2017 Winter Kansas Child

ccaks2018

Oral Health Kansas

A publication of Child Care Aware ® of Kansas

Winter 2017 Volume 16, Issue 1

ORAL HEALTH

KANSAS

5

IN

TOOTH BRUSHING

CHILD CARE

FLUORIDE: PROTECTING

SMILES FOR MORE THAN

10SEVENTY YEARS

ACA OFFERS PRIVATE

DENTAL INSURANCE

21FOR KIDS


Kansas Child

is a publication of

Child Care Aware ®

of Kansas

Executive Director

Leadell Ediger

Editors

BWearing Consulting

Angie Saenger, Deputy Director

Publication Design

Julie Hess Design

On the Cover

Aaron enjoying his first

snowfall. Aaron is the son of

Mandy Ediger, Salina, KS.

Child Care Aware ® of Kansas,

1508 East Iron, Salina, Kansas 67401,

publishes Kansas Child quarterly,

and is made possible through the

financial support of the members

of Child Care Aware ® of Kansas and

sponsorships from our corporate,

private, and foundation partners.

Kansas Child is intended to provide

a forum for the discussion of child

care and early education issues and

ideas. We hope to provoke thoughtful

discussions within the field and to

help those outside the field gain a

better understanding of priorities

and concerns. The views expressed

by the authors are not necessarily

those of Child Care Aware ® of Kansas

or their sponsors.

Copyright © 2017 by Child Care

Aware ® of Kansas, unless

otherwise noted. No permission

is required to excerpt or make

copies of articles provided that

they are distributed at no cost.

For other uses, send written

permission requests to:

Child Care Aware ® of Kansas,

1508 East Iron, Salina, KS 67401

Kansas Child is distributed at

no cost to Child Care Aware ®

of Kansas donors. Single

copies are available

to anyone at a cost of

$5 each, prepaid.

Talk

Resolved in 2017: Talk, Read, Play

You’re receiving this winter issue of

Kansas Child several weeks after the New

Year’s festivities. I wonder, did you make any

resolutions this year? Will you keep them?

LEADELL EDIGER

Child Care Aware ®

of Kansas

According to Statistic Brain, of the 45 percent

of Americans who typically make New Year’s

resolutions, only 8 percent are successful in

achieving their resolutions.

This issue of Kansas Child is all about oral

health. We welcome our partner for this issue,

Oral Health Kansas. Like good brushing and

flossing habits, resolutions require effort.

If you are one who chooses to make

resolutions, and you are determined to make

them stick, you might enjoy these helpful hints

I found in an article written by Nancy Anderson

Read

for Forbes.com:

Set short-term goals (she suggests making

New Month’s resolutions every 30 or 31 days)

Write down your goals and share them with a

friend. It helps even more to set specific action

steps (bite-size pieces instead of the whole).

Create momentum: knock off a few

important steps early in the process to build the

momentum you need to succeed.

Pick your “game-changer:” What is one thing

you can accomplish? Focus your time and energy

on that.

Get some skin in the game: Use a negative

consequence if you don’t meet your monthly

goal: Write a check to a charity that you would

normally not support. Then, swap the check

with a friend who commits to mailing it to the

charity if your monthly goal is not met.

And finally: Nudge yourself. A little

reminder along the way can help you accomplish

your goals.

Now that we know how to achieve our

resolutions, I’d like to suggest an alternative to

the traditional individual resolution. What if we

set a collective resolution and hold each other

accountable?

Here’s what I’m thinking for 2017: What if

we all collectively resolve to TALK, READ,

PLAY each and every day! If you are a child


Play

care provider or parent this task should be very

doable. Because I’m a grandmother who gets

to see one of my grandchildren almost daily,

it is a pledge I’m willing to make. Our good

colleagues at The Family Conservancy have been

working since 2014 to engage the Kansas City

area — business, governments, schools, parents,

etc. — to take up the challenge to TALK, READ,

PLAY. So why can’t more of Kansas join this

simple and noble effort?

A pledge card is now on the Child Care Aware®

of Kansas website, www.ks.childcareaware.org,

so that we can hold each other accountable. No,

this is NOT a fund-raising campaign. It is a

language-builder, a knowledge-maker, and a funcreator!

We can all do it together!

You might say, “I don’t see any young children

daily.” That’s OK. But when you do, pick up

a book, sing a silly song, or play with kitchen

spoons and measuring cups. In other words,

improvise! Your heart will grow knowing that

you touched a child’s mind! I hope you’ll join me

in making and keeping this simple resolution,

let’s make talking, reading and playing as much

of a habit as brushing our teeth!

p. 5

p. 10

IN THIS ISSUE

Tooth Brushing in Child Care................... 5

Your Child’s First

Dental Appointment................................. 8

Fluoride: Protecting Smiles

for more than Seventy Years................... 10

Sip All Day, Get Decay.............................12

What’s in Your Drink?..............................12

Healthy Snacking.................................... 14

Brush, Book, Bed.................................... 16

Book Nook:

Tooth Adventures.....................................17

Oral Health Books for Children..............18

Children Receive Dental Coverage

through CHIP......................................... 19

KanCare:

Benefits and Challenges.........................20

ACA Offers Private

Dental Insurance for Kids.......................21

Certainly Smile-Worthy........................... 22

p. 20


The Oral Health Kansas board and staff appreciate the opportunity

to contribute several articles to this issue of Kansas Child to share

insight and best practices about how to ensure all Kansas kids have

good oral health. We hope you will find them interesting and thoughtprovoking.

You will find stories about tooth brushing in child care

settings, preparing healthy snacks for little ones, the best time to take

a young child to the dentist, how to know if a child is at risk for dental

disease, and how everyone can get involved in advocating to improve

oral health policies in our state and across the country. We hope

these stories spark conversations, plant new ideas, and inspire families

and caregivers to make oral health an important part of daily life for

every Kansas child.

Dental disease is entirely preventable, yet it is the most common

childhood disease — more common than asthma! When children

or adults experience cavities, they are even more susceptible to other

chronic diseases. Baby teeth are every bit as important as adult teeth,

and healthy habits start young.

Oral Health Kansas is the statewide advocacy organization dedicated

to promoting the importance of lifelong dental health by shaping policy

and educating the public so Kansans know that all mouths matter. We

achieve our mission through advocacy, public awareness and education,

and we have more than 1,400 supporters, including dentists, dental

hygienists, educators, safety net clinics, charitable foundations and

advocates for children, people with disabilities and older Kansans. The

Oral Health Kansas staff stands as a resource to the readers of Kansas

Child. Learn more about us and subscribe to our e-newsletter by

emailing us at info@oralhealthkansas.org or by visiting us at www.

oralhealthkansas.org.

Tanya Dorf Brunner,

Executive Director

Keep learning about oral health!

Would you like to keep learning about oral health programs, tips, and policy?

Sign up for Oral Health Kansas’ Weekly Wednesday Update. This is an

e-newsletter that provides timely updates on best practices in dental care,

legislative activity, and ideas about how to help children and families take

good care of their teeth. Learn more and sign up to receive the e-newsletter

at http://www.oralhealthkansas.org/WWU.html

4 Kansas Child A Publication of Child Care Aware ® of Kansas


Tooth brushing

in child care

Children can be cavity-free, right

from the start. Many children reach

adulthood never having had a cavity.

Unfortunately, a third of children

already have tooth decay by the time

they begin preschool. Dental decay is

the most common chronic disease in

children: it is about five times more

common than asthma and seven times

more common than hay fever.

Why are baby teeth important?

Children do not begin to get their

permanent (adult) teeth until about

age 6 and the last primary (baby)

tooth is not lost until the child is

about 12 years old. This means that

baby teeth are a very important part

of a child’s development, helping the

child to eat, talk, and smile. Baby

teeth are at higher risk for tooth decay

because the hard, outside layer of

enamel on baby teeth is much thinner

than on permanent teeth. Parents

and caregivers can help children have

healthy teeth by making smart food

choices and brushing the child’s teeth

at least twice a day with fluoride

toothpaste. Keeping a child’s smile

healthy and bright is everyone’s

job — parents, grandparents, older

siblings, babysitters, teachers, and

child care providers.

Even infants need dental care.

Parents and other caregivers are

encouraged to use a clean cloth to

wipe away milk that remains in

the baby’s mouth each day. This

creates a routine so the baby begins

to anticipate and trust the practice.

When the first tooth appears,

caregivers should switch to a small,

soft toothbrush. Some children get

their first tooth at 3 months and

others not until they are 12 months

old. Brushing each morning, during

the day (if possible) and just before

bed helps to remove any food and

cavity-causing bacteria on the teeth.

Daily tooth brushing in a

child care setting

Child care providers can have

significant influence on a child’s

behavior and can help create healthy

habits. Much like handwashing and

toileting, brushing teeth should be

part of the daily hygiene routine.

Encouraging healthy habits is

important in the overall health of a

child. For some children, brushing

while at child care might be the

only time they get to brush. If you

are already practicing daily tooth

brushing in your child care setting,

congratulations! The children you

serve are fortunate. But please keep

reading! You might learn some new

approaches for children entering your

program who are not used to brushing

their teeth. Parents will thank you

and so will their children when they

grow up with healthy teeth.

Continued on page 6

www.ks.childcareaware.org Kansas Child 5


Get ready...

Continued from page 5

If you are just starting a tooth brushing routine, include families

by sending home a letter outlining your tooth brushing activity and

request that parents describe the child’s tooth brushing practice at

home. If you already have daily tooth brushing practices for children,

include that information in your application forms for new parents to

complete. Asking parents about the child’s tooth brushing practices

at home might give you some clues on how to create an individual

approach for each child.

Here are some great ideas to help you and the children in your care

get ready for tooth brushing:

•§

Help children learn what to expect and why brushing is important.

Examples:

––

Read tooth brushing books designed for young children during

your daily circle time (check out the best children’s oral health

books on page 18)

––

Show children tooth brushing videos. Check out YouTube for one

from Sesame Street as an example.

––

Teach children simple tooth brushing songs, such as those

from the American Dental Association web-site. (http://www.

mouthhealthy.org/en/Kids-Brushing-Playlist)

––

Pantomime tooth brushing on a doll, puppet, or yourself, using

your finger as a toothbrush. Encourage each child to mimic your

actions, making sure they do not put their hands in their mouth.

•§

Make brushing an everyday practice that children come to expect.

––

Post tooth brushing time on your daily calendar, including a

photo of each child brushing.

––

Remind children that tooth brushing time is scheduled, but

expect that they will soon be reminding you!

•§

Choose the place for daily brushing

––

Sitting at a table right after lunch or afternoon snack is highly

recommended. Tooth brushing as a group works well because

you can demonstrate and encourage children as you observe the

group, while also providing assistance, as needed.

Get set...

Gather the supplies you need.

•§

Toothbrushes

––

You decide if you or the families will provide child-sized, softbristle

toothbrushes.

––

Change toothbrushes every 3 months or when bristles appear

flattened or worn.

––

Label each toothbrush with the child’s name.

•§

Toothpaste

––

Experts now tell us that toothpaste with fluoride is safe to use

at every age. Make sure to use an age-appropriate amount; a

smear for infants and toddlers, a pea-size amount for children

age 3 and older.

––

You can use a small tube for each child or a larger tube for

all, as long as you are careful not to cross contaminate by

putting toothpaste directly on the toothbrushes from the tube.

Examples include placing a small dab of toothpaste on the

edge of a small paper cup or small square of wax paper.

––

The flavor of the toothpaste is a matter of choice. Be aware

that many children find mint flavoring to be “hot.” Most

children tend to prefer fruity flavored toothpaste, but they will

need to be reminded not to swallow it.

––

Store toothpaste in a locked cabinet.

•§

Toothbrush holders: There are a variety of ways that toothbrushes

can be stored. However they are stored, be sure the holder is

sturdy. It is important that brushes do not touch each other

and that brushes are allowed to air dry (do not put individual

toothbrush covers over a wet toothbrush where germs can breed)

Some options to consider:

––

Sturdy plastic cup with child’s name attached

––

Upside down sturdy paper cups with child’s name written on it

––

Commercially available classroom toothbrush holder

––

When not in use, store toothbrushes in a cupboard or on a

shelf away from children.

•§

Optional Disposable items: Small paper cup, paper plate, paper

towel. These will vary depending on the method you choose to use.

6 Kansas Child A Publication of Child Care Aware ® of Kansas


Tips to Encourage the

Reluctant Tooth-brusher

Reluctance can be triggered by shyness, embarrassment or hesitation

to try a new activity. It can be overcome by watching all the other

children brush, pretend-brushing with hand movements, or singing

tooth brushing songs with you while everyone else brushes. The child

might have tooth decay, loose teeth, or mouth sores, so tooth brushing

could be painful. Information about tooth brushing that parents

include in the application form might provide some insight into the

child who refuses to brush when you first introduce tooth brushing

in the group setting. Gentle, respectful questioning of the child

can also generate reasons. While rare, the child may be subject to

punishment or sexual abuse involving the mouth.

Including tooth brushing into a child care setting can

reinforce good habits that improve oral health through an

activity children enjoy while practicing fine motor skills.

What a great way to help children have

good oral and overall health for life!

Go!

You are ready to begin! There are many

methods you can choose to use for

group tooth brushing. Here is one

that is popular with many of the

Head Start programs across Kansas

and the nation:

1. Set out a paper towel and a small

paper cup or paper plate for each

child who will be brushing.

2. Dispense the appropriate amount

of toothpaste on each the edge of

each cup, paper plate, or wax paper.

3. Demonstrate to children how to

scoop the toothpaste onto their

brushes.

4. Demonstrate and coach children

while you model brushing your own

teeth. Use the words “small circles”

or “gentle scrubbing.” Young

children may not have the dexterity

to make circles, so gentle scrubs

are fine. Assist children, as needed.

Gloves are recommended.

5. While brushing, children can spit the

extra toothpaste and saliva into their

cup. No rinsing is needed, as water would

wash away the benefits of the fluoride.

6. Brush for 2 minutes. You can use an egg timer or a

2-minute children’s song to help.

7. When complete, they can wipe their mouths with a paper

towel and toss. They can line up to take their turn at a

sink, rinsing their toothbrush (one at a time prevents

impromptu “sword fights” under the water) and handing

the brush to an adult to put away.

Kansas regulations concerning tooth brushing

(b) Every maternity center or child care facility shall furnish or cause

to be furnished for the use of each resident and employee individual

towel, wash cloth, comb and individual drinking cup or sanitary

bubbling fountain, and toothbrushes for all other than infants, and

shall keep or require such articles to be kept at all times in a clean

and sanitary condition.

(i) Toothbrushes shall be provided for each child’s use. They shall be

used daily after meals, and shall be stored in a sanitary manner out

of children’s reach.

http://www.kdheks.gov/bcclr/regs/ccc/Preschools_and_Child_Care_

Centers_all_sections.pdf

To Continue Your Learning

on Tooth Brushing and Child Care...

Check out these additional resources

•§

Oral Health in Child Care and Early Education. National Health

and Safety Performance Standards. Guidelines for Early Care and

Education Programs. 3rd Edition. National Resource Center for

Health and Safety in Child Care and Early Education. Nov. 2016

http://cfoc.nrckids.org/standardview/spccol/oral-health

•§

Oral Health in the Child Care Setting. Tooth brushing: Easy as 1-2-3.

Two-hour on-line course provides an overview of the importance of

oral health in young children, the elements that cause tooth decay,

and how to implement a tooth brushing routine into daily activities.

http://kccto.org/programs/online-learning/course-descriptions

•§

Growing Healthy Smiles in the Child Care Setting — Implementing a

Tooth Brushing Program to Promote Oral Health and Prevent Tooth

Decay. Office of Oral Health. Massachusetts Department of Public

Health. 2009

http://www.mass.gov/eohhs/docs/dph/com-health/oral-growhealthy-smiles-child-care.pdf

www.ks.childcareaware.org Kansas Child 7


Your Child’s First Dental Visit

Setting the Stage for a Lifetime of Oral Health

Dental decay is preventable, not inevitable. Cavities can begin shortly after the first teeth emerge in toddlers. Studies show that infants

and toddlers who receive professional, preventive dental care, including fluoride varnish, have significantly better oral health than those

who do not. Parents and caregivers who are educated about oral health habits are another important factor. Encouraging young families

to seek dental services for their child by their first birthday will go a long way in improving oral and overall health that will last a lifetime.

Early Identification

Young children should have their teeth and mouth checked

by a dental professional within six months of the eruption of the

first tooth or no later than one year. The American

Academy of Pediatricians, American Dental

Association, and American Academy of Pediatric

Dentistry all support this policy. This early visit

ensures that the child’s first experience with a dental

professional is positive and helps to build a trusting relationship

that can last a lifetime. If cavities are identified early enough,

sometimes they can be treated without drilling.

Here are the services that might be provided at a child’s first visit:

Oral Health Assessment: Checking teeth and soft tissue for

areas of concern

Cavities Risk Assessment: Asking about current habits to see

if the child is at risk for cavities

Anticipatory Guidance: Providing oral health information that

is specific to the child’s current age and future needs

Fluoride Varnish, if needed: Applying a thin coat of fluoride

on teeth to protect them from cavities

You may wonder what a dental exam might look like for a

very young child. One method that is gaining in popularity is

called the Knee-to-Knee exam. The dental professional and the

parent sit opposite each other with their knees touching. The

child sits facing the parent on the parent’s lap. While holding the

child’s hands — helping the child to settle down and feel like,

“This is where I’m supposed to be,” — the parent leans the child

backwards into the lap of the dental professional. Your child may

“squeak” a bit, but that can be a good thing as their mouth is wide

open, which allows a great look inside.

Lift the Lip

Parents and others who care for young children also can

play an early role in identifying problems. “Lift the lip” is a

simple technique that can be used by non-dental

professionals to identify possible oral health

concerns.

A child’s mouth and teeth should be screened

once a month by a parent or caregiver so that

problems can be found when they are small:

Position: Place the child’s head in your lap or in your arm so

you can see the teeth and all parts of the mouth.

Clean: Remove food from teeth and gums using a clean soft

cloth or soft toothbrush.

Lift: Use your fingers to lift the child’s lips to look for white or

brown spots on any of the teeth — signs of tooth decay. If you see

any of these spots, contact a dentist.

Look inside: Look at all areas of the mouth for unusual color,

bumps, cuts, or sores. If you see any of these, contact a dentist.

8 Kansas Child A Publication of Child Care Aware ® of Kansas


How to Find a Provider

Families with babies reaching the first birthday can begin to

find a dentist by checking with the dental office that adult family

members attend. The request is simple: “I would like

for the dentist or hygienist to look at my baby’s first

teeth to see if there are any concerns and give some

advice about teething and keeping my baby’s teeth

free of tooth decay.” Keep the request simple rather

than asking them to conduct an age-one dental visit.

Another option for families who don’t have a regular dentist is

to ask the baby’s health care provider, early child care providers,

school nurses or other parents. If the recommended dentist is a

pediatric specialist, ask for an “age-one dental visit.” If the dentist

is not a pediatric specialist, simply ask about checking your baby’s

teeth. It is also a good idea to ask which dental insurance the

office accepts. If they don’t accept the insurance coverage your

family has, you can ask what the fee will be for the appointment.

Safety net dental clinics provide care to all ages, regardless of

whether the family has dental insurance. They accept payment

from Medicaid (KanCare), private insurance, and private pay. The

fee is determined by the patient’s ability to pay. Use this map to

see if you have a safety net dental clinic in your area. More details

can be found on this website: http://www.kamuonline.org/

In Kansas, a new resource for “age-one dental visits” is during

routine early childhood developmental screenings. Families with

young children who participate in developmental screenings in

their community might discover dental professionals conducting

dental screenings for children, along with application of fluoride

varnish. The dentist or dental hygienist can provide guidance for

families on teething and healthy habits to adopt so children can

remain free of cavities. Check with local health departments and

school districts in your area for availability of these services.

To help your children stay healthy, it is important for them

to see a dental professional on a regular basis, starting at age

one. This is the best way for children to grow up cavity-free and

ready to learn.

2016 KAMU Member Clinics and Satellite Clinics

As of 6/1/2016

1. Agape Health Clinic

2. Atchison Community Health Clinic

3. Bluestem PACE

4. Children’s Mercy West,

The Cordell Meeks, Jr. Clinic

5. Comcare of Sedgwick County

6. Community Health Center in Cowley County

7. Community Health Center of SE Kansas

8. Community Health Ministry Clinic

9. Crosswinds Counseling & Wellness

10. Douglas County Dental Clinic

11. Duchesne Clinic

12. E.C. Tyree Health & Dental Clinic

13. Family Service & Guidance Center

14. First Care Clinic

15. Flint Hills Community Clinic

16. Flint Hills Community Health Center

17. Genesis Family Health

18. GraceMed Health Clinic

19. Greeley County Health Services

20. Guadalupe Clinic

21. Health Care Access

22. Health Ministries Clinic

23. Health Partnership Clinic

24. HealthCore Clinic, Inc.

25. Heart of Kansas Family Healthcare

26. Heartland Community Health Center

27. Hoxie Medical Clinic

28. Hunter Health Clinic

29. Hutchinson Area Student Health Services

30. Jefferson County Health Department

31. Johnson County Department of

Health & Environment

32. Kansas Statewide Farmworker Health Program

a voucher program with 105 access points statewide

33. Konza Prairie Community Health

& Dental Center

34. KU Health Partners/Silver City Health Center

35. Lincoln County Medical Clinics

36. Marian Dental Clinic

37. Mayflower Clinic, Inc.

38. Mercy and Truth Medical Missions

39. PrairieStar Health Center

40. Rawlins County Dental Clinic

41. Saint Vincent Clinic

42. Salina Family Health Care Center

43. Shawnee County Health Agency &

Community Health Center

44. Southwest Boulevard Family Health Care

45. Swope Health Services

46. Turner House Children’s Clinic

47. Valeo Behavioral Health Care

www.ks.childcareaware.org Kansas Child 9


When screening

young children, don’t

forget the mouth

Children grow up healthy when they hit

developmental milestones at the right time.

In counties across the state, children take part

in developmental screenings to determine

how their communication abilities, fine

and gross motor skills, self-help behaviors,

hearing and vision, and social-emotional

health are progressing. In one county, oral

health is now a part of those screenings. The

Butler County Child and Family Development

Task Force has added dental screenings in

their “Count Your Kid In” screening process.

What happens at an

oral health screening?

A dental hygienist conducts the screening,

which lasts a few minutes. The screening

includes a visual check for areas of concern,

discussion with the parents regarding oral

health habits, and an optional fluoride varnish

treatment. Families are eager to find out

about the health of their child’s teeth and

mouth, and referrals are made when dental

work is indicated. Children will receive a new

toothbrush and toothpaste, and families

will gain basic knowledge of the importance

of oral health and its contribution to their

child’s overall health. Finding and treating

dental problems early will help children have

good oral health for life.

Why is this important?

In addition to early identification of dental

problems, oral health screenings produce

data that help drive oral health policy. The

screening data is useful in understanding

the oral health needs of young children,

which helps demonstrate the need for

funding dental services and developing

educational programming for families and

children. Since 2015, close to 200 children in

Butler County have received an oral health

screening. The data that is collected at these

screenings is anonymous. It is submitted to

the Kansas Department of Health and

Environment Bureau of Oral Health and

included in their statewide, dental screening

data base.

Are you interested

in oral health screenings?

Including oral health in developmental

screenings is a great way to keep children

healthy, educate families, and improve oral

health policy across the state. To find out how

to add oral health into the developmental

screenings in your community, contact Doug

Bowman at Oral Health Kansas, dbowman@

oralhealthkansas.org or 785-235-6039.

Fluori

Protecting smiles for more than

Let’s face it, most children are not

very good at brushing their teeth.

Getting your children to brush can be a

battle of wills. There are several actions

that a parent can take to improve their

children’s oral health. Providing the

benefits of fluoride is one action that

can protect children from unnecessary

pain and trauma.

Why is fluoride important?

Baby teeth are more than a practice

set. Children have baby teeth until they

are at least 12 years old, and sometimes

even longer. Children’s teeth can be more

vulnerable to decay because they have

thinner enamel, and because children have

a limited diet and do not yet have the skills

to brush effectively.

A tooth that has a cavity can spread that

infection to surrounding teeth. All teeth

are important, and when baby teeth are

lost too soon, children can have challenges

with social development, proper chewing,

and even their facial features. Most

importantly, baby teeth hold the

space for the adult tooth that is

forming and getting ready to push up

into the mouth. Fluoride builds and

strengthens the enamel walls of the adult

teeth, while preventing cavities in the

baby teeth. This is what makes fluoride an

important nutrient for the development

and protection of teeth. It is important for

parents to know the sources of fluoride

and the role it plays in good oral health.

Fluoride comes in several forms, and

together they work to help prevent or lessen

the severity of decay in children’s teeth.

Community water fluoridation

Cavities are the number one preventable

chronic disease in children in the United

States, and the number one way to

10 Kansas Child A Publication of Child Care Aware ® of Kansas


de

seventy years

prevent cavities is drinking water with

fluoride. Fluoridation of water

began in 1945 and has been used to

strengthen teeth effectively for more

than 70 years. Fluoride is a mineral that

exists naturally in all water supplies, and

water is considered to be fluoridated when a

public water system adjusts the fluoride to a

level that is optimal or ideal for preventing

tooth decay. It takes a very small amount

of fluoride in the water to provide effective

protection against cavities.

Drinking water straight out of the tap

is the easiest and safest way to provide

protection against tooth decay. The only

requirement is to drink it every day! Most

bottled water does not have fluoride in

it, but people who live in communities

without fluoridated water can

purchase bottled water with fluoride,

which can be found in most stores in

the nursery section. The pink label will

identify it as containing fluoride.

Fluoridated toothpaste

Another great defense against tooth

decay is good tooth brushing habits

that include using toothpaste with

fluoride. All children should brush for

two minutes, two times a day using a

small-headed soft toothbrush that is ageappropriate.

The American Academy of

Pediatrics recommends toothpaste with

fluoride as soon as the first tooth

begins to erupt. Parents should use a

smear of fluoride toothpaste until the

child turns three and use a small peasized

amount after age three. An adult

should always dispense the toothpaste

and assist with brushing. Swallowing

a small amount of toothpaste is not a

problem, but spitting out as much as

possible is encouraged. Do not swish

with water after brushing. This helps

ensure the fluoride has time to soak into

the teeth. Since the 1950s, fluoridated

toothpaste has been an important part

of preventing cavities for children and

continues to be today.

Fluoride varnish

Fluoride varnish also is an effective

tool in fighting tooth decay. It can be

applied by a trained medical or dental

professional at routine office visits or

in community-based settings. Painting

this clear, sticky gel on the teeth is a quick,

easy, and painless process, but the

teeth might feel a bit fuzzy for a few

hours. This varnish covers the teeth

and allows the fluoride to become part of

each tooth, right where it is most needed.

Fluoride varnish protects teeth from acid

attacks that cause tooth decay. According

to the American Academy of Pediatrics,

fluoride varnish can be applied every three

to six months for children of all ages. This

method of using fluoride gives children

an extra boost to protect their teeth

from decay.

Parents who ensure their children

regularly use fluoride find that their

children have less severe decay. Fluoride

in all forms helps form strong teeth,

repairs areas that are under acid attack,

and helps prevent cavities. It also

can reduce both painful tooth problems

for children and costly dental and

medical bills for parents. Fluoride is an

excellent way to get children off to the

right start that can last a lifetime. Let

this next generation live a life free

of dental decay.

Is my child

at risk for

cavities?

Try out this simple quiz to see if your child

is at risk for getting cavities.

A “yes” answer to any of these

questions can put your child at greater

risk for cavities.

Y N

n n Has your child ever had a cavity?

n n Has a daily caregiver or someone

who lives in the same house as

the child had a cavity in the past

two years?

n n Does your child share toothbrushes

with other family members?

n n Does your child go to bed with a

bottle containing any liquid other

than water?

n n Does your child regularly use a

sippy cup containing any liquid

other than water?

n n Does your child snack regularly

on foods containing sugar and

white flour?

What change can you make to lower the

risk of your child getting cavities?

A “yes’” answer to any of these questions

will help protect your child from cavities.

Y N

n n Does your child drink water daily

that contains fluoride?

n n Are your child’s teeth brushed by an

adult before bedtime?

n n Does the toothpaste you use for

your child contain fluoride?

n n Has your child been seen by a

dental professional?

What change can you make to protect

your child from cavities?

If you have decided to make a change

or two:

•§

How important is it to you to make

this change?

•§

How confident are you that you can

make it?

•§

What support do you need from others

to help make this change?

www.ks.childcareaware.org Kansas Child 11


Sip all day,

What’s in Your Drink?

Oral Health Kansas has a sugary drink display available to check out for up to one month at

no cost. Organizations, schools, and businesses may check out the display to share at an

event, in a lobby, or anywhere else it can be seen and enjoyed. The display includes ten popular

beverages and shows how much sugar is in each. The sugar is shown in clear glass jars, and

each drink has a sign that lists the number of teaspoons of sugar it contains. The display also

includes healthier beverage options as alternatives to sugary drinks.

This display has been popular at health fairs, schools, clinics, dental offices and day care

centers. People report that it changes their perspective of how much sugar the drinks contain.

Some even report they decided to stop drinking a favorite beverage because of the amount of

sugar. Others have taken pictures of the drink display to share with family members. Both adult

and child versions of the drink display are available. They include drinks popular with different

age groups, from chocolate milk

and juice to energy drinks and

sugary coffee beverages.

Oral Health Kansas will

ship the display for free and

reimburse shipping costs to

return it. It is free to use, but

its effect may be priceless. To

reserve a drink display, email

Oral Health Kansas at info@

oralhealthkansas.org.

It’s no secret there is a strong link

between the frequent use of sugary

drinks and getting more cavities.

Ninety-one percent of children in the

United States drink sugary beverages daily.

In the last decade, the calories consumed

from sugary beverages have jumped 60

percent in children. At the same time, 30

percent of children now have cavities by

the time they reach preschool age.

Soft drinks tend to get all the media

attention, but fruit juices are not a better

option. Parents, child care providers and

kids are drawn to the convenience of

the small, 6.75-ounce juice boxes. The

boxes are attractive — bright colors with

promises of 100 percent real juice and

vitamins give people the idea that juice is

a healthy choice. In fact, even though

they have more nutrients, they contain

just as much sugar and calories as soft

drinks. Drinking too much juice can lead

to tooth decay and obesity.

What are sugary drinks doing to

your child’s teeth?

Drinking juice, soda or sports drinks

might help wash down a meal or help

your thirst, but they leave unwanted sugar

behind on teeth. Tooth decay is caused by

bacteria in the mouth using sugar

from foods and drinks to produce

acids that dissolve and damage the

teeth. Each “acid attack” lasts for

around 20 minutes. Every time you

take a sip of a sugary drink, the

acid attack begins all over again.

Stay hydrated the right way

Our bodies need water to

function properly. Did you know

lack of water can make a

person feel tired? Next

time you or your child

12 Kansas Child


get decay

of children in the United States

91 % drink sugary beverages daily

start to feel sluggish or cranky, reach for

water. Tap water is free and easy! Just turn

on the faucet. If the water in your area is

fluoridated, there is the added benefit of

protecting teeth from cavities. Water is good

for your whole body and won’t damage your

teeth like sugary drinks.

Here are some other benefits from

drinking plenty of water:

•§

It washes out leftover food and cavitycausing

bacteria in the mouth.

•§

When chosen over a sugary drink, it is

healthier and filling, which

can prevent overeating that leads

to obesity.

•§

It improves cognitive and physical

performance.

•§

It flushes out toxins that can lead to

illness.

Fun and easy ways to get kids to

drink more water

There is a growing number of early

child care programs that make drinking

water available to young children whenever

they wish. The goal is to increase water

consumption each day and reduce

children’s dependence on juice or sweet

beverages for hydration. Kansas City

Kansas Community College’s Child Care

Center, for example, offers water in pitchers

at every meal, allowing the children to

pour it themselves. While at school, some

children drink two cups of water at the

meal and have water fountains available at

all other times throughout the day. Here

are tips for encouraging children to drink

fluoridated water during the day.

Make it fun: Drink from single-use bendy,

silly, or colored straws. Or children can

choose their favorite cups or water bottles.

Keep it portable: Water bottles that can

be carried anywhere and refilled with tap

water are great.

Flavor it: Children used to drinking

juice, juice drinks, or pop (soda) might

think water is too plain. Add fruit, such as

lemon, lime, or orange slice, blueberries,

raspberries, strawberries, or fresh mint.

Ice it: Serve water with ice cubes or

crushed ice. Look for ice cube trays in fun

shapes such as dinosaurs, letters,

or animals.

Make it available: Set up a station where

children can get a drink of water so they

do not get thirsty. It can be as simple as

keeping a non-breakable water pitcher

on a low counter or a chair where young

children can reach it.

Model it: Young children learn by watching.

Be a good role model by drinking water

instead of drinks that have sugar.

Feel free to enjoy the occasional sugary

drink as a treat. Here are some ways to

reduce the amount of sugar in beverages

that children and their families are

drinking:

•§

Plain white milk can be a healthy option

at meals, but flavorings add a lot of

sugar.

•§

Look on the packaging on juices to

make sure there is no added sugar.

•§

If you are eating out, ask to replace the

default sugar-sweetened beverage with

water.

•§

Give your child a water bottle to refill

throughout the day at daycare or

preschool.

•§

When other people, such as

grandparents or babysitters look after

your child, ask them to give your

children low-fat milk or water rather

than other drinks.

Be creative and come up with some other

fun ideas! Helping children make smart

choices early on will result in a longer life

with good oral and overall health.

The Benefits of Water

Water is the cornerstone for all body

functions. It is sugar-free, caffeine-free

and calorie-free, plus it costs nothing!

Water washes out leftover food, residue

and cavity-causing bacteria in the

mouth that wears away enamel. Water

cleans every mouth with every sip.

It is as easy as turning on the tap.

Reserve drinks such as juice and soda

for an occasional treat.

As a money-saving and protective

choice, most tap water contains

fluoride, which has the added benefit

of protecting teeth from cavities.

Carry a refillable water bottle for easy

access and add healthy fruit such as

lemons and berries to water.

To prevent dehydration, it is best to not

only drink water throughout each day,

but also eat raw vegetables and fruits,

which are valuable sources of water.

www.ks.childcareaware.org Kansas Child 13


Fishing “Snack-tivity”

Here is an idea that combines healthy snacking with a fun activity

addressing fine motor skills, sequencing, language production

and imaginary play. Using carrots, whole-grain fish-shaped snack

crackers, and hummus or peanut butter, children have a great time

“catching” their snack! For complete details, check out this web-site:

http://www.two-daloo.com/toddler-snack-idea-fine-motor-fishing/

Healthy

Snacking

Mini Pizza Crackers

Ingredients

•§

24 whole-wheat crackers

•§

3 tablespoons pizza sauce

•§

Pizza topping, such as diced vegetables (for example,

mushrooms, olives, or peppers) or cooked and cubed beef,

chicken, or ham

•§

1½ cups shredded low-fat cheese

Directions

Snowman Crackers

Ingredients

•§

1 box round whole-wheat or rice crackers

•§

1 package light cream cheese, softened

•§

1 can black beans, drained and rinsed

•§

1 carrot, cut into thin strips about ¼ inch long

•§

1 red or orange bell pepper, cut into

strips about ¼ inch wide

•§

1 to 2 celery stalks, cut into

short thin strips

Directions

1. Spread a thin layer of cream

cheese onto 3 crackers.

2. Arrange the crackers to make a snowman.

3. Add black beans for eyes, a mouth, and

buttons; a carrot for a nose; bell pepper

for a hat; and celery for arms.

Safety tip: An adult should slice

the ingredients.

Featured December 2013: Tooth brushing Tips

1. Spread each cracker with ½ teaspoon pizza sauce.

2. Put pizza topping on top of sauce.

3. Sprinkle pizza topping with low-fat cheese.

4. Put crackers on a microwave-safe plate.

5. Microwave on high for 1 to 2 minutes, until cheese melts. Before

serving, check to make sure that the cheese is not too hot.

Young children eat small amounts of food because

their stomachs are small. This means they are more likely to eat

several times each day. Most people are aware that sugar causes

cavities, but did you know that foods that are not sweet, but that

are made with white flour also can cause cavities? This includes

snacks such as pretzels and crackers. Studies show that children

who snack on foods with sugar and white flour throughout the

day are more likely to get cavities.

How do sugar and white flour cause cavities?

To get a cavity, three ingredients must be present. Germs that

cause cavities live in our mouths. They need sugar and white

flour (simple carbohydrates) to live and grow. The germs break

down foods with sugar and white flour to form acid. Each time

these types of foods are eaten, more acid is formed that can eat

away at the enamel of teeth for 20-40 minutes. We call these acid

attacks. The more acid attacks you have during the day, the more

likely they are to make holes (cavities) in your teeth. Check

out the graph below to see how these ingredients make up the

Cavity Equation.

We don’t feel the acid attack happening, but our teeth can be

under attack every day. Because of this, in order to prevent tooth

decay, how often we eat is just as important as what foods we eat.

Here is an example: If we eat 3 times a day, breakfast, lunch and

dinner, and we eat the kinds of food that germs like to eat, we have

three, 20-minute acid attacks daily. But if we eat little bits of these

foods or sip on sweet drinks all day long, we have many, many acid

attacks throughout the day that damage the enamel of our teeth.

The graph on the next page shows how frequent snacking on

sugary foods can cause our teeth to be under “attack” all day long.

Safety tip: If children are too young to read or follow written

directions, they are too young to use a microwave without

supervision.

Featured February 2013: Oral Health Literacy

14 Kansas Child A Publication of Child Care Aware ® of Kansas


1 2 3

Here are 3 great ways to help keep the acid from destroying

your teeth:

1 Limit the times you eat simple carbohydrates.

Choose snack foods that do not contain sugar or

white flour. Eat carbohydrates only at mealtime.

2 Swish with water right after eating to wash off the food.

3

Remove the germs from your mouth by brushing

and flossing.

Finding hidden sugar

Many foods contain added sugar. The best place to check for

sugar is in the ingredients list on the food label. Be aware that

sugar can be listed by many different names. Look for words like:

•§

Beet sugar

•§

Brown sugar

•§

Cane sugar

•§

Corn sweeteners

•§

Corn syrup

•§

Cane juice

•§

High fructose corn syrup

•§

Honey

•§

Malt syrup

•§

Molasses

•§

Raw sugar

•§

White sugar

This ingredient list shows three types of sugar in a granola bar.

Ingredients: Whole Grain Oats, Sugar, Canola Oil, Rice

Flour, Honey, Salt, Brown Sugar Syrup,

Baking Soda, Soy Lecithin, natural Flavor. CONTAINS

SOY; MAY CONTAIN PEANUT,

ALMOND AND PECAN

INGREDIENTS.

Tips for healthy snacking and healthy teeth

Here are some tips that can help you keep children

cavity-free:

•§

Think of sugary foods as “treats” that you save for

special days and non-sugary foods as snacks that

can be eaten every day.

•§

When offering sugary foods and drinks, try to

serve only at meal time.

•§

If you need to travel with cereal or crackers, make

sure to choose whole grains.

•§

Encourage child to try new snack foods that do

not contain sugar.

•§

Give a child water or plain white milk to drink

with snacks.

•§

Offer only water when a child is thirsty.

•§

Avoid foods that cause choking, such as popcorn,

nuts, seeds, raw carrots, or whole grapes. Cut

foods into small pieces.

•§

Try using soothing words or actions rather than

food to calm a child.

www.ks.childcareaware.org Kansas Child 15


BRUSH

BOOK

BED

Young

Structuring a Young Child’s Bedtime Routines

children thrive when they have

structure. In Topeka, a new program is

being launched that will help families start

bedtime routines that will keep kids healthy,

and make a habit out of reading. The Brush,

Book, Bed program works with low-income

families to make it a habit to brush teeth

and read a book before bedtime.

Bedtime can be a particularly stressful

time for young families, but there is help

available to address this challenge. The

Brush, Book, Bed program, designed by

the American Academy of Pediatrics, offers

a simple and clear message for all parents

of young children:

•§

Every night, help your child to brush

his or her teeth.

•§

Snuggle up and read a book.

•§

Get to bed at a regular time.

Every night, help your child to

brush his or her teeth.

BRUSH Young children need

assistance from an adult to ensure that

tooth brushing is done effectively. The need

for brushing before bedtime is essential in

removing food particles from the mouth.

This will prevent the onset of tooth decay

during the night’s sleep. Look for guidance

on tooth brushing in the article found on

page 7 of this magazine.

At bedtime, it should be noted that

brushing teeth does not have to occur in

the bathroom. Two minutes at the bedside

might reduce the distractions that could

otherwise unravel the routine. It is not

necessary or recommended to rinse after

brushing, as this simply washes away the

helpful fluoride provided by the small dab

of toothpaste. If it is absolutely necessary

to spit, try having an extra cup on hand

for that specific purpose. The intent is

to minimize the distractions from the

bedtime routine.

Continued from page 17

16 Kansas Child A Publication of Child Care Aware ® of Kansas


Continued from page 16

Snuggle up and read a book

(maybe more than one).

BOOK It is never too early to

start reading to a child. When selecting

a book at bedtime, choose something

that is appropriate for the child’s age and

temperament, and provides the “winding

down” mood you hope to create. Some

children will insist on making their own

choice. Don’t allow the selection process

to get out of hand. Try asking: “This

book or that one?” Providing a small

number of options allows the child a

sense of controlling their environment,

while helping to avoid looking at all the

books in your library.

Get to bed at a regular

(predictable) time.

BED The importance of sleep

to your child’s health (and yours)

cannot be overstated. The closeness or

“snuggle” time is a critical component

of the going-to-bed process. Fostering

a sense of warmth and security while

reading the book(s) will contribute to

the child’s willingness to go to sleep. A

standard, nighttime routine that clearly

helps the child wind down is a good first

step. Striving for a regular bedtime and

sticking to it is critical. If you are waiting

for signs of sleepiness such as yawning,

you might already have lost the battle by

delaying the process.

In Topeka, three home-visiting

programs are pilot-testing the Brush,

Book, Bed program. As a way to teach

children about their teeth and visiting

the dentist, they are providing families

with children’s oral health books

recommended by the Maryland Dental

Action Coalition. Families also will

receive some popular non-oral health

children’s books. Through the pilot

project, children and families will be able

to learn how to create a bedtime routine

involving brushing teeth and reading

books. The lessons learned through the

project will help create a program that

organizations across the state can use to

help families create healthy habits that

will last a lifetime. Communities that

are interested in offering Brush, Book,

Bed should contact Doug Bowman

at Oral Health Kansas: dbowman@

oralhealthkansas.org or 785-235-6039.

Tooth Adventures

By Alice Eberhart-Wright, Family and Early Childhood Specialist

Books can help families and early childhood educators teach children to care for

their teeth. This issue of Kansas Child is all about oral health, so I turned to my stash

of children’s books on that topic. I limited myself to a

few written by favorite authors and featuring wellloved

characters.

The Tooth Book, by Dr. Seuss, is a Bright and

Early board book. Babies getting their first teeth

will probably love to chew on it! The rhyming

verses are fun for adults and

beginning readers to read

aloud and serve as a delightful

introduction to a focus on

teeth. There are some simple

facts worked into this silly

story about teeth in people

and animals: numbers of

teeth in your mouth, what happens when you

gobble junk and how teeth help you talk, rather

than quack like a duck. This Dr. Seuss book is so

much fun that you could read it every day until

children have memorized it: “They sure are handy

when you smile. So keep your teeth around awhile.”

Next is a pop-up board book from Sesame Street called Ready, Set, Brush! We love

this book because it has all sorts of things to manipulate while learning how much

toothpaste to put on the brush, the motions involved in brushing teeth and tongue,

and how to swish water around in your mouth. Readers

can also count the teeth in Martha Monster’s

mouth. Children reading this book will need

supervision from adults or older children.

Otherwise, the toothbrush will disappear and

Sesame Street characters will lose body parts!

Some people may think that you can’t give

children books because they will tear them up.

Instead, consider that this is a book to enjoy

together, to be read, put back on a shelf and

retrieved frequently for positive time between a

child and an adult or older child.

Finally, I chose the old, familiar Berenstain

Bears Visit the Dentist. Children should start

visiting the dentist as babies, so it’s important

to have a book that orients them with some

of their trusted, lovable literary friends.

What will the dentist do in that room with all

those gadgets? Will it be scary or an exciting

adventure? Will the dentist be nice? Brother has

a cavity and gets a filling that requires all sorts of

interesting procedures while Sister curls up on

mother’s lap looking a little worried. Sister only has

a loose tooth. The dentist gives a little tug and out it

comes. She heads home with a tooth for the tooth

fairy and a balloon proclaiming “I brush every

day,” instead of a lollipop.

These are but a few of the many great books on

this topic. See page 18 for more titles.

www.ks.childcareaware.org Kansas Child 17


Oral Health Books

for Children

Oral Health Care

Highly Recommended

Brush, Floss, and Rinse: Caring for Your Teeth and Gums*

Amanda Doering Tourville, Picture Window Books, 2009

Ready, Set, Brush

Sesame Street, Readers Digest Children’s Books, 2008

Brushing Teeth

Mari Schuh, Capstone Press, 2008

Toothful Tales: Becoming Me Cavity Free

Jeanette Flannery Courtad, DDS

Mentors International Publications, 2015

Recommended

Brush, Brush, Brush!

Alicia Padron, Scholastic, 2010

Brush Your Teeth Please

Leslie Mcguire, Studio Fun, 2013

Flossing Teeth*

Mari Schuh, Capstone Press, 2008

Visiting the Dentist

Highly Recommended

At the Dentist*

Mari Schuh, Capstone Press, 2008

Going to the Dentist

Anne Civardi, Usborne, 2010

Dentists Help

Dee Ready, Capstone Press, 2013

Dentists

Kristin L. Nelson, Lerner Publishing Group, 2005

Recommended

Max Goes to the Dentist*

Adria F. Klein, Picture Window Books, 2006

My Dentist, My Friend

P. K. Hallinan, Ideals Children’s Books, 2002

A Visit to The Dentist’s Office

Patricia J. Murphy, Capstone Press, 2005

A Day in the Life of a Dentist

Heather Adamson, Capstone Press, 2004

The Berenstain Bears Visit the Dentist

Stan and Jan Berenstain, Random House, 1981

General Information About Teeth

Highly Recommended

Loose Tooth*

Mari Schuh, Capstone Press, 2008

Mouth*

Cynthia Klingel and Robert B. Noye, Gareth Stevens Publishing, 2010

I Know Why I Brush My Teeth

Kate Rowan, Scholastic, 2000

Recommended

All about Teeth*

Mari Schuh, Capstone Press, 2008

Snacks for Healthy Teeth*

Mari Schuh, Capstone Press, 2008

The Tooth Book

Dr. Seuss, Random House, 2003

The book list and additional information about each book

is available at http://guides.hshsl.umaryland.edu/dentistry/

DentalBooksForChildren

*Bilingual edition also available 4/15

18 Kansas Child A Publication of Child Care Aware ® of Kansas


Children receive

dental coverage

through CHIP

Contact your representatives

to continue coverage for children

What is CHIP?

The Children’s Health Insurance Program

(CHIP) provides free or low cost health

coverage to kids and other family members,

even kids whose parents make too much

money for Medicaid coverage can qualify

for CHIP. To qualify in Kansas, kids must be

under the age of 19. Over the past 15 years,

CHIP has done an excellent job in reducing

the number of children without health

insurance. And, under the Affordable Care

Act, even more kids are covered.

What’s covered?

Under CHIP, there are 26 completely

free “preventative health services” that

include vaccinations and 10 essential

health services that include pediatric

dental and vision care, emergency services,

maternity and newborn care.

What’s at stake?

CHIP provides health and dental

coverage to more than 8 million children

nationwide and is in jeopardy of running

out of funding. If funding for the program

runs out, millions of low-income working

families will be worse off. Children

currently enrolled in CHIP would be

required to get private coverage on the

health insurance Marketplace, and it is

estimated that nearly two million children

would not be eligible for a tax credit.

Without any payment support, replacing

CHIP coverage with private insurance will

simply be unaffordable for these families.

In fact, if CHIP ends, families will pay

much more for children’s coverage, even

if they are eligible for a tax credit. Under

CHIP, families are protected from paying

no more than 5% of their income for

their children’s health and dental-related

expenses, but many CHIP income-eligible

families purchasing private coverage could

be expected to pay nearly 9% of their

annual household income in addition to

their premiums. And unlike CHIP, in most

state Marketplaces, there is no guarantee

that children will receive dental coverage

when they purchase a health plan.

Act now

Congress must act in 2017 to ensure

that this critical children’s health coverage

continues, and it is up to families, providers

and advocates to stand up and deliver that

message. Allowing CHIP funding to expire

would be a step backward for families

- especially at a time when our country

has made important strides in expanding

coverage. Contact your representatives

(see below) and make sure they know that

letting CHIP end is not an option.

See if you qualify

Each state program has its own rules

about who qualifies for CHIP. There are

two ways to see if your children qualify:

•§

Visit www.insurekidsnow.gov and

select Kansas. Or call 1-877-543-7669.

•§

Fill out a Marketplace application.

HealthCare.Gov will tell you which

programs you and your family qualify

for. If it looks like anyone is eligible

for CHIP, they will let your state CHIP

agency know so your coverage can

start right away.

To find out more information on CHIP

or how to contact your representatives,

contact Rachel Alexander at ralexander@

ohks.org or 785-235-6039.

SENATOR

PAT ROBERTS

109 Hart Senate Office Building

Washington DC, 20510

202-224-4774

Email form

SENATOR

JERRY MORAN

Russell Senate Office Building

Room 361A

Washington DC, 20510

202-224-6521

Email form

CONGRESSMAN

ROGER MARSHALL, MD*

Contact Information Pending

http://www.whoismyrepresentative.

com/

CONGRESSWOMAN

LYNN JENKINS

(2ND DISTRICT)

1027 Longworth HOB

Washington DC, 20515

Phone 202-225-6601

Email form

CONGRESSMAN

KEVIN YODER

(3RD DISTRICT)

215 Cannon HOB

Washington DC, 20515

Phone 202-225-2865

Email form

CONGRESSMAN

MIKE POMPEO**

(4TH DISTRICT)

107 Cannon HOB

Washington DC, 20515

Phone 202-225-6216

Email form

*Dr. Marshall was elected in November 2016. He will be sworn into office in January 2017. At this writing, his Congressional contact information has not yet been set.

**On November 18, 2016, Congressman Pompeo was nominated by President-elect Trump to serve as the new CIA Director. A replacement for the Congressman may be selected by early

2017, at which time new contact information would be available.

www.ks.childcareaware.org Kansas Child 19


ACA

KanCare: Benefits and Challenges

The Kansas Medicaid program, known as KanCare, provides

health and dental services to more than 450,000 low-income

Kansans. The program is funded with a combination of state

and federal funds, and since 2013 it has been operated by

three private, managed care organizations: United Healthcare,

Sunflower Health Plan, and Amerigroup.

KanCare covers dental services for children that include

cleanings, fluoride varnish, and fillings. For adults, coverage

is limited to cleanings and emergency extractions. This means

the parents of many children on KanCare do not have dental

coverage. Their children are able to get dental problems such as

cavities fixed, but parents must go without care when they have

dental issues.

The number of dental providers who accept KanCare patients is

low, compared to the number who accept patients with private

insurance. This is due in part to the low rates KanCare pays for

services. In general, KanCare pays dentists less than the actual

cost of providing the services.

Because few dentists accept KanCare patients, it can be difficult

to find a dental provider. In July 2016, the problem increased

when the KanCare rates for dental providers were further cut in

an effort to help balance the state budget. The additional rate

cut resulted in some prominent dentists deciding to stop seeing

KanCare patients.

The KanCare program has faced additional challenges during

the past several months as the process to determine people’s

eligibility has become very slow. Low-income Kansans have been

waiting weeks or months to find out if they are eligible for the

program, and in the meantime, they have not had coverage for

medical or dental services.

Oral Health Kansas is an advocate for KanCare dental services.

The organization believes it is critically important for low-income

Kansans to have access to dental services to maintain both their

oral health and their overall health. If you or a family you know

has had trouble finding KanCare dental services for a child or a

parent, please contact Oral Health Kansas. Stories about the real

challenges Kansas families are facing help Oral Health Kansas

explain to lawmakers why it is important to invest in a strong

network of dental providers who serve KanCare patients. Contact

Oral Health Kansas at info@oralhealthkansas.org with your story.

How is dental

coverage offered in

the Marketplace?

Are families required to purchase

dental insurance for their children

through the Marketplace?

What services

are covered?

What is the cost breakdown of

dental plans in the Marketplace?

Are you

eligible for cost

assistance?

20 Kansas Child A Publication of Child Care Aware ® of Kansas


ACA Offers Private Dental Insurance For Kids

All across the country, the Affordable Care Act (ACA) is helping to make health care accessible to millions of people. In fact, six

years after its passage, 20 million more Americans now have health care coverage thanks to the ACA, and this number is expected

to grow as more people continue to seek the quality, affordable care they need.

In November 2016, Kansas kicked off another open enrollment period for the Health Insurance Marketplace. The Health Insurance

Marketplace is an online price comparison website where consumers can purchase health insurance. The Marketplace is open each

year during the annual open enrollment period. Open enrollment is the only time you can apply for cost assistance, enroll in a plan,

or switch plans without qualifying for a special enrollment period.

The ACA requires that pediatric dental coverage be offered on the

Marketplace, either as part of a qualified health plan (QHP) that

combines medical and dental coverage or as a stand-alone dental

plan, sold separately. This means that any child or adolescent

(age 0-18) enrolling in health coverage on the Marketplace is also

eligible to enroll in dental coverage.

In nearly all counties in Kansas there is at least one combined health

plan offered that includes pediatric dental coverage. For the 2017 plan

year, BlueCross BlueShield Kansas Solutions, Inc., is the only insurer

offering plans that include pediatric dental. However, this insurer does

not offer plans in Johnson or Wyandotte counties.

In addition to medical plans that include pediatric dental coverage,

families have the option to purchase their children’s health and dental

coverage through separate plans. These stand-alone dental plans may

also allow adults to purchase dental coverage for themselves at an

additional cost.

Families enrolling their children in a medical plan that does not

include dental insurance are not required to enroll them in a

dental plan.

Any plan offering pediatric dental coverage must cover preventive

and restorative services, such as cleanings, fluoride treatments,

dental sealants, X-rays, and fillings. Orthodontic services such as

braces typically are covered only when medically necessary. You

can find the full list of services at: https://www.insurekidsnow.gov/

state/ks/index.html.

When purchasing a dental plan separately from a medical plan,

families will be required to pay an additional monthly premium for

that dental coverage.

High-coverage dental plans have a lower deductible or copayment

at the dental office but a higher monthly fee. This means that a

family will pay more every month but less for dental services at the

time of the visit.

Low-coverage dental plans have lower premiums but higher

copayments and deductibles. A family will pay more when they use

dental services but less in monthly premiums.

When buying health insurance through the Marketplace, a family

might be able to get financial assistance to help pay their monthly

premiums. The amount of financial assistance available will

depend on the household income.

Families can use this assistance to help pay for any health plan

in the Marketplace, and get the same amount of assistance

no matter which health plan they buy. If families get enough

assistance to cover the full premium for a health plan and still

have money left over, they can use that money to pay for a

separate children’s dental plan. However, they cannot get financial

assistance if they are buying only a separate dental plan.

To compare dental plans in the Marketplace and find details about

each plan’s costs, copayments, deductibles, and services covered,

visit: https://www.healthcare.gov

Future of the ACA

The incoming Trump Administration has pledged to repeal and replace the ACA, which is also known as Obamacare. It is impossible

to say how, if or when the law will be replaced. Many parts of the ACA remain popular, including the provision that adult children

under age 26 can remain on their parent’s insurance policy, and the stipulation that people cannot be denied coverage if they have a

pre-existing condition. Today, the ACA remains the law of the land. More than 100,000 Kansans have been able to purchase health

insurance through the Marketplace, and the percent of Kansans who are uninsured dropped from 9 percent in 2009 to 6.3 percent in

2016 following the passage of the ACA.

For additional information regarding dental benefits in the Marketplace, contact Rachel Alexander at ralexander@oralhealthkansas.

org or 785-235-6039.

www.ks.childcareaware.org Kansas Child 21


Certainly Smile-Worthy

Kansas Can Improve

Oral Health in 2017

with Dental Therapists

A guest article by Amanda Gress

Director of Government Relations

Kansas Action for Children

It’s no secret that regular dental care

carries enormous benefits for children’s

overall health and well-being.

Cavities and toothaches hurt, and dental

decay makes it difficult for kids to succeed in

school and grow up healthy. Unfortunately,

too many Kansas families struggle to find

regular, affordable dental care, and our

children’s oral health suffers as a result.

That’s why the Kansas Dental

Project is working to increase access

to dental care in our state by adding a

new mid-level provider, called a dental

therapist, to the dental team. Dental

therapists will work with a dentist’s

supervision to provide routine restorative

and preventive care, through the most

common procedures like cleaning teeth

and filling cavities. They will be dental

hygienists who receive rigorous education

and training to provide additional

procedures and serve more of their

patients’ oral health needs.

Dental therapists have been

flourishing as a part of the

dental team in Minnesota for

five years, and in Alaska

for more than a decade.

Maine and Vermont also

have authorized dental

22 Kansas Child A Publication of Child Care Aware ® of Kansas


therapists to practice, and Washington

and Oregon are currently launching dental

therapy programs. Extensive research

confirms that dental therapists provide

safe, high-quality care to patients most in

need. Kansas can follow these states’ lead

to realize the benefits of increased access

to oral health care.

Here are our top three reasons why the

Kansas Legislature should allow dentists to

hire dental therapists in 2017:

Establishing dental therapists will

1 create Kansas jobs. Dentists can grow

their practices by hiring dental

therapists to serve the large number of

Kansans who currently go without dental care.

Dental therapy can save the state

2 money. Since dental therapists cost

less to employ than dentists, they can

help publicly funded safety net clinics with

limited budgets serve more patients. Regular,

preventive care prevents costly emergency

room visits. Best of all, Kansas can allow dental

therapists to practice at no cost to the state.

Dental therapy will improve the oral

3 health of Kansas children. Every

Kansas child should receive the dental

care they need to be healthy, no matter where

they live or what kind of insurance they have.

Dental therapists can help address our state’s

severe dental workforce shortage so that

more families can find dental care for their

children. That’s certainly smile-worthy!

Momentum for dental therapists

is growing across the country, and

Kansas has the opportunity in 2017

to establish them in our state. More than

50 organizations, including professional

associations, advocacy groups, and health

care providers, support dental therapists

for Kansas. We need your help to convince

the Kansas Legislature that now is the

time to approve this solution for Kansas

oral health care needs. Please talk to your

elected officials about why access to dental

care is important to you and the children

in your community, and visit www.

kansasdental.com to learn how you can

help bring dental therapists to Kansas.

www.ks.childcareaware.org Kansas Child 23


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Open your eyes to the importance

of quality early education. Donate today!

Early Learning

is More Than

Just Basic Care.

Early learning is quality child

care and preschool opportunities

that expose children to positive

learning experiences that are

critical to their emotional, social

and intellectual development.

Why Does Early

Childhood Matter?

When children trust their

caregivers to respond

consistently to their needs,

they learn to regulate their

emotions and behavior. Strong

social-emotional skills are the

foundation of lifelong learning.

What Makes an Early

Education Program a

High-quality Program?

• Strong health and safety standards

• Qualified, well-educated teachers

• Proven curricula and learning processes

• Meaningful involvement by parents

Proven Impact

Long-term studies of the impact

of high-quality early education

estimate a 700% return on

investment. That is, for every

$1.00 invested, $7.00 is saved

through reduced social spending.

Your support of early childhood is needed now more than ever. www.ks.childcareaware.org

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