Do you know what is the most prevalent chronic illness among children in the U.S.? Diabetes? Obesity? Asthma?

According to the American Academy of Pediatric Dentistry (AAPD), the number one chronic childhood illness in the U.S. is pediatric dental disease, also known as severe tooth decay. Though cavities are often viewed as a normal part of childhood, the severity of the consequences associated with childhood tooth decay is often unknown.

More than 40 percent of children have dental cavities by the time they reach kindergarten. Left untreated, severe tooth decay can lead to malnourishment, anemia, emergency surgery, life-threatening secondary infections and even death. Seriously impacting self-esteem, employment prospects, social development and overall quality of life, untreated tooth decay and gum disease also have a direct correlation to serious health issues in adulthood including heart disease, stroke, pulmonary disease and pre-term, low birth-weight babies.

In addition to personal health consequences, tooth decay should be a serious concern for schools as well. Children with poor oral health often have difficulty eating, sleeping and concentrating in school. They also experience lower academic performance and are three times more likely to miss school as a result of dental pain or complications. Children from low-income families and some racial groups experience much higher rates of tooth decay. According to the AAPD, 80 percent of all dental problems in children are found in the 25 percent of children from lower income groups that are often on public assistance and eligible for Medicaid or CHIP.

A child who experiences mouth pain may not be able to eat a balanced diet. They are often unable to chew properly or long enough to promote good digestion, resulting in lost nutrients. The resulting lack of nutrition can lead to weakened bones and muscles and poor overall development. Other side effects of pediatric dental disease include an unsightly appearance, which is a major factor in a child’s life, affecting their confidence, self-esteem and socialization. Bullying due to decayed teeth is a daily experience for millions of children and teens each year. The good news is that pediatric dental disease is nearly 100 percent preventable, and the pain, embarrassment and bullying often associated with poor oral health can be avoided.

Based in Charlotte, North Carolina, America’s ToothFairy: National Children’s Oral Health Foundation® was formed in 2006 to provide an aggressive collaborative response to eliminate children’s suffering from preventable tooth decay. In collaboration with health professionals, educators, school nurses, students and volunteers across the U.S., the foundation provides resources and programs to increase access to vital oral health services, improve oral health literacy and raise awareness of the importance of oral health and its connection to overall health. Following are six ways schools can utilize free or low-cost resources to improve student oral health:

Integrate Oral Health Education Into Health Curriculum

Only a few states include oral health education in school health curriculum, and even fewer mandate its inclusion. America’s ToothFairy makes available to schools a full 12-lesson oral health curriculum as part of its ToothFairy 101® Community Education Kit. This kit is available for a suggested donation or may be free to schools. Developed with guidance from leading dental and allied health professionals, the Kit contains a magnetic display board, magnets, giant toothbrush, and associated 275 page bi-lingual curriculum covering everything from basic brushing and flossing to mouth safety, mouth piercings, drugs and alcohol.

Hold an Annual “Oral Health Day”

Exacerbating the tooth decay epidemic is a significant lack of awareness within vulnerable populations, and still limited understanding in the general population, of the importance of oral health, ways to prevent tooth decay, and the connection between oral health and overall health. At an annual Oral Health Day or at health fairs, emphasize healthy nutrition, drinking water instead of sugar-sweetened beverages, visiting the dentist regularly, and practicing “2×2” (brushing two times per day for two minutes).

Equip School Nurses to Connect Children to Dental Services

According to a recent survey of school nurses by the National Association of School Nurses (NASN), dental pain is the number two reason children visit their school nurse. School nurses can access a free HRSA tool on the resources page of to help families locate local dental providers that accept a range of benefit plans.

Support School-Based Dental Sealant Programs

Dental sealants are a thin plastic coating painted on the chewing surfaces of teeth — mostly molars and pre-molars — that form a protective shield over the tooth enamel and last up to 10 years. According to the Centers for Disease Control and Prevention, dental sealants reduce tooth decay in children by more than 60 percent, and school-based sealant programs are considered a best practice in preventing dental caries in children. Visit, the Seal America site of the National Maternal & Child Oral HealthResource Center, to learn more about school-based dental sealant programs.

Become a #MySmileMatters School

Middle and high school students can join the #MySmileMatters Youth Movement, a national initiative to engage youth in promoting the importance of a healthy smile and building healthier communities. Each #MySmileMatters school receives an annual Engagement Plan that includes step-by-step instructions for year-round engagement in oral health including educational outreach, community service, fundraisers, awareness-raising activities, toothbrush and toothpaste collection drives, and advocacy activities. #MySmileMatters is also an excellent way to expose students to careers in the dental field.

Establish a Hygiene Closet for Students Without Access to Basic Necessities

Hygiene closets provide a safe, private way for low-income students to access hygiene products. Hygiene closets typically include toothbrushes, toothpaste, and floss as well as other basic necessities such as shampoo, soap, laundry detergent, deodorant, etc. To keep your hygiene closet stocked throughout the year, consider holding a Smile Drive to collect oral care products for underserved children and teens. Students, teachers, faculty and community members get involved by donating and collecting oral care products to stock their school’s hygiene closet or support a local charity reaching underserved children.

While the Affordable Care Act expands dental benefit coverage for children, it does not address critical access to care issues caused by the loss of school-based dental education programs, state budget cuts, low reimbursement rates that prevent providers from accepting Medicaid patients, health professional shortage areas, and the overall lack of Medicaid dollars going toward dental care. As a result, a significant number of students come to school every day suffering from headaches, infections, lack of sleep, and severe tooth and jaw pain. But there are steps schools can take to not only keep students healthy but to improve their academic performance and attendance.

Children with good oral health reduce their risk for dental-related health complications, maintain positive self-esteem, and increase their opportunities for success in the future. Best of all, good oral health will keep your students smiling.

Contact America’s ToothFairy at or 800-559-9838 to learn more.

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