Oral health refers to the health of the teeth and gums. This term is often used interchangeably with dental health, although dental refers specifically to teeth. 

Oral health is part of overall health. People with poor oral health have an increased risk of heart disease, stroke, pregnancy complications, osteoporosis (weak bones), and more. Tooth decay can cause pain and embarrassment, and interfere with good nutrition. Kids with tooth decay may have a hard time concentrating in school and have worse educational outcomes. A failure to treat tooth decay can eventually lead to the loss of the tooth, which in turn can affect eating, speaking and social connections. Oral health was artificially divided from the rest of health care, leading to a fractured, unfair system. 

Parents can advocate for school-based services including:

• Expanding school nurses’ scope of practice to include oral health screenings and application of fluoride varnish and Silver Diamine Fluoride (SDF). This is happening in Maine.

• Expansion of the 802 Smiles Network that brings oral health care to schools or transports students to a dental clinic during school hours.

• Education and resources for parents whose children are receiving care during the school day to ensure continuity and parent engagement.

• Ensure students and parents know when the child has a “dental home” connected to school services that they retain when they leave school.

How to engage:

• Attend school board meetings - most meetings include a public comment period where community members can raise issues.

• Write/call your school nurse leader, principal, or community school coordinator

Many people face barriers to accessing health care. Working people cannot always get time off work to attend multiple appointments, or even a single appointment when the provider is at a distance. Some families lack reliable transportation. There are countless patient-centered reasons to dismantle the artificial separation between oral and medical health systems and payment structures. Primary care offices are authorized to provide some oral health screening and treatment, including applying SDF, but few practices do. Parents can drive the demand for this service by asking their pediatrician/family physician/primary care provider to offer this care. 

Porter Pediatrics in Middlebury is one example of a primary care office that integrates oral health care into their practice. The required training for physicians and Nurse Practitioners is minimal, and the potential impact is big.

How to engage:

• Ask your pediatrician or primary care provider if any clinicians are trained in the Smiles for Life curriculum or whether they plan to integrate oral health assessment, prevention and non-invasive treatment into their standard of care.

• Let your provider know that you support medical dental integration.

• Let us know what you learn!

Fluoride in public water systems is thought to be one of the most safe, cost-effective ways to deliver therapeutic levels of fluoride to the population. The approach has been in place for 80 years, with more than two thirds of Americans on fluoridated public water systems. In Vermont the rate is lower, with a little over half of the population served, due to our rural nature and the number of houses served by wells and springs versus town water systems. 

While recent news stories and unscientific positions from the current federal administration have called the safety of fluoride into question, as with many substances, dosage matters. The levels of fluoride put in public drinking systems is kept at a safe level. Over the years, as use of toothpaste and mouth rinses with fluoride has increased, some research suggests that CWF is having a smaller impact on reducing tooth decay as a result. 

How you can engage:

• Counter misinformation about fluoride in your community.

• Organize to protect existing fluoridated water systems.

• Let us know what is happening in your community regarding fluoridation.