The University of Arizona

College of Agriculture and Life Sciences

Improving Lives, Communities and the Economy

First Smiles - Oral Health Care Saves Money

Two small girls brushing a stuffed frog's theeth.

First Smiles – Early Oral Health Care Saves Money

  • Preventive oral health care starting before 1 year of age lowers the amount spent over a lifetime on dental care by 40%.
  • The First Smiles program, with a $190,000 grant from First Things First in 2012, provided preventive oral health to children from birth to 5 years, plus their families and childcare providers in Cochise County.
    • 1,925 oral health screenings performed with referral to dentist
    • 1,793 children had fluoride varnish applied, which can reduce decay 20-50%
    • 24 childcare centers had 1,080 children brushing with fluoride toothpaste each day
    • 321 education sessions reached 6,327 children and families



Teaching Kids to Care for Their Teeth

Baby’s first tooth.

So cute – and so vulnerable.

Dental care should start as soon as that first tiny tooth emerges. But often it doesn’t.

In Arizona an estimated 30 percent of 2- to 4-year olds have untreated tooth decay.

The First Smiles program is out to change that. Tots get dental screenings at preschools, childcare centers, immunization clinics. They learn why it’s important to take care of their teeth. Afterwards, 95 percent report they brush twice a day. Many also receive a fluoride varnish treatment, which can reduce decay 20 to 50 percent.

Dental hygienist Joyce Flieger directs the Cochise County First Smiles program, developed by Evelyn Whitmer, University of Arizona, College of Agriculture and Life Sciences, Cooperative Extension agent.  Its success led to similar programs in other rural counties.

This program is funded through First Things First, a 2006 initiative that provides early childhood development, health and education for Arizona's children from birth to age 5.

“Most of the children we see have never been to a dentist. The parents have no idea if their children have cavities or dental problems,” Flieger said.

“Last week I saw a boy, 5. His face was swollen, his eye running. He had a huge abscess – the biggest one I’ve ever seen.”

Untreated, such an infection can spread throughout the body. In some cases, young children have died when it spread to the brain.

Tooth decay or loss can impact development of other teeth and lead to difficulty eating, speaking and learning. 

One culprit is mutans streptococci, a bacteria transmitted from mother to child soon after the first teeth erupt. It can cause tooth decay, strep throat and ear infections. “This is the number one chronic disease in children – and the most preventable,” Flieger said.

She’s known as the Tooth Lady. She gets kids excited about brushing, flossing and checkups. Kids go home with a toothbrush, toothpaste and information sheets for mom and dad. Parents learn to put babies to bed with a bottle of water – not milk, juice or other liquids that can cause tooth decay.

Recently a mother ran across the school lawn toward Flieger. “Are you the Tooth Lady? You got my kid to brush his teeth. I never could. Now he’s brushing every day. It’s wonderful.”


Impact Stories

These stories provide examples of how University of Arizona College of Agriculture and Life Sciences Cooperative Extension (CALS-CE) translates research-based information to help people solve real, everyday problems and improve the quality of life. They highlight the impact CALS-CE has had on Arizonans.

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