Uncover Challenges to Good Oral Health

Learn the reasons why some kids have a hard time protecting their smiles from tooth decay.

This article has been adapted for children based on: Underserved Families Still Face Major Barriers to Dental Care (Dentistry Today Feb., 2018)

Over the last 100 years, the way we care for our smiles has changed and improved by quite a lot! As scientists learned more about what causes cavities and gum disease, we’ve created better ways to protect our mouths and keep our smiles healthy. For example, did you know that before 1938 most people used a wooden or bone handle with stiff, wild boar hair stuck into the end to clean their teeth?!

Many other inventions like fluoride toothpaste, waxed dental floss, and high-tech tools at the dentist’s office have made our mouths healthier than ever before. But, there are still millions of kids in the United States who can’t go to the dentist like they should—and many don’t even own a toothbrush! These kids have challenges that get in the way of getting the dental care they need to keep their mouths healthy. Here are some examples and what we can do to help them:

Their parents don’t know how important it is to take care of their kids’ teeth.

Believe it or not, some parents think that if their child gets a cavity in a baby tooth, it’s okay because the tooth will be replaced with a new tooth anyway. They don’t think it’s worth the money to go to the dentist to keep these temporary teeth healthy.

These parents never learned that baby teeth are important for holding the space that the adult tooth needs when it takes its place. If the baby tooth is lost before the adult tooth is ready, teeth can grow in crooked or too close together (which means the child might need braces.) Also, baby teeth are needed to chew, speak correctly and for smiling!

How can we help? We can teach parents of very young children how important it is to brush and floss every day, avoid sugary drinks and snacks, and visit the dentist. We can also teach kids at school why it is important to take care of their teeth so that when they are parents they know to take care of their kids’ teeth too.

There aren’t enough dentists where they live.

Families that don’t live near cities or large towns (we call these “rural areas”) may have to travel for hours to get to the nearest dentist or to a dentist that they can afford to pay. This can be really hard for families that don’t have a car that is in good shape and can drive for long distances. Plus, if they have to travel too far to get to the dentist, parents might lose a whole day’s worth of work and won’t be able to pay for all their bills.

How can we help? There are special dentists that provide “mobile” services. That means they have special dental equipment that can go with them to schools or community centers to provide dental exams and cleanings where the kids learn or play. America’s ToothFairy helps these dentists treat the kids for free if their parents don’t have enough money to pay.

They have to wait too long.

Families that don’t earn much money need help from the government to pay for their dental care. This help is called Medicaid. The problem is, not many dental offices will see patients who use Medicaid. The dental offices that do often have too many patients who have to wait a long time for their visit—sometimes more than a year! To have a healthy smile, everyone must visit the dentist two times each year. This isn’t possible if you must wait one year for an appointment.

How can we help? If the special clinics that treat these patients can get donations and free products that they need to provide care, they can help more patients! America’s ToothFairy helps them get extra money, free products and the equipment they need so that more kids can see the dentist each year.

Fear of the dentist.

When we only go to the dentist when we have a bad toothache, it can be an unpleasant experience. Some people only think of pain when they think of going to the dentist.

But when we go to the dentist two times each year like we should, the dentist can stop cavities before they get to be painful. When kids learn this, they don’t have to be afraid of going to the dentist anymore.

How can we help? Teaching kids and parents that going to the dentist for check-ups and cleanings is important. When they learn that ignoring a problem only makes it worse, they are more likely to go. Also, dentists have medicine to help block pain so patients who need to have a cavity filled can be comfortable. Their trip to the dentist doesn’t have to be a painful one!

Language and culture.

When people come from other countries to live in America they are called immigrants. Sometimes immigrants haven’t learned to speak English yet—it’s a tough language to learn! And sometimes the countries that they come from don’t know a lot about keeping their mouths healthy and free of infection. These people can be extra afraid to go to the dentist because they don’t understand what the dentist is telling them.

How can we help? America’s ToothFairy has educational materials in many languages that can help immigrants learn about proper oral health care. People who care about immigrants can find these materials on our website.

Some kids don’t own a toothbrush.

1 in 5 kids in the United States live in homes that don’t have enough food. Many of these kids also do not have a toothbrush and toothpaste, or must share a toothbrush with a family member. This is very unhealthy because they can spread germs that make them sick and the bacteria that cause cavities!

How can we help? Volunteers can hold a Smile Drive to collect toothbrushes, toothpaste, and floss and give them to kids who need them. Their friends, family and people they work with give them these items to share at schools, churches, homeless shelters, food pantries and other places that help families in need. (You can learn more at


There are many reasons why kids don’t always have what they need to keep their smiles healthy, but when we all work together to help, more kids can avoid the pain and embarrassment that is caused by tooth decay.

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