Caring for Our Children (CFOC)

Chapter 3: Health Promotion and Protection

3.1 Health Promotion in Child Care

3.1.5 Oral Health Oral Health Education

All children with teeth should have oral hygiene education as a part of their daily activity.

Children three years of age and older should have developmentally appropriate oral health education that includes:

a.     Information on what plaque is;
b.    The process of dental decay;
c.     Diet influences on teeth, including the contribution of sugar-sweetened beverages and foods to cavity development; and
d.    The importance of good oral hygiene behaviors.

School-age children should receive additional information including:

a.    The preventive use of fluoride;
b.    Dental sealants;
c.    Mouth guards for protection when playing sports;
d.    The importance of healthy eating behaviors; and
e.    Regularly scheduled dental visits.

Adolescent children should be informed about the effect of tobacco products on their oral health and additional reasons to avoid tobacco.

Caregivers/teachers and parents/guardians should be taught to not place a child’s pacifier in the adult’s mouth to clean or moisten it or share a toothbrush with a child due to the risk of promoting early colonization of the infant oral cavity with Streptococcus mutans (1).

Caregivers/teachers should limit juice consumption to no more than four to six ounces per day for children one through six years of age.

Studies have reported that the oral health of participants improved as a result of educational programs (2).
Caregivers/teachers are encouraged to advise parents/guardians on the following recommendations for preventive and early intervention dental services and education:

        a.    Dental or primary care provider visits to evaluate the need for supplemental fluoride therapy (prescription pills or drops if tap water does not contain fluoride) starting at six months of age, and professionally applied topical fluoride treatments for all children every 3-6 months starting when teeth are present (3,4);
        b.    First dental visit within six months after the first tooth erupts or by one year of age, whichever is earlier and whenever there is a question of an oral health problem;
        c.    Dental sealants generally at six or seven years of age for first permanent molars and for primary molars if deep pits and grooves or other high risk factors are present (4,6).

Caregivers/teachers should provide education for parents/guardians on good oral hygiene practices and avoidance of behaviors that increase the risk of early childhood caries, such as inappropriate use of a bottle, frequent consumption of carbohydrate-rich foods, and sweetened beverages such as juices with added sweeteners, soda, sports drinks, fruit nectars, and flavored teas.

For more resources on oral health education, see:

Parent’s Checklist for Good Dental Health Practices in Child Care, a parent handout in English and Spanish, developed by the National Resource Center for Health and Safety in Child Care and Early Education at;

Bright Futures for Oral Health at;

California Childcare Health Program Health and Safety in the Child Care Setting: Promoting Children’s Oral Health A Curriculum for Health Professionals and Child Care Providers (in English and Spanish) at and its 12345 first smiles program at;

and National Training Institute for Child Care Health Consultant’s Healthy Smiles Through Child Care Health Consultation course at
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS Pacifier Use Routine Oral Hygiene Activities Toothbrushes and Toothpaste 100% Fruit Juice Oral Health Policy
  1. American Academy of Pediatrics, Oral Health Initiative. Protecting All Children's Teeth (PACT): A pediatric oral health training program. Factors in Development: Bacteria.
  2. Dye, B. A., J. D. Shenkin, C. L. Ogden, T. A. Marshould, S. M. Levy, M. J. Kanellis. 2004. The relationship between healthful eating practices and dental caries in children aged 2-5 years in the United States. J Am Dent Assoc 135:55-66.
  3. American Academy of Pediatric Dentistry, Clinical Affairs Committee, Council on Clinical Affairs. 2008-2009. Guideline on periodicity of examination, preventive dental services, anticipatory guidance/counseling, and oral treatment for infants, children, and adolescents. Pediatric Dentistry30:112-18.
  4. American Academy of Pediatrics, Committee on Practice and Ambulatory Medicine.2016. Policy statement: 2016 Recommendations for preventive pediatric health care. 
  5. American Academy of Pediatrics, Section on Pediatric Dentistry. 2009. Policy statement: Oral health risk assessment timing and establishment of the dental home. Pediatrics 124:845.
  6. American Academy of Pediatrics, Section on Pediatric Dentistry.2008. Preventive oral health intervention for pediatricians. Pediatrics 122:1387-94.