Pediatric Program Connects Literacy With Better Brushing

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Photo courtesy of Penn Dental.

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Photo courtesy of Penn Dental.

Many kids have a simple routine before they go to sleep, often brushing their teeth and getting a bedtime story. A team at the University of Pennsylvania School of Dental Medicine, though, thought it could help parents make a stronger connection between these activities to improve literacy and oral health at the same time.

“As pediatric dentists, we care about brushing and healthy bedtime routines. And so books are integral to that,” said Stephanie Rashewsky, DMD, who was inspired by the nonprofit Reach Out and Read program during an outpatient rotation at the Children’s Hospital of Philadelphia to launch Books, Brushing, and Bedtime (BBB).

Rashewsky worked with Rochelle Lindemeyer, DMD, director of Penn Dental’s pediatric residency program, to apply for grants from the Dental Trade Alliance Foundation and the ADA Foundation to purchase books about dental health for kids ages one to 5 years.

“If you’re talking about bedtime routines, you also talk about brushing and brushing with a small smear of toothpaste,” said Rashewsky. “And at the same time we can discuss reading to a child because that makes for such a healthy sleep routine.”

Personnel began giving out these books to parents and patients in Penn Dental’s waiting room. There were few stories aimed at infants and toddlers in particular, though. This was especially troubling, since the American Academy of Pediatric Dentistry recommends the first dental appointment when the first tooth appears.

So, Penn Dental students Ashley Abraham, Kelby Okada, and Giselle Galanto wrote a rhyming story about the importance of brushing at bedtime. Classmate Elizabeth Freund created the illustrations. After additional collaboration with staff and a special education teacher, they produced 2,000 copies of Brushtime, Bedtime in board book format.

With bright colors, simple language, and playful illustrations, the book connects with infants and toddlers while teaching them how to hold and move their brush for a good cleaning. And printed on sturdy cardboard, it stands up to its audience’s enthusiastic reactions—and teething, too.

“The first patient I read to wasn’t even a year old, but she pointed to a puppy and a kangaroo and was so excited,” said Abraham. “Just seeing her fully engaged and reacting to the words I was speaking, the prompts I was giving her, the cadence of reading aloud… it sounds cliché, but it really was a dream come true.”

“Parents were telling us the books were making their children more excited about brushing and that the books were making them more excited to come to their dental visit,” said Rashewsky.

The BBB program is doing more than handing out books in its clinic. Its research initiative follows up with children at their next visit to see if they have better outcomes such as fewer cavities, more interest in brushing at bedtime, and increased reading before going to bed.

“We haven’t really seen the full spread of what’s going to happen with it and what the impact might be, but I think there’s room for growth here,” said Lindemeyer.

Copies of Brushtime, Bedtime are given out at Penn Dental and at the Michigan clinic where Rashewsky now works. Also, Lindemeyer said that Penn Dental alumni have expressed interest in getting copies for their practices.

“I’m so lucky I was a child who grew up with reading. But every child doesn’t get that,” said Rashewsky. “And then to be able to give this to every child is really amazing.”

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