Program Spotlight

How Should a Dinosaur Brush His Teeth?

“Did you brush your teeth this morning, Daniel?” Daniel, a kindergarten student at Biscayne Elementary School on Miami Beach, shrugged his shoulders to the oral hygienist’s question. Then he grinned and muttered a meek: “I forgot.”

It's It’s doubtful that Daniel will forget tomorrow – or the next day. 

On this mid-January morning, he and 450 of his classmates were examined by dental professionals, taught how and when to brush their teeth – and practiced brushing on a dinosaur (not a live one!). They were quizzed on what they’d been told to remember and then received a water-less, non-foaming, pre-pasted disposable toothbrush – one they can use at lunch and then toss away.

Maritza Jean, a Miami-Dade College dental hygiene student, demonstrates correct brushing technique.

On three separate mornings, two in January and one in early February, more than 1,000 students at three Miami Beach schools were treated to free examinations, or “screenings,” as part of the Children’s Oral Health Initiative, funded by The Children’s Trust. The initiative is operated by Unidad of Miami Beach with staffing assistance by Miami Dade College students enrolled in the college’s 18-month dental hygiene program.

Dental disease is the most common chronic health problem of childhood, and studies show that nearly all children and teens have gingivitis, the first stage of gum disease. Yet only one in 10 Medicaid children in Florida under the age of six receive any dental services, and there’s just one dentist for every 10,000 children with this health insurance program for low-income families, according to a 2009 Oral Health Workforce and Children report.     

“It’s clear that there are vast unmet oral health needs in this community,” said Dr. Elliot Montgomery Sklar, Health Program manager for Unidad. The Beach is an especially transient population, and for a multitude of reasons – money, time off from work, concern for their immigration status – too few parents take their children to the dentist or hygienist as needed, he explained.

So the hygienists and dentists come to the children. The initiative launched in 2004, attempting to meet a vast need for dental care in the community with a small staff. 


“Unidad came to the college and begged us to help,” said Dr. Susan Kass, the director of Miami Dade College dental hygiene program. “Our students do a lot of community service and this gives them some real hands-on experience. We try to make it as light-hearted and fun as possible.”

Altha Louis and Karlyndria Missick, both seniors and soon to graduate, are two of the 50 or so students assisting. They used a foot-long toothbrush on the pink stuffed dinosaur’s teeth to show two first-grade boys the right strokes and direction to brush the teeth and gums.

“When they knew I was studying hygiene, I was invited to my daughter’s school to give some instruction,” Missick said, adding “I fell in love with this community service project.”

The screening process, which takes just a few minutes, has three parts. The children’s teeth and gums are checked. Then, paperwork is completed – one copy goes to the parents, one is filed with the school and another with Unidad; if needed, a referral is made for follow-up care. Finally, the children are given colorful printed information and quizzed again to help them retain what they’ve been told.

For those children who require additional care, the initiative depends on Dr. Barry Ragone and Dr. Lynda Colaizzi, two local dentists. Their professional help is critical to the success of the initiative. 

Dr. Ragone, who launched his dental career treating poor children in Appalachia, opens his nearby office from 4:30 to 9:30 p.m. and sometimes on Saturdays to accommodate working parents. He performs any more complicated dentistry required.

“I do whatever needs to be done,” Ragone said. “When they come to me, I know that many of these children are seeing a dentist for the first time – I want them to have a good experience.” Half of his clients are children referred from the screenings, and he often donates his services or charges significantly below the regular rate. .

Dr. Colaizzi, a dentist and children’s health care advocate, has been instrumental in supplying the initiative with the innovative disposable toothbrushes, especially timely since the Colgate corporation stopped providing Unidad with the regular type. A 180-day (school year) supply of the pre-pasted brushes costs about $27 per child – a dentist’s fee for the lowest-priced filling runs $35.

Though the benefits of providing dental screenings for children shine like freshly brushed teeth, little evidence exists to document their importance. Sklar, who earned his Ph.D. in Public Health at FIU, has focused Unidad’s attention on generating that evidence, in hopes of securing much needed additional funding to expand the initiative.

Unidad is screening some of the children for the second time and noting improved dental health and hygiene though it continues to be a challenge to convince parents to seek follow-up care for their children if it’s recommended.

Jack and Ricardo, both first graders at Biscayne Elementary, are sitting nearly side by side, each has his mouth stretched open wide for the hygienist to get a good look inside.

Their exam over, the boys wait as the hygienists make notes on the forms. Both seem a little shy, possibly for having had their pictures taken in such a compromising pose.

“How did you do, any cavities?” I ask Ricardo.
“Nope,” he says, shaking his head, “just germs, but I’m going to brush as soon as I get home.”

Written by Michael R. Malone