Publications

A Healthy Smile Never Gets Old 2.0

Date Published March 2026

A Healthy Smile Never Gets Old 2.0 is the Center for Oral Health’s updated statewide assessment of oral health among older adults in California. Building on the original report released in 2018, this second edition examines changes in oral health status, access to care, and quality of life across skilled nursing facilities and community settings. As the first report of its kind in California, it provides a look at the evolving oral health needs of the state’s growing older adult population. The findings highlight persistent disparities and offer actionable recommendations to improve access, equity, and healthy aging.

Keeping Kids in Class The Impact of School-Based Oral Health and the Need for Standardized Absence Tracking

Date Published: October 2025

This report examines how untreated dental disease contributes to preventable school absenteeism in California and evaluates the role school-based oral health programs play in keeping children present and ready to learn. Drawing on preschool absenteeism records, parent surveys, and structured discussions with school administrators, the analysis reveals that dental pain, difficulty accessing timely care, insurance and transportation barriers, and the absence of standardized tracking systems all contribute to missed instructional time. Quantitative findings demonstrate measurable links between oral health and attendance, while qualitative insights and parent-reported outcomes highlight the convenience, satisfaction, and navigation support associated with on-site preventive services such as screenings and fluoride varnish. Data tables and comparative analyses illustrate how programs like Early Smiles Sacramento reduce disruptions and improve access, yet also expose a significant systems gap: most districts do not code dental-related absences, leaving the true burden largely invisible. The report ultimately serves as a policy-relevant foundation for statewide standardized absence tracking and sustained investment in school-based oral health delivery to advance both educational continuity and health equity.

Bridging the Gap: A Needs Assessment of School-Based Oral Health Disparities Between Rural and Urban Children in California

Date Published: July 2025

This in-depth needs assessment examines the uneven access to school-based oral health services experienced by children across rural and urban regions of California. Drawing on survey responses from families and school staff, the report highlights widespread barriers—including geographic isolation, transportation challenges, provider shortages, and a lack of coordination within school systems. Data visualizations and firsthand quotes provide a deeper understanding of the systemic gaps that prevent many students from receiving timely preventive care. The report serves as a foundational resource for identifying disparities and informing future strategies to improve equity in school-based oral health delivery.

Advancing Whole-Child Health: A Guide to Oral Health Integration in School Wellness Centers

Date Published: July 2025

This interactive, web-based guide offers practical support to districts looking to integrate oral health into new or existing wellness systems. Structured around five core sections—planning, partnerships, operations, service delivery, and sustainability—the guide walks users through implementation strategies tailored to school settings. It emphasizes oral health as a vital piece of the whole-child approach and provides links to workflows and tools.

Integrating Oral Health into School Wellness: An Advocacy Guide for School Leaders and Community Partners

Date Published: July 2025

This advocacy guide equips school leaders, wellness teams, and community partners with messaging, policy strategies, and real-world examples to support the integration of oral health into school systems. Building on the findings of a statewide needs assessment, the guide includes data-driven talking points, a step-by-step integration roadmap, and local success stories from Trinity, Alpine, and Sacramento Counties. It is designed to help advocates build buy-in, align with education priorities, and turn awareness into action.

Health Equity in Oral Health: Moving Beyond Equality to Justice

Date Published: May 2025

The Center for Oral Health offers a bold reimagining of what it means to advance oral health equity in the United States. Going beyond traditional notions of equality, it explores how systemic barriers—like lack of access, limited integration with medical care, and underinvestment in marginalized communities—undermine oral health outcomes. Grounded in the Social-Ecological Model and the Quadruple Aim, the paper highlights COH’s innovative approaches, including school-based care, teledentistry, and community health worker navigation. It features real-world examples from programs like Early Smiles Sacramento and the Big Bear Rural Health Clinic and offers a roadmap for transforming oral health into a just and inclusive system for all.

Smiles at Risk: Protecting Adult Dental Care in California

Date Published: May 2025

Across California, Medi-Cal dental benefits are once again under threat—putting the health, dignity, and economic stability of millions at risk. Drawing from lived experiences in San Bernardino and Sacramento Counties, this joint commentary from the Center for Oral Health and Dientes Community Dental Care makes a powerful case for why protecting adult dental coverage is not only compassionate but fiscally smart. Learn how you can help preserve access to essential oral health services statewide.

Water Fluoridation: Facts vs. Fears

Date Published: January 2025

The Center for Oral Health (COH) reaffirms its dedication to evidence-based public health initiatives with the release of its latest white paper, Water Fluoridation: Facts vs. Fears. This publication emphasizes water fluoridation as a scientifically proven, cost-effective strategy for preventing dental decay and addressing oral health disparities. The paper also highlights the success of COH's Early Smiles Sacramento (ESS) program, showcasing the positive impact of integrating fluoride varnish applications with oral health education to promote preventive care, including the use of fluoridated tap water for brushing.

Investing in Our Youth The Early Smiles Initiative for Low-Cost Dental Services

Date Published: July 2024

The Center for Oral Health (Center) is advocating for comprehensive reforms to enhance oral health care across California. This includes urging state legislators to allocate $10 million in the upcoming budget to expand school-based dental care programs to all public schools statewide within the next three years. Additionally, the Center emphasizes the necessity of Medi-Cal Dental reimbursements for dental screenings and oral health education, as well as mandating annual oral health assessments from pre-K through 12th grade in public schools.

Six Years of Sacramento Smiles

Six-Year Evaluation of the Early Smiles Sacramento Program

Early Smiles Sacramento is a school-based oral health program founded by the Center for Oral Health. This report is an update from the 2017, one-year evaluation of Early Smiles Sacramento. All data presented in this report spans 6 program years, from the program’s inception in September 2016 to June 2022.

Early Smiles Sacramento Impact - 2022

Six Years of Sacramento Smiles

Early Smiles Sacramento Fact Sheet - 2022

Date Published: July 2020

Early Smiles Sacramento is an innovative public-private partnership dedicated to minimizing the dental disease burden among children in Sacramento County.

5 Things You Should Know About Keeping Your Childs Teeth Healthy

Date Published: April 2020

Oral Health of Older Adults

Date Published: March 2018

Despite their unique challenges with access to care, mobility, aging, and health complexities, there has been little attention paid to the status of oral health in older adults. “A Healthy Smile Never Gets Old” examines the unique oral health needs of older adults. It also offers a series of recommendations for improving access to care and strengthening oral and overall health and well-being amongst older Californians.

A Healthy Smile Never Gets Old

A California Report on the Oral Health of Older Adults

This report highlights the oral health status and key issues amongst older adults in California. This is the first report to document oral health needs of this population in the state. We hope this report is used to influence and shape policies to improve the oral health of older adults.

Sacramento Smiles

Evaluation of the Early Smiles Sacramento Program

Early Smiles Sacramento is a school-based oral health program funded by the Center for Oral Health. This report explains what the program is about and the issues it seeks to address. Beyond that, this report also presents findings of a one-year evaluation of the program.

What is Early Smiles Sacramento?

Date Published: October 2017

Early Smiles Sacramento is an innovative public-private partnership dedicated to minimizing the dental disease burden among children in Sacramento. But what are the oral health needs among such children exactly? What does Early Smiles specifically do to help, and how is it unique among similar programs? Read “What is Early Smiles Sacramento?” for answers to these and other questions.

Women, Infants & Children: Early Entry into Dental Care Guidebook

Date Published: December 2011

We created this guidebook to assist dental providers and public health advocates in developing Early Entry into Dental Care programs within their own communities. The guidebook provides background information on WIC (women, infants, and children) and the benefits of early preventive oral health care, guidance for planning dental care and education services, and more.

“Mommy, It Hurts to Chew”

An Oral Health Assessment of California’s Kindergarten and 3rd Grade Children

Children are victims of the single most widespread disease among children in California: tooth decay. This report sheds light on this epidemic through careful research and also offers simple recommendations on what can be done to prevent this issue from spreading further.

Healthy Teeth Begin at Birth

Date Published: May 2005

Your child's baby teeth will fall out, but that doesn't mean they're less important. Read helpful tips on how to jumpstart the oral health of children with this First 5 fact sheet. Topics covered include diet, home tips on preserving oral health, the role of dental and medical providers in helping children, and more. This fact sheet offers helpful tips and reminders for parents and others who work with children.