Skip to main content Skip to site navigation

Oral Health


Oral Public Health Program
Healthy mouths, healthy bodies, healthy communities

The Oral Public Health Program (OPHP) works with community partners to improve the conditions for oral health in San Mateo County, particularly for those facing historical and systemic barriers to oral health.

The OPHP currently focuses on reaching pregnant people and children ages 0-5 and their parents/ caregivers who are on Health Plan of San Mateo (Medi-Cal) health insurance.

See below for: 

The Oral Public Health Program is funded by the California Department of Public Health, under Contract 22-10196. 


Oral health is essential to our general health and well being. It’s all connected!
Oral health is about MORE than a nice smile

Healthy mouths, healthy bodies

Babies and children with healthy mouths can eat enough healthy foods and get enough sleep to help their bodies grow and develop well, because they don’t have problems chewing, eating, or sleeping due to an infection in their mouth.

Babies and children with healthy mouths have healthier immune systems, because their bodies don’t have to fight off infections from bacteria in their mouth, which can spread to other parts of their body. 

Asthma and oral health

  • Some asthma and acid reflux medicines (about half of children with asthma have acid reflux) and mouth breathing can make the mouth dry. A dry mouth can cause cavities, mouth sores, bad breath, or gum disease. Some asthma medications can cause oral yeast infections (oral thrush).
  • Make sure your child rinses their mouth with tap water after using their inhaler. When using an inhaler before bed, rinse or brush teeth immediately afterward. Chew sugar-free gum with xylitol to help dry mouth and get rid of the taste of medications. If you think your child may have oral thrush, contact their doctor. If you are worried your child may have an asthma attack at the dentist, talk to the dental staff ahead of the visit to discuss ways to make your child more comfortable.

Healthy mouths, healthy minds

When children have good oral health and no infections in their mouths causing pain, they’re less likely to miss school days, or have problems learning or concentrating. This is why in the state of California, all children enrolling in public school kindergarten must have an oral health assessment completed by a dentist and turned into their school by the beginning of the kindergarten year. Learn more here.

Healthy mouths, healthy spirits 

Children with healthy mouths can have better self-esteem, feel happier, and have better social relationships than children with unhealthy mouths. Children with unhealthy mouths may have problems speaking, and they may be embarrassed or have lower self-esteem because of their mouth, teeth, or gum problems.

Healthy mouths, healthy finances

Practicing good daily oral health habits and having access to a regular dentist, healthy foods, and fluoridated tap water can all help keep your dental expenses low. An unhealthy mouth can be expensive to treat, and require you to take more time off work.


For pregnant people, children, and parents/ caregivers of children


  • Routine, routine routine! Practicing good oral health is all about establishing and keeping a daily oral health routine, following the instructions below.
  • Brush your teeth and tongue morning and night2 times a day at least–with fluoride toothpaste and a soft toothbrush that is the right size for you for 2 minutes. 
  • Spit out the toothpaste, but don’t rinse it off with water or mouthwash.
  • Floss at least once before bedtime.
  • Eat foods and drinks low in added sugars. Too much sugar in the mouth for too long can cause tooth decay and gum disease.
  • Snack on healthy foods and drinks at specific times, not all throughout the day.
  • Drink tap water with fluoride.
  • See the dentist at least twice a year for a check-up.
  • If you take medications, ask your doctor or dentist if they may increase your risk for oral health problems. For example, some medications cause dry mouth or oral yeast infections. Take the steps your doctor and dentist recommend to best care for your oral health while on these medications.


  • It is safe and important to see the dentist during your pregnancy.
  • Changes to your body during pregnancy may make your gums more sore, red, or likely to get a mild (reversible) form of gum disease. It is important to keep gently brushing and flossing your teeth. Use a soft toothbrush with fluoride toothpaste.
  • If you have morning sickness and vomiting, protect your teeth from the acid that can cause teeth erosion by rinsing with tap water or a teaspoon of baking soda and a cup of water. Before bed, rinse with an alcohol free mouthwash with fluoride.
  • Having a healthy mouth yourself will help your child to have a healthier mouth too.
  • If you smoke or use tobacco, quit. See here for help.
  • For additional information, see the pregnancy and oral health webpage here.


  • Take your baby to their 1st dental appointment when their 1st tooth comes in, or by their 1st birthday. If your child’s dental office tells you they see babies starting at age 2 or older, schedule the appointment as close to your baby’s first birthday as possible. Ask the office if it’s possible to schedule a quicker initial ‘get to know you’ visit when your baby turns one. Click on the video above or here to learn more.
  • Wipe the baby’s gums with a soft wet cloth after each feeding. During nighttime feedings, keep a bottle with water in it nearby and give them a little water after the feeding to rinse their mouth.
  • If your baby needs a bottle to fall asleep, it should only have water in it. Babies that fall asleep with a bottle with milk in it can get tooth decay called “Baby Bottle Syndrome” because the milk pools in their mouth and bathes it with sugars that cause tooth decay. If your child falls asleep while feeding, remove the bottle as soon as you notice they are no longer sucking.
  • Start brushing your baby’s teeth with a small smear of fluoride toothpaste when their first tooth appears with a soft toothbrush. You can use a rubber finger brush for babies. Use a rice sized amount of toothpaste until they’re about 3, when you can switch to using larger pea sized amounts. 
  • Start flossing their teeth when they have two teeth that touch. You can use floss picks if they are easier to use.
  • Babies should not be given juice to drink.
  • Parents/ caregivers need to keep their mouths healthy and not share utensils with their baby. Rinse your baby’s pacifier with water to clean it. Do not use your mouth to clean it. Bacteria from the parent’s mouth can transfer to the baby’s mouth.
  • According to the American Academy of Pediatrics, when your baby is 6 months, your pediatrician can start to do oral health checkups and apply fluoride varnishAll infants and children should have fluoride varnish every 6 months until age 5.  Children might need it every 3 months if they have a higher risk of dental decay. These fluoride varnish applications are covered for free by public (HPSM Dental) and private dental health insurance plans.


  • It’s all about establishing and keeping to a daily oral health routine! Do not skip the daily oral health routine, even when it gets hard. Brush and floss together as a family. See our books and songs page for ways to make the routine more fun.
  • Kids need their parents/ caregivers to help them brush and floss their teeth until they’re about 7-8 years old, and have the skills to do it themselves.  
  • Kids should see the dentist twice a year, and get fluoride treatments and sealants to protect their teeth.
  • Kids should drink lots of water, and should not drink juice, sodas, and other sugary drinks. If they have juice or a sugary drink, it should only be about 4 ounces (half a cup) or less.
  • Kindergartners- in California, public school kindergartners need to see a dentist for a checkup and complete the Kindergarten Oral Health Assessment to turn into their school at the start of the school year. See here for more information.
  • According to the American Academy of Pediatrics, all children should have fluoride varnish every 6 months until age 5.  Children might need it every 3 months if they have a higher risk of dental decay. These fluoride varnish applications are covered for free by public (HPSM Dental) and private dental health insurance plans.
  • The American Dental Association recommends that every child have an orthodontic evaluation by 7 years of age.
  • Ask your child’s dentist about what protective gear they should wear in their mouth if they play sports.


While you are pregnant

  • Get a dental checkup. It is safe to have dental care when you are pregnant, including dental x-rays, local anesthesia, certain medications, cleanings, fillings and other dental treatments. Do not put it off until after you have the baby.

    • Health Plan of San Mateo Dental covers dental services while you are pregnant and after you have the baby. Click here for more details about coverage.
    • Some dental offices will request a referral from your OB/GYN to schedule a dental appointment. Talk to your doctor if you need help getting dental care or making an appointment. Tell the dental office staff that you are pregnant and your due date. 
  • Changes to your body when you are pregnant can make your gums sore, puffy, and more likely to get a mild gum disease that is reversible called gingivitis. This is why it is important to brush and floss everyday and visit the dentist. If your gums are sore, you can use a softer toothbrush. If gingivitis is not treated, it could lead to a more severe gum disease that could cause tooth loss. 
  • If you have morning sickness and vomiting, protect your teeth from the acid that can cause teeth erosion by rinsing with tap water or a teaspoon of baking soda and a cup of water. Before bed, rinse with an alcohol free mouthwash with fluoride.
  • Chewing gum or mints with “xylitol” is recommended during pregnancy and until the baby is about two years old, because it can reduce the amount of bacteria in the mouth.
  • Continue to practice good daily oral health habits: brushing twice a day with fluoride toothpaste for two minutes, flossing at least once before bedtime, drinking fluoridated water, and eating healthy foods and drinks low in added sugars.

After the baby is born

Click here to see how to care for your baby’s gums, baby teeth, and mouth.

To download brochures in English and Spanish about oral health and pregnancy, click here for English, and click here for Spanish / Español.

KOHA flyer

Kindergarten Oral Health Assessment (KOHA)
Information, forms, and reporting templates for schools and parents/caregivers

The Problem

Tooth decay is the most common, chronic childhood disease. According to the California Department of Education, dental problems are the cause of 874,000 school days missed each year, which costs schools over $29 million annually in average daily attendance funding. Dental caries is a preventable disease; yet, more than half of California kindergarteners have experienced tooth decay, and by third grade, this number rises to over 70 percent. Data show that more than a quarter of these children have dental disease that, if left untreated, has deleterious effects on children’s academic performance, social-emotional development, sleep and nutrition, and leads to poor general health outcomes. 

California State Requirements

The Kindergarten Oral Health Assessment (KOHA) requirement was passed into law under the Education Code Section 49452.8 in 2005 by Assembly Bill 1433 (AB 1433). It requires all public school kindergartners and only those first graders enrolling in public school for their first year to have an oral health screening completed by a licensed dental professional. 

The goal is to raise awareness about the importance of oral health and help connect children to a regular source of dental care.  An oral health assessment is a quick, basic screening to identify the overall health of the mouth. It is not a full oral health evaluation, or a substitute for regular, comprehensive appointments with a dentist every 6 months.

It is one way schools can support children’s school readiness and success by identifying children suffering from untreated dental disease and helping parents establish a dental home.  

Some schools in San Mateo County host free oral health screening days on-site, provided by outside dental professionals and organizations. The law was updated with Senate Bill 379 (SB 379) in 2017 to allow schools to use passive consent for these oral health screening school events. Passive consent means every child will receive a screening unless their parent/guardian has signed a form (an “opt-out” letter) indicating they would not like their child to receive the screening.

The Oral Public Health Program collaborates with the San Mateo County Office of Education to ensure all schools and districts are in compliance with this KOHA mandate.

Public school grade levels that must meet this requirement

  • Kindergarten, not including Transitional Kindergarten- All public school children entering Kindergarten grade level must have the KOHA completed. While students in Transitional Kindergarten (TK) can technically complete the assessment during their TK year, the required data for those students (see below) should not be submitted until their kindergarten year.
  • Any student in first grade in public school, only if they did not attend public school Kindergarten the prior year - Some children do not attend public school Kindergarten, and their first year in public school is first grade. For these first grade students only–not all public school first graders–the oral health assessment is required. 

School staff responsibilities around KOHA data collection and entry

By the end of the school year, or by July 1st at the latest, the KOHA legislation requires specific KOHA data to be totaled and entered into a database annually by school staff. 

The database developed for this purpose is called the “System for California Oral Health Reporting,” or “SCOHR.” See step by step instructions on how to use SCOHR below.

School staff often work closely with the County Local Oral Health Program and with the County Office of Education to comply with the KOHA data collection and entry requirements (see more details below).

The Kindergarten Oral Health Assessment is different from the first grade health exam requirement, and both are required 

  • The KOHA is required for public school kindergartners, and only those first graders enrolling in public school for their first year. It must be completed by a licensed dental professional (a dentist or dental hygienist).
  • The first grade health exam is required for first graders, and must be completed by a medical professional. 
  • See our County Health webpage about all school and childcare health requirements here.

How the KOHA requirement is communicated to parents/ guardians

The registration packet for each public school kindergarten student contains the KOHA packet (see below). The KOHA packet consists of:

  • KOHA Notification Letter- describes what the requirement is, what parents need to do, and includes information about how to access dental care in the county, as well as basic oral health information 
  • KOHA Form – the actual screening/assessment form parents need to take to their child’s dental appointment and have the dental provider complete. If the child’s school is hosting a KOHA screening day, the dental providers at the school will complete the required form there.
  • Waiver of the KOHA Requirement- dental providers complete the KOHA assessment during the child’s regular dental appointment. However, if children do not yet have a dentist or dental insurance, cannot easily get to a dentist during their Kindergarten year, or do not attend a school hosting an on-site KOHA screening event, a waiver form may be completed. Parents are encouraged to contact their school health staff, Health Plan of San Mateo Dental, or the Oral Public Health Program if they need help completing the KOHA requirement.

Oral health educational trainings and resources
For healthcare workers, promotores, and early childhood educators

“Open Wide” training for health and early childhood professionals, from National Maternal and Child Oral Health Resource Center

  • Click here to access the Open Wide training
  • Open Wide is a series of 4 self-paced modules designed to help professionals working in programs (e.g., Head Start, home visiting, WIC) promote oral health in the course of promoting general health for children from birth to age 6 and their families