A publication of Child Care Aware ® of Kansas
Winter 2017 Volume 16, Issue 1
SMILES FOR MORE THAN
ACA OFFERS PRIVATE
is a publication of
Child Care Aware ®
Angie Saenger, Deputy Director
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,
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Kansas Child is distributed at
no cost to Child Care Aware ®
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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?
Child Care Aware ®
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
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
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
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
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
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!
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
Oral Health Books for Children..............18
Children Receive Dental Coverage
through CHIP......................................... 19
Benefits and Challenges.........................20
ACA Offers Private
Dental Insurance for Kids.......................21
Certainly Smile-Worthy........................... 22
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 email@example.com or by visiting us at www.
Tanya Dorf Brunner,
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
4 Kansas Child A Publication of Child Care Aware ® of Kansas
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
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.
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.
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.
Gather the supplies you need.
You decide if you or the families will provide child-sized, softbristle
Change toothbrushes every 3 months or when bristles appear
flattened or worn.
Label each toothbrush with the child’s name.
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
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!
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
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.
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
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.
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
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.
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
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
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
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.
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
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.
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 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
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
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.
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
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
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
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.
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
What change can you make to protect
your child from cavities?
If you have decided to make a change
How important is it to you to make
How confident are you that you can
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@
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
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
It improves cognitive and physical
It flushes out toxins that can lead to
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,
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
Plain white milk can be a healthy option
at meals, but flavorings add a lot of
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
Give your child a water bottle to refill
throughout the day at daycare or
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
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:
Mini Pizza Crackers
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
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
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
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
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
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
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.
Remove the germs from your mouth by brushing
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:
High fructose corn syrup
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
Tips for healthy snacking and healthy teeth
Here are some tips that can help you keep children
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
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
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
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
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.
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
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
Oral Health Care
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
Mari Schuh, Capstone Press, 2008
Toothful Tales: Becoming Me Cavity Free
Jeanette Flannery Courtad, DDS
Mentors International Publications, 2015
Brush, Brush, Brush!
Alicia Padron, Scholastic, 2010
Brush Your Teeth Please
Leslie Mcguire, Studio Fun, 2013
Mari Schuh, Capstone Press, 2008
Visiting the Dentist
At the Dentist*
Mari Schuh, Capstone Press, 2008
Going to the Dentist
Anne Civardi, Usborne, 2010
Dee Ready, Capstone Press, 2013
Kristin L. Nelson, Lerner Publishing Group, 2005
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
Mari Schuh, Capstone Press, 2008
Cynthia Klingel and Robert B. Noye, Gareth Stevens Publishing, 2010
I Know Why I Brush My Teeth
Kate Rowan, Scholastic, 2000
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/
*Bilingual edition also available 4/15
18 Kansas Child A Publication of Child Care Aware ® of Kansas
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.
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.
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.
109 Hart Senate Office Building
Washington DC, 20510
Russell Senate Office Building
Washington DC, 20510
ROGER MARSHALL, MD*
Contact Information Pending
1027 Longworth HOB
Washington DC, 20515
215 Cannon HOB
Washington DC, 20515
107 Cannon HOB
Washington DC, 20515
*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
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
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
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 firstname.lastname@example.org with your story.
How is dental
coverage offered in
Are families required to purchase
dental insurance for their children
through the Marketplace?
What is the cost breakdown of
dental plans in the Marketplace?
eligible for cost
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
Families enrolling their children in a medical plan that does not
include dental insurance are not required to enroll them in a
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/
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,
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
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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SALINA, KS 67401
PERMIT NO. 122
PO Box 2294, Salina, KS 67402-2294
Call Toll Free 1-855-750-3343
Open your eyes to the importance
of quality early education. Donate today!
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
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
• Strong health and safety standards
• Qualified, well-educated teachers
• Proven curricula and learning processes
• Meaningful involvement by parents
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