Kids learn the tooth about oral health from dentist’s series of books

A moment of serendipity while in dental school helped Dr. Jeanette Courtad create a momentous project decades later to promote oral health among kids and expectant mothers— a book series called “Toothful Tales.”

Now a dentist at Colorado School of Mines for two decades, Dr. Courtad was a freshman at University of California San Francisco School of Dentistry when she needed to engage a group of kindergarteners for a community outreach project on the importance of brushing. She tapped into her lifelong artistic side, as a painter and sculptor, and created personified teeth.

“I felt like it was really important for that age group to understand that the plaque and germs can be on all different surfaces of the teeth and gums and tongue,” Dr. Courtad said. “So, I carved, out of couch foam, three teeth — a molar, a cuspid and an incisor — and covered them in terry cloth, a fabric that I could attach Velcro germs to, which I cut out and put on the teeth. Then, I made faces out of the Velcro, as well.”

The cartoon-like sculptures spoke to the imaginations of the kindergarten students while imparting oral health facts. They helped to illustrate that teeth are three-dimensional, Dr. Courtad said, and that you have to spend time and effort to get all the germs off.

“Obviously, the teeth were sad when they were covered in these Velcro germs before the kindergartners took a giant toothbrush and actually brushed those little germs off the teeth with me, showing them they were in the grooves on top of the molar and on the front, back and sides of all the teeth,” Dr. Courtad said.

Based on those initial characters, Dr. Courtad eventually carved out a bigger goal — to contain that education for posterity by writing, illustrating and publishing a book, which ultimately started the series.

“I got the idea that the more visual I can make this, the better,” she said. “The three teeth that I carved became the characters of the book. I wanted the names to be close to what their clinical names are. So, Incisa is kind of a spokesperson for the mouth, right in front of the mouth, explaining the scientific concepts.

“I made the cuspid, or Cuspi, more concerned with aesthetics and how things feel. She doesn’t like to be covered in sticky sweets. And then Mola brings out the functionality since it’s the more powerful chewing surface of the mouth. I tried to address all aspects of oral functioning with the teeth characters.”

The tongue is also a character personified in the form of Tongo. “The tongue is considered the antihero in the books because, even though he helps clean any sticky sweets off the teeth, Tongo is the one wanting them in the first place,” Dr. Courtad said.

She published the first book, “Toothful Tales: How We Survived the Sweet Attack,” in 2009. Two additional books followed, making a series that Dr. Courtad plans to continue expanding. The other books, respectively, are “Toothful Tales: Our Sensational Dental Adventure” and “Toothful Tales: Becoming Me Cavity Free!”

“Becoming Me Cavity Free!” is a primer aimed largely at expectant mothers to aid them in caring for their babies’ primary teeth. Dr. Courtad collaborated with the University of Maryland School of Public Health’s Herschel S. Horowitz Center for Health Literacy and its founder, Dr. Alice M. Horowitz, to create a story for educating underserved expecting parents.

“That’s an interesting use of a picture book because my first two books are for early readers, mainly directed toward children,” Dr. Courtad said. “The third one can be read with children as well. But, it’s used for new moms who may have English as a second language or have limited dental experience to get the messages across in a visual manner where, even if they can’t pick up every word in the story, they can tell by the image what that word might be.”

They envisioned that the book also could be an educational aid in other settings, for example, in doctors’ offices to help general physicians and obstetricians educate pregnant women on oral health during pregnancy and after babies are born.

“Our collaboration on this publication came as a result of research we have been conducting in Maryland over several years,” Dr. Horowitz said. “All too many caregivers simply do not understand how much they can do to ensure their child is cavity free.”

The book, Dr. Horowitz said, helps to teach expecting mothers how to ensure their own oral health as a precursor to also ensuring their babies’ oral health. “We teach moms to begin cleaning their infants mouths as soon as they come home from the birthing center,” Dr. Horowitz said. “Waiting until the infant has a tooth is too late.”

From a holistic standpoint, Dr. Horowitz said, “Becoming Me Cavity Free!” has even greater value beyond imparting basic dental health practices and habits. “In addition, we use the book to urge moms to read to babies as soon as they bring him/her home because there is good research that shows reading to infants early on stimulates cognition. Moms are a baby’s first educator, first physician and first dentist.”

Public health departments have ordered “Becoming Me Cavity Free!” to package in their well-mother care kits, Dr. Courtad said.

One such municipal body, the Lincoln Trail District Health Department in Kentucky, uses “Toothful Tales: Becoming Me Cavity Free!” in a community outreach program to pregnant women within its six-county district area.

“These books will help provide a great deal of the education because they are easy to read and provide important information to pregnant women using fun graphics,” wrote Diana Leathers, Maternal Child Health Coordinator and a registered dental hygienist, in a testimonial blurb to Dr. Courtad.

Ms. Leathers wrote that the health department uses the “Toothful Tales” book to engage patients in its Women, Infants, and Children (WIC) program and its Health Access Nurturing Development Services (HANDS) program. “After searching many places for a book to increase oral health literacy for pregnant women, Dr. Courtad’s books were a perfect answer! We have also used these books with our HANDS and WIC patients in the past to increase oral health literacy — both English and Spanish versions,” she said.

For the next installment in her series, Dr. Courtad would like to target college-age students to emphasize the effects that snacking and sugary beverages have on teeth.

Dr. Courtad and Dr. Horowitz again will collaborate (with dental hygienist Sharon Clough) in a training at ADA 2018 – America’s Dental Meeting in Honolulu. Their session, part of a series of courses that include information on fluoride, is Preventing Caries in the Pregnant Woman and Her Child (7800), Oct. 20, 7-8:30 a.m.

For more information on Dr. Courtad’s books, visit www.toothfultales.com. To register or learn more about ADA 2018 – America’s Dental Meeting, visit ADA.org/meeting.

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