do, but none of it would have been possible had it not been a collaborative, multi-agency endeavor.”

Students At ER Taylor and Gordon J. Lau Elementary schools were taught healthy dental habits, while having a great time laughing and singing songs with volunteers. At the San Francisco General Hospital, screenings were held for members of the community, including WIC (women, infant and children) families, on Oct 17. Abby Cadabby visited during the screenings to show children her support. Afterwards, children—and their caretakers—waited in the shade of the brick entrance wall for a photo with their friend from Sesame Street.

“Our school has participated in screening events over the last ten or so years,” said Ms. Marlene Callejas, principal at ER Talyor. “This event is special because it reaches so many kids and has been so enjoyable for them. Now when a child goes to the dentist, it will be a positive experience and they won’t be afraid because they’ve had this opportunity here.”

Photo Credit: Rachel Garber

After their screenings and dental education, all of the children were given a complimentary backpack containing a toothbrush and toothpaste, and the Healthy Teeth, Healthy Me kit, which includes an interactive DVD. All the materials in the multimedia, bilingual kit are available to download for free on www.SesameStreet.org/teeth.

“The DVD from Sesame Street is a huge part of all this,” said Dr. Jeffrey Jang, chair of community dental health, San Francisco Dental Society. “During these screenings the kids get dental education but the parents don’t. When they bring this DVD home in their backpacks, the family watches it together and realizes that this is an important issue.”

The ADA and Sesame Workshop also have a history of working together and the ADA served on the advisory board for the Healthy Teeth, Healthy Me initiative.

“The key messages of these organizations are parallel,” said Dr. Calnon. “What we’re trying to do is not just educate, but give caregivers tools with which to change their habits and hopefully raise a generation of kids with a new outlook on dental health.”

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On one of the days, we were at the E.R. Taylor Elementary School, which serves over 700 diverse, low-income children from pre-k to 5^th grade in San Francisco.   That day, all of the children in school received oral health education, while the kindergarteners, 2nd and 5th graders received dental screenings from the Give Kids A Smile volunteers.  It was heartening to see so many of these volunteers- dentists, hygenists, dental students, dental staff- volunteer their time and their resources to make sure these children are getting the care they need and deserve.   As I was talking to the principal, she mentioned that these screenings were so important to her because when a child doesn’t have to think about their body, they can focus on school.  As budget cuts slash away more things each year, including having a school nurse on hand, she was just so grateful for the events and the resources like these screenings that help keep her students healthier and more school-ready.

As a Project Manager on the Healthy Teeth, Healthy Me initiative, I work with various community health organizations, healthcare providers, and schools to distribute these free materials nationwide.  However, this was the first time I experienced in person how our materials get distributed and integrated into programs, and the important work our partners are doing in communities through events such as these.   Being able to experience something like this firsthand really made me appreciate not only the work that we do in helping create these outreach resources here at Sesame, but the people who are in the communities everyday carrying out work that is much needed.  We are just glad that our project can be of support to providers and families in staying healthy, and we will continue to create resources that can be of help to our many community outreach partners to carry on the mission of healthy habits.

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As part of its commitment to the health and wellbeing of children across the country, Sam’s Club is offering free health screenings for children at all locations with a pharmacy. In addition to the screenings, a limited supply of “Healthy Teeth, Healthy Me” outreach kits will be distributed as well, in the hopes of providing children and parents with the information they need to make choices that will have a positive impact on their oral health.

Sam’s Club has been offering free health screenings every second Saturday of the month for a year and a half. But this screening, which focuses on children’s health, is the first at which Sesame Workshop outreach kits will be distributed. Each screening has a different health-related focus, but at any screening basic health information like body mass index and blood pressure can be measured as well.

“It’s open to anyone,” said Cynthia Collins, the pharmacist who manages the Chicago area market. “We encourage people who are not Members to come in as well. It’s absolutely free, no appointments needed. The services at the screening could be worth close to $200. It gets to be really rewarding once we see people really depend on us, because of the climate that we’re in.”

“We’ve done children’s health before,” she added. “But we’ve never had the (“Healthy Teeth, Healthy Me”) kits before.”

The screenings will be the Saturday, August 11, from 11 a.m. to 3 p.m. at Sam’s Clubs with a pharmacy nationwide.

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It’s critical that children learn the importance of oral health early in life. That’s why Sesame Workshop was so excited for last week’s launch of “Health Teeth, Healthy Me,” our new bilingual oral health outreach initiative that helps teach kids, parents and caregivers why it’s never too early to start learning how to brush your teeth. Please take a few minutes to watch some highlights from the “Healthy Teeth, Healthy Me” launch, but don’t blame us if you find yourself singing the “Brushy Brush” song for the rest of the day.

If you want to learn more about our new oral health initiative, made in partnership with Sam’s Giving Made Simple and the MetLife Foundation, read our question and answer session on the importance of oral care among young children with Dr. James Crall. You can also check out Sesame Street’s ”Healthy Teeth, Healthy Me” page to find more fun videos and games that make kids smile while also teaching them how to keep that healthy smile.

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Sesame Workshop: First and foremost, tell me about the general state of oral health among young children in this country?

Dr. James Crall:  Looking at the big picture over time there have been significant improvements in children’s oral health in this country. However, the first ever U.S. Surgeon General’s report on oral health in 2000 noted that there remains a “silent epidemic of dental problems.” Nationally things have improved since then, but despite those improvements there is still disparity in children’s oral health and millions of children still face significant problems accessing dental care, especially young children.

SW: Tell me more about that disparity. What groups is it between?

JC:  Some work analyzing national data has demonstrated that low-income children, in particular low income children from certain ethnic and racial minority groups, have rates of tooth decay 3 to 5 times higher than their more affluent white counterparts. There also has been an increase in kids developing cavities in their pre-school years, what we refer to as Early Childhood Caries or ECC. Many times the decay is severe enough that by age one or two these children have to be taken to the hospital for treatment under general anesthesia or they end up in emergency rooms, despite all the improvements we’ve made overall. A lot of this is avoidable if we can help families understand the importance of good oral health habits early in life.

SW: What’s causing these health issues? Are there gaps in knowledge or incorrect assumptions on the part of parents that are fueling the problems you’ve seen?

JC: There’s an attitude that we know still persists. People say a children’s first set of teeth – which many refer to as baby teeth, but which I prefer to call primary teeth – well, those are going to fall out anyway so we don’t need to pay attention to them. That attitude even persists with many parents who are well educated.

Overall about ¾ of the kids in the country today have pretty limited experience with dental disease. Those kids generally are doing the things we recommend and their parents are vigilant about their oral health – so the problems with those kids are minimal. Those kids have limited experience with cavities during their pre-school years. Maybe they get an occasional cavity as they get older. The other 25 percent still have some very significant problems. Those kids sometimes have large numbers of decayed teeth by age two, which can lead to infections that spread to other parts of their body and cause pain and other consequences that often go unnoticed or neglected.

I don’t want to create the notion that it’s only about low-income kids. Although they tend to get decay earlier and have more decay, it also happens in more affluent and more educated families as well. Overall, we still need to do a much better job of educating the public. We also have work to do on the professional side to make sure that all dentists understand the importance of early dental visits, ideally beginning by age 1.

SW: What should parents do to ensure these early oral health issues don’t affect their children?

JC:  Children should have a dental visit by their first birthday. Kids’ first teeth usually start to come when they’re about six-months-old. Parents often don’t realize that they need to begin taking care of their kids’ teeth at that early age and often don’t start until it’s too late, that is until the youngsters already have cavities and dental disease. A big part of why there is an increase in tooth decay in young children in this country after years and years of decline is the persistence of some basic gaps in the public’s general knowledge about how to best care for children’s teeth.

SW: What are some other day-to-day things parents can be doing to encourage healthy oral habits?

JC:  Parents do have to work with their kids on a daily basis, especially preschool children who generally lack the motor skills to brush their teeth properly. They have to be taught to brush all the surfaces of all their teeth. They have to be taught to use an appropriate amount of fluoride toothpaste and to avoid swallowing the toothpaste. Parents also have to minimize kids’ exposure to refined sugars, whether  in drinks or foods, and avoid putting a child to bed with a bottle that contains liquids other than water. They should minimize sticky, sugary foods and offer healthy alternatives: vegetables, fruits, and more natural foods that, as the Muppets say go “crunch” when they’re eaten. And again, it’s important for your children to start visiting the dentist early, ideally by age 1.

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