Children’s Oral Health/Lesson Plan

Goal: WIC participants will understand the importance of oral health in children and know how to care
for their children’s teeth.

Objectives: WIC participants will be able to:

A. State why baby teeth are important.
B. Perform a lift the lip exam on a child.
C. Identify how to prevent tooth decay in children.

Introduce yourself. Ask if anyone knows why baby teeth (also known as primary teeth) are
important.

I. Why are baby teeth important?

Key Points:
A. They help a child learn how to speak properly.
B. Baby teeth help to build a child’s self esteem.
C. Baby teeth make sure that there is enough room for permanent teeth to come in.
D. Baby teeth are important for feeding and good nutrition in children.
E. Tooth decay can cause infection, poor nutrition, poor weight gain and early loss of baby
teeth that could damage permanent teeth.

II. What do I need to know in the beginning?

Key Points:
A. Before your baby is born, they have twenty primary teeth below the gums that develop in the
fourth month of pregnancy.
B. At about six months, your baby’s teeth will begin to push through their gums.
a. It is common for babies to drool and cry more when their teeth begin to come in.

III. Ask: How can I prevent tooth decay in my infant or toddler?

Key Points:
A. Starting the first few days after birth, take a wet cloth and wipe it over your baby’s gums after
each feeding.
B. Never give your baby a pacifier dipped in soda or other sugar filled drinks.
C. Frequent consumption of foods high in sugar (for example, candy, cookies, sweetened
beverages, fruit juice) greatly increase the risk of developing tooth decay.
D. If your must put your baby to bed with a bottle, make sure it is filled only with water.
b. Babies who fall asleep with milk or juices tend to develop baby bottle tooth decay –
decay that forms when children are allowed to drink sugary liquids throughout the day and
night from a bottle.
C. Use a cotton swab or small toothbrush to clean the baby’s teeth daily to remove plaque.
D. Once a month, perform a lift the lip exam on your child to check for decay.
a. Have your child sit on the floor and look up at you. Lift their lip and check the front
and back of the top and bottom teeth. Look for white spots and/or dark stains on your
child’s teeth. White spots on teeth can be a sign of early tooth decay or cavities and dark
stains may indicate current tooth decay. If you see any spots or stains, take your child to
see a dentist. In addition, make sure you brush your child’s teeth each day using a very
small smear of toothpaste with fluoride on a small, soft toothbrush.
E. Avoid sharing silverware or chewing food for your baby.
 a. Bacteria that live in your mouth can cause tooth decay in your baby’s mouth.
F. Promote breastfeeding rather than feeding with infant formula.
a. If using formula, “ready –to-feed” formula is preferred over formula mixed with water
containing fluoride during the first year of life to help ensure that infants do not exceed the
optimal amount of fluoride intake.
b. If using powdered or liquid concentrate infant formula, it should be mixed with water
that is fluoride-free or contains low levels of fluoride to reduce the risk of fluorosis.
G. Use a sippy cup only as a temporary transition between a bottle and a regular cup. Just like a
bottle, a sippy cup should never contain juice or other sugary liquids.
H. Tooth decay is an infectious disease! To avoid transmitting to your child the germs or
bacteria that cause tooth decay, keep dental plaque off of your teeth by brushing with a
fluoridated toothpaste and flossing.
a. Dental plaque is made up of the germs or bacteria that cause tooth decay.

IV. Ask: How can I prevent tooth decay in my school-aged child?

Key Points:
A. Toothbrushing at least two times a day using toothpaste with fluoride.
B. Until your child is 6 or 7, you or another adult should help your child in brushing and flossing
their teeth.
C. Once a child has two teeth touching each other, it is important to begin flossing the child’s
teeth once a day.
a. Parents should floss their child’s teeth until the child is approximately 9 years old.
D. Only use a smear sized amount of toothpaste with fluoride on your child’s toothbrush.
a. Make sure they spit the toothpaste out instead of swallowing it.
E. Give your child juice only at mealtimes and not throughout the day.
F. Ask your dentist about sealants.
a. Sealants are protective plastic coatings that prevent food from settling into the grooves
of the teeth and causing decay.
G. Giving your child healthy meals and snacks and teaching them healthy habits.

V. Ask: What else do I need to know?

Key Points:
A. Remember these equations:
Plaque + Sugar= Acid
Acid + Healthy tooth + No Fluoride = Decay (cavities)
B. It is important to brush and floss everyday because there are serious consequences from not
taking care of your teeth.
a. These consequences include: Bad breath, tooth decay, tooth loss, pain, infection, and
gum disease.
C. Make brushing fun for your children. Be enthusiastic, it is contagious.
E. Remember to be a good example for your child because they learn their good dental habits
from you.

Activity Suggestions:

For children, read the story of the three friends.

If time permits, go over “When will my tooth fall out” to talk about different types of teeth and what to
expect when loosing baby teeth.

Have participants pair up and have one participant put their hands and fingers together. Give the other
participant string or yarn and have them practice flossing having the fingers represent teeth.

Take a teaspoon of sugar, a packet of unsweetened gelatin, and ¾ cup of water to mix. Pour gelatin into
two clean, shallow containers with covers and allow cooling. Scrape between teeth with a toothpick to
remove food and plaque and place toothpick in one dish. Cover, label and leave in a dark warm place.
After 3-5 days, bacterial growth should appear on the dish with the toothpick.

Evaluation Plan: Evaluation will be based on verbal responses from WIC participants. If the group
consists of 8 participants ask at least 2 people to answer one of the following questions below. Note:
If the group is larger or smaller than 8 participants, roughly ask 25% of the group.

-- What should you put in your baby’s bottle or sippy cup?

-- When do you start cleaning your baby’s teeth?
-- When should you first take your child to the dentist?

How to Get and Keep a Healthy Grin

Why Baby Teeth (primary teeth) Are Important:

• Chewing food
• Speaking
• Appearance
• Healthy Baby Teeth = Healthy Adult Teeth
• Hold Space for Adult (Permanent) Teeth
• Healthy!!

Early Childhood Caries (ECC):

• Early Childhood Caries are cavities in very young children.

• They are caused by;
o Too much sugary food and drink
o Poor oral hygiene
o Lack of enough fluoride.
How to Prevent Early Childhood Caries:

• After feeding, wipe your baby’s gums with clean gauze pad.
• Begin brushing your child’s teeth when the first tooth erupts.
o If you notice white spots and/or dark stains on your child’s teeth, use a
very small smear of toothpaste with fluoride on a small, soft toothbrush.
• Do not put your baby to bed with a bottle, especially if its filled with milk or
another sugary liquid
• Avoid sippy cup use, especially if its filled with milk or another sugary liquid
• Don’t dip pacifier in sweet liquids.
• Allow sugary liquids only at mealtimes.
• Keep your mouth clean and healthy.
 KID’n Around Page

Here are some important items related to good oral health. Have your child identify these items.
 Good Nutrition for Good Dental Health/Lesson Plan

Goal: WIC participants will understand the impact of food on oral health and will be able to select
nutritious foods that are good for teeth.

Objectives: WIC participants will be able to:

A. Identify nutritious foods that promote dental health.
B. Choose a variety of foods that are good for teeth.
C. Identify the food groups and their place in the food pyramid.
D. Discuss the importance of dental nutrition.

Introduce yourself. What are healthy foods?

I. Ask: How much of each healthy food should we eat each day?
Key Points:
A. Eat a balanced diet. Eating healthy food will help us have energy and healthy bodies.
B. It is important to eat foods from all of the following groups
Grains: 6 ounces
Vegetables: 2.5 cups
Fruits: 2 cups
Milk: 3 cups
Meats/Beans: 5.5 ounces
Extras: oils and fats use sparingly
C. A balanced diet is very important in helping to prevent cavities.
- Cavities are a result of what we eat and how often those foods are eaten
- They are also a result of not taking good care of your teeth.
Activity:
Read each statement and ask participants if it is true or false.
1. The average American will consume approximately his or her own body weight in
sugar in one year. TRUE
2. Eating apples, celery, and carrots does not remove plaque. FALSE
3. The longer the sugar stays in the mouth and the more frequently sweets are eaten,
the more chance cavities have to form. TRUE
4. Brushing your teeth immediately after eating sweets does not help prevent cavities.
FALSE
5. Sweets are less harmful to teeth if eaten with a main meal, rather than between
meals. TRUE
6. Natural sugars such as honey, molasses, corn sweetener, and raw sugar have the
same cavity producing effects as refined sugar. TRUE
7. Table sugar is more harmful to teeth than sugars that occur naturally in fruits and
milk. TRUE

II. Ask, How does food cause tooth decay?

Key Points:
A. Pieces of food get trapped in the tooth surface when we eat.
B. When foods such as bread, cereals, pasta, crackers, and potato chips stay in the mouth
for long periods of time.
- If we do not brush and the food stays on our teeth, the bacteria that live in our
mouth breaks the food into sugars.
 C. These sugars are converted into acids that eat away at the tooth enamel.
- Enamel is the protective outer coating of the tooth.
D. If you snack a lot, food is left on the teeth longer and increases your risk of tooth decay
(cavities).
E. For these reasons, sugars and starches should be eaten during mealtimes when there is
a higher level of saliva (spit) production to help prevent cavities.
- Foods that produce cavities include cake, candy, cookies, cough drops,
doughnuts, gum, honey, jams, jellies, mints, molasses, pies, popsicles, soft
drinks, syrup, and table sugar.

Suggested Activities

1. Have participants use foods from the basic food groups to plan a day’s worth of meals for their
families.
2. Have participants watch the hidden sugar demonstration attached to this lesson.
3. Ask participants to name a food with hidden sugar that they have eaten in the last 24 hours. Then
ask then to substitute a nutritious snack in its place.
4. Use a table knife to cut an apple. Then use the same knife to cut a marshmallow. In this case, the
knife represents the tooth. Ask the participants to notice how the marshmallow sticks to the tooth.
When sticky foods are eaten, and teeth are not brushed, it causes more risk for tooth decay.

For Adults and Children:

1. Dental Bingo game. Create cards using magazine pictures of foods and cardboard. Give clues for
each such as: mark a food in the vegetable group. Be creative.

For Children:
1. Read the Happy tooth and Sad tooth story.
2. Cover any size play blocks with magazine pictures of nutritious foods and use foods with added
sugars as well. Let children choose a block and talk about whether the food is both nutritious and
dentally good for the teeth. If so, have them use the block to build a strong tower.

Evaluation Plan: Evaluation will be based on verbal responses from the WIC participants. If the
group consists of 8 participants ask at least 2 people to answer one of the questions below. Note:
If the group is larger or smaller than 8 participants, roughly as 25% of the group.

-- What are cavities?

-- What types of food can cause cavities?
-- Name a tooth-friendly snack.
 Fun Foods for Your Teeth
Food and Tooth Decay:

• Plaque is a sticky substance that forms on your teeth after eating.

• Decay and gum disease are caused by plaque.
• Plaque irritates the gums and can make them red and swollen.
• The germs in plaque make acids that destroy tooth surfaces.

Foods That Can Cause Tooth Decay:

• Candy
• Mints
• Sticky foods like caramels or jellybeans
• Sugary drinks (soda, sweet tea, sweetened juices)
• Fruit juice

Ways to avoid Tooth Decay:

• Limit the amount of decay causing food eaten.

• Brush your teeth using toothpaste with fluoride after every meal.
• Drink water instead of sugary drinks.

Fun and Nutritious Foods:

Fruits Cereal
Berries Pears
Carrots Sunflower seeds
Nuts Oranges
Tomatoes Pizza
Yogurt Popcorn
Chicken Tacos
Eggs Cheese
Melons Celery
Turkey Sugar free gum/soda
Salad Pumpkin seeds
Pineapple

Remember the next time you reach for a snack, pick a food that is
low in sugar and low in fat. Your teeth and body will thank you.
 KID’n Around Page

Here are some foods that are important for good dental health. Have your child name these foods.
 The Dental Visit/Lesson Plan

Goal: WIC participants will understand the importance of having regular dental visits for themselves and
their children.

Objectives: WIC participants will be able to:

A. State the importance of visiting a dentist.
B. Identify the members of the dental health team.
C. State the frequency of dental visits.
D. Explain what to expect when going to the dentist.

Introduce yourself. Ask how many people have visited a dentist.

I. Ask: Why do we need to visit a dentist?
Key points:
A. The dentist and dental hygienist are the main members of the dental professional team in
the dental office who will be providing care to you and/or your child.
B. A dentist is a doctor who examines and takes care of the teeth, gums and the surrounding
soft tissues.
- Dentists provide dental examinations, preventive and treatment services.
1. The examination is done in order to make a determination of the health of
your teeth, gums and surrounding tissues.
2. Treatment services can include fillings, dental sealants, crowns (caps),
bridges, dentures, extractions, and various surgical procedures.
C. A dental hygienist is a trained professional who cleans your teeth, takes x-rays, applies
fluoride treatments, provides dental sealants and gives oral health information.
- Dental hygienists also can assess your teeth and gums to determine when you
need to see a dentist.
D. Tooth decay is the number chronic disease affecting children in the United States.
- It is important to keep all scheduled dental appointments to keep a healthy mouth.
E. You should have your teeth and your children’s teeth cleaned once every 6 months,
especially if at high risk for tooth and gum disease. A dental professional can clean your
teeth better than you can do at home and detect any problems you or your children may
not know you have.

II. Ask: Why should my family and I go to the dentist?

Key Points:
A. To have your teeth cleaned and examined every 6 months.
B. If you or your child are experiencing any pain and/or swelling in the facial area, you
should contact a dentist immediately.
C. A child should see a dentist by the time their first tooth erupts and no later than their first
birthday.
D. After this first visit, your child should see the dentist for a teeth cleaning once every 6
months.

III. Ask: What should I expect when I go to the dentist?

Key Points:
A. When you first walk into the office, a smiling receptionist will greet you.
B. Someone will call you to be seen.
 C. When you enter the exam room, you will notice all of the dental equipment.
For example: the chair, the light over the chair, x-ray machines and instruments.
D. The dental professional will be wearing barriers to prevent passing germs.
For example:
Eye wear- to protect the eyes from splatter.
Mask- to protect the mouth and nose.
Long gowns- to protect bodies.
Gloves- to protect hands.

NOTE: If you have any of the dental equipment, demonstrate. Other barriers are put over
the chair, light and hand piece. Sterilizers are used to kill germs on the instruments.

IV. What should I do to get ready for my child to see a dentist?

Key Points:
A. Children should understand that the dentist and dental hygienist are friendly people who will
help them keep and take care of their teeth.
B. Be positive and make dental appointments a pleasant experience.
C. Children learn from example, so it is important for you to brush with fluoridated toothpaste
and floss your teeth as well as see the dentist on a regular basis.
D. Good health habits are formed at an early age so it is up to you to help your child have a
healthy smile for life.

Suggestions:

If any children are around, read “Timmy visits the dentist” to them.

To go over tooth structures make a bulletin board comparing animal teeth to human teeth or
show pictures of the animals while describing the differences.

Give out all the roles of a dental team including dentist, receptionist, hygienist, assistant,
patient and play “Who Am I” by giving clues and having them guess who you are talking
about.

Evaluation Plan: Evaluation will be based on verbal responses from the WIC participants. If the
group consists of 8 participants ask at least 2 people to answer one of the questions below. Note: If
the group is larger or smaller than 8 participants, roughly as 25% of the group.

-- What is a dentist? What is a dental hygienist?

-- How often should you and your child visit the dentist’s office?
-- When should your child first see the dentist?
 Your Child’s First Visit to the Dental Office

It is important for your child to see the dentist when the first tooth erupts or no later than
their first birthday. Here are some things to expect during your child’s first visit.

The Dentist and Dental Hygienist:

• Are friendly dental professionals who will help your child take care of their teeth.
• Will teach you how to clean your child’s teeth.
• Will talk to you about fluoride and good dental habits.
• Will check for tooth decay and other problems.

What Might Be Done for Your Child on the First Visit?

• Carefully examine the development of their mouth.
• Count their teeth and give them rides in the chair and explain everything that is going to be done.
• Show how to brush their teeth.
• A fun and safe visit with a visit to the toy box

What Can You Do to Make Your Child Less Fearful of Going to the Dental Office?
• Ask the dentist about the procedures during the first visit so there are no surprises.
• Talk to your child about what to expect and build excitement about going to the fun office.
• Have your child go with you and watch you while you have your appointment.
• Be patient with your child and calm them if they are frightened and reassure them
• If your child is young, you can sit in the dental chair and hold your child in your lap.
• Play dentist with your child by taking turns looking into each other's mouths with flashlights

What Other Tips Should You Know?

• You should be prepared with an action plan for both a positive or negative reaction from your
child.
• Do not have overly high expectations for your child – young children will be fussy, not sit still or
cry.
• Bring with you to the appointment your child’s complete medical history.

A Positive Attitude is Contagious:

• Be positive and make dental appointments a happy experience.
• Children learn from example, so be sure to brush and floss your teeth and
see the dentist.
• Good habits are formed at an early age, so it is up to you to help your child
have a healthy smile for life!

If you would like to find out if you are eligible for dental services,
please call the HealthChoice Enrollment hotline at 1-800-997-7388.
KID’n Around Page
Here are some things that can be found in a dental office. Have your child name these items.
 Oral Health for Pregnant Moms/Lesson Plan

Goal: WIC participants will understand the importance of good oral health during pregnancy.

Objectives: WIC participants will be able to:

A. Identify the cause of dental problems during pregnancy.
B. State when baby teeth form.
C. Identify ways of keeping baby teeth healthy.

Identify yourself. Ask how many mothers have been to a dentist since they got pregnant?

I. Ask: Why do I need to take care of my teeth during pregnancy?

Key Points:
A. Anything that damages a mother’s health can affect her baby, so good dental health is
important.
B. Pregnancy gum disease often happens during pregnancy, which is when the gums become
swollen, red, and bleed easily.
- It happens because of hormone changes in the body.
- This condition should go away after pregnancy, but if your gums are still swollen
after birth, see your dentist.
C. The baby does not take its calcium from your teeth and bones; it gets its calcium from
what you eat.
- This means you need to eat plenty of calcium so your baby will have strong teeth
and bones.
D. Baby teeth begin to form during the sixth week of pregnancy.
- Permanent teeth begin to form at twelve weeks (postnatally) and continue to form
until they are eight years old.

II. Ask: Why do I have more dental problems during pregnancy?

Key Points:
A. Because the need for food has increased, snacking also increases - especially on sticky
foods that stay on your teeth longer. This puts you at higher risk for developing tooth
decay.
B. Hormone changes cause gums to swell and get red.
C. Pregnant moms sometimes become busier and run out of time and energy to care for
themselves, therefore their dental health may not be as good.

III. Ask: How can I keep my teeth and my baby’s teeth healthy?
Key Points:
A. Eat a balanced diet with plenty of calcium and other vitamins.
B. Let your dentist know that you are pregnant.
C. Avoid taking x-rays while you are pregnant.
D. Tooth decay is an infectious disease! To avoid transmitting to your child the germs or
bacteria that cause tooth decay, keep dental plaque off of your teeth by brushing twice a
day with fluoridated toothpaste.
- Dental plaque is made up of the germs or bacteria that cause tooth decay,
E. Floss your teeth twice at least once a day.
F. Keep gums healthy by flossing once a day.
 G. See your dentist or hygienist for your regularly scheduled appointments.
H. Snack on foods such as fruits, vegetables and cheese.
I. Avoid foods, especially if they’re sticky, and sugary drinks (sodas, sweetened juices, fruit
juices) that contain a lot of sugar. These foods and drinks can cause tooth decay.

IV. Ask: Is there anything else that I need to know?

Key Points:
A. Recent information shows that keeping teeth and gums healthy helps to prevent premature
low birth weight babies.
B. Gum disease is an infection inside the mother’s body.
-It causes higher levels of labor hormones that could induce labor before the baby
is ready to be born.
C. Be cautious with your dental health during pregnancy. Your body and your baby will
thank you.

Activity Suggestions:

When talking about calcium, go over the food guide pyramid, and how many servings a person needs out
of each group.

Give brushing and flossing tips when going over how to keep your teeth and your baby’s teeth healthy.

Evaluation Plan: Evaluation will be based on verbal responses from the WIC participants. If the
group consists of 8 participants ask at least 2 people to answer one of the questions below. Note: If
the group is larger or smaller than 8 participants, roughly as 25% of the group.

-- What can cause dental problems during pregnancy?

-- When do baby teeth begin to form?
-- Name one way to keep baby teeth healthy.
 Dental Health for Pregnant Moms

Good dental health habits are important during pregnancy. Here are some tips to keep
you and your new baby healthy:

Brush your teeth twice a day with a fluoride toothpaste.

Floss your teeth once a day to keep your teeth and gums healthy.

See your dentist or hygienist for your regularly scheduled appointments.

Snack on healthy foods such as vegetables, fruit, and cheese.

Avoid foods that are sticky and that contain a lot of sugar. These foods can
cause tooth decay.

Do you know about…

Dental Services for Pregnant Moms?

If you have Medicaid or are enrolled in the Maryland Children’s Health Program (MCHP), you
can get dental care.

Dental care is available for pregnant women of any age.

If you do not receive Medical Assistance or MCHP, but think you are eligible, please contact your
local health department or department of social services.

Good dental health can reduce your risk of having a premature baby.

If you have good dental health habits, your child will have good
dental health habits too.