Th 162492

The tooth fairy's friend

Nov. 1, 2004
School teachers can emphasize dental education through a variety of classroom activities, and the author finds an enthusiastic "friend" in a Kansas elementary school.

by Mary Martha Stevens, RDH, PhD

Renée Shofner, a first grade teacher in Wichita, Kansas, swishes and swallows with two students after lunch.
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If you have not worked as a dental health educator in an elementary school setting, you have missed one of the best career paths in our profession. Working with school children can be so exciting. Although school dental health programs are not plentiful throughout the country, the ones that have survived annual budget cuts continue to make a difference in the oral health of thousands of children each year.

One of the most appealing aspects about this type of position is the creative atmosphere. When I worked in the public schools in a small school district in Arizona, the elementary school children called me the "Tooth Fairy." In turn, I would sometimes tease a supportive school teacher or nurse by calling them the "Tooth Fairy's friend." I was fortunate to have many friends.

I eventually moved back to my hometown in Kansas and met Renée Shofner, a first grade teacher at The Independent School in Wichita. She is so skilled at incorporating dental health education into classroom activities that she should be teaching dental health for early learners to hygienists throughout the country.

A veteran elementary school teacher for 15 years, Shofner first became interested in dental health education when she was teaching first grade in Pinetop, Ariz. Native American children who lived on a nearby reservation were bused to her school.

"Dental health was not a priority for the parents of these children," Shofner commented. "This is when I first became involved in Children's Dental Health Month (CDHM)." During the month, Shofner had her students brush every day at school.

"We had a large classroom with lots of storage which made it easy to keep the toothbrushes clean," she said. "The kids really loved it, and it made a big difference in the way they took care of their teeth. I've been hooked on dental health ever since."

Fun dental activities at school

One dental health education activity that Shofner uses throughout the year is called, "Our Tooth Chart." The chart, which hangs on the wall near the classroom door, celebrates the monthly loss of her students' deciduous teeth. Whenever students lose a tooth, they are allowed to place a tooth sticker next to the month in which it was lost. The date and student's name are written on the sticker to commemorate the event. At the end of the school year, the students are always excited to learn which month had the highest tooth mortality.

Anesa Mitchell's, "Brush your teeth 2 times a day" poster hangs outside her classroom door.
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"We'll discuss the months in which they lost the most and the least amount of teeth - then it becomes a math activity too," Shofner explained. "If they lose a tooth at school, I place their tooth in a plastic tooth necklace so they won't lose it before they get home." Shofner indicated that she orders the yearly tooth chart, stickers, and necklaces from the teachers' magazine, Really Good Stuff (

Isaac Stevens proudly displays a new toothbrush and his personalized swish-and-swallow chart.
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In addition to keeping track of lost teeth, one of Shofner's favorite daily classroom activities is story time. She has a variety of creative, informative and entertaining children's books about tooth loss and good dental health practices. Since her students are losing teeth throughout the year, dental health topics are not restricted to CDHM.

Noelle Ikawa places a sticker on the tooth chart after losing a deciduous tooth.
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Every year her students' all-time, favorite book is, Andrew's Loose Tooth, by Robert Munsch. The book's illustrator, Michael Martchenko, electrifies the reader's imagination with drawings of a young boy who can't find anyone who knows how to pull his loose tooth.

Renée Shofner places a sticker on Andrew Hammar's swish and swallow chart.
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"It's so funny," said Shofner, "and the kids get it! They've all had a tooth that's hanging on by one root, that looks like it's going to drop out, but they can't get it out." Shofner indicated that she often finds herself watching a student struggling with a loose front tooth. "They keep pushing it back and forth with their tongue - it looks awful. The tooth's flopping around, but it won't come out. So, that's why my students love that book. When I read it to them, we just laugh together," smiled Shofner.

Other "tooth books" Shofner reads to her students include ones that may be appropriate for young patients in the dental office. They include:

I Know Why I Brush My Teeth, by Kate Rowan
Nice Try, Tooth Fairy, by Mary W. Olson
The Lost Tooth Club, by Arden Johnson
Moose's Loose Tooth, by Jacqueline A. Clarke
Loose Tooth, by Steven Kroll
The Tooth Book, by Theo. LeSieg

All of the books, except for The Tooth Book, are distributed to the school market by Scholastic, Inc., which can be found on the web at

Early planning for Children's Dental Health Month

Each fall, when Shofner receives her Crest(r) First Grade Dental Health Education Program materials, she orders next year's materials. "I've found that ordering next year's materials immediately ensures that Crest won't run out of what I need for my students. The program materials are great, and they're free," said Shofner. The Crest First Grade education materials include: toothbrushes, toothpaste, disclosing tablets, teacher's guide, a take-home activity, tooth adventure video, sing-along CD, and a classroom poster.

"Aside from reordering the Crest program, I begin planning for CDHM in January. Each year I try to improve my CDHM activities," said Shofner. "I have a good set of bulletin boards I've worked on over the years." She uses a variety of creative resources that target elementary school teachers, including the following publications, materials and activities:

Really Good Stuff ( has a tooth chart, tooth stickers, and tooth necklaces, as well as other creative tools.

February, published by The Education Center, Inc. (, offers a true-false game focusing on how to maintain good oral health, a tooth fairy pattern, and fact sheet.

• Carson-Dellosa Publications ( provides dental health patterns and activities for bulletin boards, as well as a tooth award pattern that acknowledges good brushing habits.

Copycat, published by Copycat Press, Inc.(, has a variety of dental health ideas and activities for teachers K-3, as well as children's books that are appropriate for CDHM.

The Mailbox, published by The Education Center, Inc. (, provides ideas from other teachers on how to present dental health education in the classroom.

Renée Shofner's first grade class shows off during Children's Dental Health Month.
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"The Mailbox magazine is a good resource for envelope patterns that can be Xeroxed, cut out, folded, and used to send a lost tooth home in," said Shofner. "For example, when I was doing a unit on elephants, I found an envelope pattern that said, '________'s Tusk,' and it had a little picture of an elephant holding a tooth on it. The children felt this personalized envelope was so special."

Swish and swallow

For the past three years during CDHM, I have been fortunate to meet with Shofner's first grade class to present a fun-filled unit on dental health education. This year was no exception, as even more delightful surprises awaited my arrival. Outside the classroom door, I was met with rows of posters - each with a picture of a computer-generated toothbrush, the student's photograph, name, and a student-written dental fact on it. The posters were classroom art projects that had been embellished by Shofner's incredible computer graphics skills, which were well known throughout the school.

Several first grade students greeted me at the door with pictorial drawings that included hand-written comments on dental health. Inside the classroom, the bulletin boards were filled with colorful dental health information. CDHM tooth brushing charts were being waved in the air like flags. Shofner had fashioned the charts into large toothbrushes with white paper towel bristles that, again, each child had made as an art project.

But, to my surprise, there were small, computer-designed swish and swallow charts lying on each student's desk. Shofner had decided to use the "swish and swallow" concept as a month-long, class project. During previous visits, I had emphasized that this technique could be used to remove some food debris after eating snacks and meals, even though daily brushing was essential. Since Shofner's classroom was not conducive to brushing every day, she had decided to have her students swish and swallow at school. The swish-and-swallow charts were being used to keep track of their new oral health ritual.

"I wanted to reinforce this habit since it was something the students could do anywhere," said Shofner. I was so intrigued with her creativity that I asked if I could return in a month to learn the project's outcome.

Immeasurable outcomes

During my second visit to Shofner's classroom, at the end of CDHM, I learned what the swish and swallow process had entailed. Every day after lunch and recess, each student filled a paper cup half full of water and picked up a paper towel on the way back to their desk. After the students continued from page 21

were seated, Shofner would demonstrate the swish and swallow procedure.

"We would swish for about 30 seconds, swallow, take a little rest, and swish for about 30 seconds again. They loved to swish and swallow," said Shofner. "Then, the students would wipe their desks with the paper towel, place it in the cup and throw it away. Next, they would begin our D.E.A.R. program, which means 'drop everything and read.' They did this quietly while I placed stickers on their swish and swallow charts. They love stickers."

Shofner wasn't looking for any particular outcomes with her daily swish and swallow activity.

"I wanted them to realize that they didn't need a toothbrush in their hands all the time in order to take care of their teeth, even though they were keeping a daily brushing chart at home," she added. "I emphasized brushing twice a day at home, especially at bedtime. Of course, they got stickers for that, too. And, if we ate a sticky, late afternoon snack at school, they would remind me that we needed to swish and swallow. This whole process definitely made the children more aware of the importance of their teeth."

She also noted that the parents were amazed at how excited their children were about their newfound dental health behaviors. "One mother told me, 'Now I have to help him floss his teeth every night.' Although I'm sure not all of them were flossing every day, most of them seemed to be brushing," Shofner concluded.

As I was preparing to leave her classroom, I asked the students what they had learned during the past month. Shofner had a student select a tongue depressor from the can that sat on her desk. It was then that I noticed each tongue depressor had a student's name on it. As the children thought about their month-long experiences, Shofner moved to the front of the class.

Referring to the first selected name on the tongue depressor, Shofner asked, "Bryant, tell us about the different kinds of teeth we have in our mouth."

Bryant thought for a moment. "Uh, we have canine teeth," he replied.

Quickly, Shofner shot back. "Do you remember how many canine teeth we have?"

"Four," Bryant answered with confidence.

"Four, where?" flashed Shofner.

Bryant paused for a moment, "Uh, um, by the incisors?"

"Yes, there are two on top and two on the bottom, what else?" Shofner responded.

"And, molars," said Bryant.

Shofner continued, "And, what else?"

"Incisors," Bryant said with a smile.

"Yes, and what did we say incisors were like?" queried Shofner. Without hesitation, Bryant replied, "Scissors."

This extemporaneous game continued with the selection of other students' names. It seemed the flow of dental health information was endless.

Trying to inspire the public to adopt good oral health habits is not an easy job. So, let's face it - we need all the friends we can get. Year after year, Shofner innocently and anonymously plays the part of the dental hygienist's best friend. And, possibly, she may be having a greater, long-term impact on the dental health habits of the community than her neighborhood dental professionals. In any case, Renée Shofner's "got it" and in turn, her students are "getting it" every day she walks into the classroom.

Renée Shofner truly deserves the honor of being called the "Tooth Fairy's friend." Renée Shofner can be reached at [email protected].

It's time for us to acknowledge our tooth fairy friends.

If there is a Renée Shofner in your neighborhood, contact Mary Martha Stevens, RDH, at [email protected]. Please include your name and telephone number along with any information about your "friend" that you feel is noteworthy. Don't forget - the "Tooth Fairy's Friend" is someone who cares deeply about the oral health of their community that they have taken actions to make our job a little easier. At first, our friends may be hard to distinguish because they come in all sizes, shapes, and professions. But once their accomplishments have been witnessed, they can't be missed by the discerning eye of a dental hygienist.

Who has shared your mission - a school nurse, teacher, principal, or board member? Maybe your friends are in political office or maintain public health jobs. Sometimes nursing home administrators and aides have astounded us with their commitment to the oral health of their residents. And the list goes on...

Who came to your mind after you read the article above? RDH would like to honor your "friend" by telling their story.

Mary Martha Stevens, RDH, PhD, is a consulting editor for RDH. She is also an adjunct instructor in the Center for Independent Study at Butler County Community College in Andover, Kan. She can be contacted at [email protected].