​Nadereh Pourat, Center director of research, is co-author of a new policy brief about a project in Los Angeles aimed at improving oral health among children younger than six years of age. In this brief interview, Pourat discusses primary teeth, child-wary dentists, and dental insurance.

Q: Why is it important to examine a child's baby teeth when they fall out naturally anyway?

​Primary teeth are more vulnerable to cavities because the hard exterior of the tooth is thinner. Most people don't realize that cavities are caused by bacteria feeding on sugar and that these bacteria are contagious. The first step is to educate parents to avoid passing the bacteria to their young children, the second step is to make sure these bacteria are kept in check, and the third is to address problems early. Healthy habits such as not sharing utensils, brushing with toothpaste and reducing sugar in the diet can guarantee healthy permanent teeth.

Having an examination is essential to promote these healthy habits and reduce the chance of getting cavities during the rest of children's lives.

Q: In your policy brief, the UCLA-First 5 LA 21st Century Dental Homes Project launched many strategies to improve access to care and quality ― including training for medical and dental providers on how to deal with kids. Was there a dentist "fear factor"?

​Most dentists are trained to deal with adult patients, but a child may not be instantly cooperative about opening his or her mouth so a stranger can look in it ― there will be resistance. Examining a child younger than six years old requires a child-centric approach by a comfortable, confident dentist. Delivering oral care to very young children also requires different techniques, such as having the child held in the parent's arms, since a child is unlikely to be able to sit in a chair on his or her own.

Q: Is having insurance enough to ensure children receive basic preventive dental care?

​That's something we touch on in the policy brief. Simply having insurance is probably enough to get you in the door to receive prevention such as fluoride varnish or cleaning. However, providers need to go further and manage children that are at high risk for cavities.

For example, the provider has to assess the risk by asking parents about frequency of sugary drinks and foods, brushing regularly and with fluoride toothpaste, and sending the kids to bed with a bottle of milk. Risk assessment should be covered by insurance so that providers will take the time to do it. We know that there are many children that don't receive risk assessment and risk-based care. This project shows several ways we can address this significant problem for all young children.