Baby teeth

TOTSTeaching new moms about oral health gives babies something to smile about

By Nicole La Hoz

After learning that her 2-year-old daughter will need dental fillings, Sheena Smith grabbed a toothbrush from her dentist and nodded her head to every dietary recommendation.

Serve milk at meals. And if Kelsey Toms, Smith’s daughter, wants juice, ensure that it’s from actual fruit.

“With children’s teeth being smaller, they’re more susceptible to getting cavities,” Kathy Parsons, a College of Dentistry second-year resident, told Smith.

The services are a part of the Treating Our Toddlers Oral Health Program, or TOTs, an initiative of the College of Dentistry’s department of pediatric dentistry that educates pregnant women and new mothers about the effects of oral health on children.

“They fix her teeth for me,” Smith said. “That’s all that matters to me. I just want her to have healthy teeth.”

Leda Mugayar, D.D.S., leads the early-prevention program.

“It’s all about the education,” Mugayar said. TOTs teaches its clients the importance of being cavity-free for life.

The College of Dentistry department of community dentistry and behavioral science is also helping encourage oral health among children and mothers.

In May, they started to provide education and intervention services, dental screenings, fluoride varnish applications and dental clinic referrals at the Park Avenue location of Women, Infants and Children, a government program that provides nutrition counseling and support for women and their children.

Dental care for children under age 5 and pregnant women under 21 are provided in the TOTs clinic.

“We do know that the oral health status of women and children are related,” said Jaana Gold, director of the UF WIC Oral Health Program and a professor in the College of Dentistry.

Mother-to-child transmission of germs causing caries, the most common infectious disease in children, occurs through kissing and using the same spoon.

“Although dental care during pregnancy is safe and can prevent long-term health problems, many women do not seek dental care during pregnancy or for their young children,” Gold said.

The program will visit WIC one to two days a week in collaboration with the College of Medicine department of obstetrics and gynecology. Leaders hope to expand the number of visits per week this fall.

“I don’t think you can do prevention without education,” Mugayar said. “I cannot prevent accidents on the road if I do not educate you. That’s what we’re trying to do in this clinic.”

TOTs dentists see babies every three months until they’re 3-and-a-half years old. Most patients are Medicaid recipients, and at that age Medicaid stops paying for fluoride varnish, a high concentration of fluoride applied to the surface of teeth.

With consistent visits, dentists follow mothers through breastfeeding stages and babies’ transitions from liquid to solid foods. Habits like bottle feeding at night are the most prevalent causes of dental caries in children under 3, making diet a critical part of children’s dental care.

“Brushing and cleaning is not the secret,” Mugayar said. “It’s what you eat. What you put in your mouth, not necessarily what you remove from there, matters most.”

TOTs gives mothers an advantage. Mugayar said the program instills the concept of oral health in mothers early, and babies become desensitized to dental visits.

It leaves them one step ahead — even before their teeth have grown in.

“Coming to the dentist becomes something fun,” Mugayar said. “We grow together: mother, baby, dentist.”

This story ran in the June 2013 issue of the UF Health The POST.