The ABCD Tiny Bites Newsletter

Summer 2019

Your quarterly children’s oral health newsletter for Snohomish County, provided by the Access to Baby and Child Dentistry (ABCD) Program. Stay informed of program updates and learn about promoting children’s oral health with patients, clients, and families.

News Bite

Updated guidelines for pediatric dental sedation

Sometimes dental procedures for children are necessary, and require the child to be still for a long time. There may be pain and fear associated with these procedures for the child. In these circumstances sedation or anesthesia are needed in order to perform procedures safety and effectively. However, there are increased risks involved with deep sedation and anesthesia, and these risks are greater for children under 6 years old. There is no standardized reporting or database for how many children undergo general anesthesia for multiple cavities, but interviews with dental professionals by the New York Times seem to indicate the problem is on the rise and widespread. The new guidelines from the American Academy of Pediatrics (AAP) and the American Academy of Pediatric Dentistry (AAPD) aim to reduce the risk of adverse events (although rare) related to deep sedation and anesthesia for young children.  

The AAP and AAPD published Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures in the June 2019 issue of Pediatrics. The guidelines outline what to do during dental procedures that require deep sedation or anesthesia. Essentially, there should be two people in the room who are trained in offering advanced life support if needed. One person is the dentist or oral surgeon who is in charge of the procedure, and the second person is the independent observer in charge of monitoring the patient’s status. The independent observer must be "a physician anesthesiologist, a certified registered nurse anesthetist, a second oral surgeon, or a dentist anesthesiologist."

More information for parents and caregivers:

Boy at dentist

Health Message Bite

Baby teeth are important

  • Tooth decay is the most common chronic disease of childhood. However, it is almost totally preventable.
  • Baby teeth, or primary teeth, help us eat food, speak, and hold space for permanent adult teeth.
  • Healthy baby teeth mean a healthy mouth for adult teeth.
  • Tooth decay can impact your child's overall health and ability to learn. Children with dental pain have a hard time paying attention and miss more school than other children.

Source:  Cavity Free Kids

Little girl brushing teeth

Resource Bite

For dental and health care professionals

Evidence-based practice guidelines from the JADA.
Get trained on ITR. See details under ABCD Trainings.
Public messaging on safety and link to clinical guidelines.
Resources for medical teams and parents/caregivers.
Education, training, and advocacy.
Toothbrushing at the table

Training Bite

Child Care Provider Training - Recap

Starting this August, the new WACs for licensed child care providers will require daily tooth brushing activities (WAC 110-300-0185). In anticipation of the new requirement, the ABCD program is partnered with the Child Care Health Outreach team at the Snohomish Health District to host a training on June 1. There were 40 trainees at the event! The Child Care Team is finalizing tooth brushing at the table guidelines. Stay tuned.

Get a snapshot of children's oral health in Snohomish County. See the Smile Survey Report and infographic at under Data & Reports. To get a look at how two child care centers in Everett have implemented toothbrushing into their daily routine, check out two videos from the Snohomish Health District: Teaching Toothbrushing in Child Care and Teaching Toddlers to Brush Their Teeth.

Paul cancer survivor

Dental Access Coalition (DAC) Bite

HPV-linked Oral Cancer - a Survivor's Story

If you attended the April 10th training at Homage Senior Services, you'll recall that you heard Paul Benedict's survivor story, read by one of the presenters, but Paul could not be there to tell the story himself. Now you can view and share Paul's powerful story with colleagues, friends and family via YouTube. The videos were produced by the Granite Falls High School Advanced Multimedia Program, funded by the American Cancer Society and sponsored by the Snohomish Health District Vaccine Preventable Diseases Program.

Medical Teams International dental van now participates in a monthly root canal clinic sponsored by Verdant Health Commission in Lynnwood.

The Community Health Centers of Snohomish County (CHCSC) is expanding their School-based sealants program. They are operating in schools in the at Mukilteo, Edmonds, and Darrington School Districts. CHCSC was recently featured in an Everett Herald Article.

Want to suggest the next training topic for the DAC? Would you like to be added to the email distribution list? Send an email to Sarah de Jong at

The ABCD Program participates in the DAC. Meetings are held quarterly on the fourth Friday from 9 to 10:30 am at the Snohomish Health District in conference room 309 AB. The next meeting is on September 27.

Our Mission

Improve access to comprehensive, coordinated dental care.
Mobilize community resources, agencies and institutions to action
Advocate for prevention and early intervention.

Access to Baby & Child Dentistry

Program Bite

ABCD trainings

Do you see children under 6 on Apple Health/Medicaid in your practice? Would you like to become ABCD certified to earn enhanced Medicaid rates? Would you like to earn free UW CE credits? Are you an ABCD trained dental practice who needs to train new providers or staff? Do you still need the Interim Therapeutic Restorations (ITR) training? If you received phase 1 ABCD training, you can get the phase 2 ITR training. 

If this sounds like you, please contact the ABCD Coordinator to request a training: Felicia Cain,, 425.339.8697


Low-Cost dental resource list

The ABCD Program updates this list quarterly. You can find the latest version here.
To be added or removed from the list, or to make edits to your listing, please complete this online form

Need help finding a dentist for your clients?

Adult clients in Washington, whether on Medicaid, private insurance or no insurance, can contact Dentist Link. A referral specialist can find a dentist in the client’s area. A Spanish-speaking referral specialist is available. Clients or providers can call, text, or complete the online form at

Need help finding a dentist for young children on Medicaid/Apple Health?

There’s extra help available through the ABCD program for children under 6 on Medicaid/Apple Health. Contact the ABCD Coordinator directly, Felicia Cain, or 425.339.8697, or complete this online form:

Case management services available for your ABCD clients

Are you a private practice dental office who sees patients under 6 years old on Medicaid/Apple Health? Do they need extra help with transportation, language access, or other basic needs? If you answered yes to these questions, the ABCD Coordinator may be able to help. Contact her with your questions. Felicia Cain: 425.339.8697 or

Keep up with the latest from the Snohomish Health District by subscribing to our blog and newsletters at
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