Wellness

• Schedule a Check-up: The American Academy of Pediatrics (AAP) recommends annual checkups from age 3 through adolescence. Schedule early to secure an appointment before the school year starts.
• Mental Health: Have open and honest conversations with children about their concerns. Speak with the pediatrician on tools to help with anxiety.
  • Parenting & Back-to-School: Emotional Safety Starts at Home
  • Raising Joy Podcast: Back to School Anxiety
• Oral health: Children should visit the dentist every six months. Make sure kids brush twice a day for two minutes and floss daily. Make an appointment.
• Update child vaccinations: Navigating vaccines can feel overwhelming. Talk to your pediatrician. The Texas Department of State Health Services requires certain immunizations before children can attend school.
  • To schedule an appointment, visit Cook Children's website or your county's health department website.
  • If a child is not of school age but attends daycare, other requirements may apply.

  • College students are required to receive the meningococcal vaccination.

    

• Sport physicals: The annual UIL pre-participation physical evaluation form applies to middle school and high school students. Sports physicals give doctors the opportunity to check for a variety of concerns, from vision issues and asthma to a lingering sprain or even a serious heart condition.

Healthy Routines

• Sleep: Sleep fuels a child's memory and concentration. Without consistent rest, children struggle to focus in class and retain what they learn, impacting their academic performance.
• Key elements for building a bedtime routine:
  • Establish a consistent schedule by going to bed at the same time each night.
  • Limit screen time at least one hour before bedtime.
  • Keep bedrooms quiet, cool and dark.
  • Create a calming routine, such as reading together.
• Transportation safety:
  • E-Bike and E-Scooter safety: Always wear a helmet.
  • Driving: Drive slowly through school zones and watch for pedestrians.
  • Car Safety: Ensure your child is in the correct car seat or booster for their age and size.
• Nutritious meals: Plan balanced breakfasts and lunches to keep energy levels stable throughout the day.
• Screen time: According to the American Academy of Child and Adolescent Psychiatry, children ages 8 to 18 in the United States spent an average of 7.5 hours a day using screens in 2025. Set clear daily limits for non-academic screen use.

Make a Plan

• Virtual care: If school district offers it, sign up for the Cook Children’s School-Based Virtual Health Program.
• Allergy action plan: Provide updated emergency allergy plans and medications to the school nurse.
• Medication management plan: Submit required doctor authorization forms for any daily or emergency medications needed during school hours.

“Teeth are so important in so many ways, forms and fashion,” Tonya Fuqua, D.D.S., director of Child Oral Health at the Center for Children’s Health, led by Cook Children’s Health Care System. “The mouth is the gateway to our body, and it is connected to the rest of our body. And it starts with once a kid is born.”

The assessment also revealed 57% of children (about 651,000) received at least two or more preventive dental visits aligning with the American Academy of Pediatric Dentistry recommendations.

 A Celebration to Sink Your Teeth Into

In honor of National Children’s Dental Health Month in February, the Cook Children’s Save-A-Smile program hosted a celebration this week in collaboration with the Fort Worth District Dental Society, the Texas Dental Association, and the Children’s Oral Health Coalition.

The organizations transformed the Cook Children's Medical Center Fort Worth Atrium into a dental-themed landscape. Patients received age-appropriate oral health kits, participated in arts and crafts, and chose a Build-A-Bear teddy bear or "tooth" to keep as a reminder of good oral hygiene.

“Healthy mouth, healthy body because if your mouth is healthy, that will hopefully lead you to a healthier body,” said Dr. Fuqua.

A child’s smile holds enormous potential for fostering emotional well-being, communicating happiness and building connections with others. It can also be a powerful indicator of physical health.

“There is a clear connection between oral health and overall mental and physical health,” said Tonya K. Fuqua, DDS, director of oral health for the Center for Community Health, led by Cook Children’s. “Teeth can be very telling about what is going on in a child’s life, the socioeconomic barriers they face and underlying health issues they may have. That’s why it’s so important for the dental health of children to be as high a priority as their physical health.”

Connecting the dots between oral and physical health to improve a child’s overall wellness is the purpose of a grant awarded by the American Academy of Pediatric Dentistry (AAPD) Foundation to Cook Children’s Health Care System’s Renaissance Neighborhood Health Center and the Center for Community Health’s Save-A-Smile Program. Cook Children’s is one of only two recipients nationwide to receive the grant.

“The AAPD Foundation is dedicated to making dental care accessible to all children by supporting nonprofit clinics providing routine cleanings, advanced treatments and ongoing care that helps kids in need,” said Douglas Keck, DMD, MSHed, AAPD Foundation president, pediatric dentist, and dental director of a Federally Qualified Health Center in Florida. “Our support of Save-A-Smile and its medical dental interface initiative represents a pivotal step in bridging the gap between oral health care providers and primary health care practitioners. By working together, we aim to provide sustainable compassionate care for children in need.”

The grant supports a three-year pilot project aimed at developing best practices for bridging the gaps between pediatric medical and dental care. It makes way for a community health worker (CHW) to be embedded with Renaissance Neighborhood Health Center to educate and support families while identifying and addressing any barriers that keep them from completing care.

Cook Children’s Renaissance Neighborhood Health Center is a primary health care home for children living in southeast Fort Worth. The center has both a dental and medical clinic under one roof, making it the ideal location to conduct the pilot. Many within the center’s patient population are considered financially vulnerable and qualify for government-supported health programs such as Medicaid and Children’s Health Insurance Program (CHIP). They may also face non-medical drivers of health such as food insecurity, housing issues and adverse childhood experiences.

Making Connections

Juanita Valles is the community health worker assigned to this medical/dental integration project at Renaissance.

“Families tell me their problems and I listen,” Valles said. “Right now, everyone is struggling financially. Sometimes they need transportation to appointments, childcare, clothing, diaper assistance, car seats for the kiddos, household items or even dental care for the parents themselves. That’s where I come in.”

When a family has a need, Valles works to clear the path to make it easier for them to follow through with medical and dental care. She even goes so far as to make in-home visits with her trusty stuffed assistant, Leo the Lion, when working to educate a family and overcome barriers.

“I take Leo with me everywhere I go and use him to show kiddos how to brush their teeth the right way,” she said. “We also teach them to drink lots of water and stay away from sugary drinks.”

Children with untreated dental problems often have difficulty with pain, eating, sleeping, self-esteem, school attendance and grades. Cook Children’s 2021 Community Health Needs Assessment revealed that more than 175,000, or 1 in 7, children living in Cook Children’s eight-county service area were not able to get the dental care they needed. This rate is 9 times higher than national estimates and 5 times higher than state estimates. Stated barriers included inadequate dental insurance coverage, difficulty scheduling and lack of education and resources for dental care.

“You really relieve all barriers by addressing the social service component of why families may not get the dental care they need for their kids,” Dr. Fuqua said. “And the pediatrician’s office is the perfect place to start because children often visit their pediatricians more frequently in their first years of life than they do dentists.”

Leveling Up

Results from year one of the pilot, which began in January 2023, have already triggered system-wide change, Dr. Fuqua says. Dental screening questions were implemented across all of Cook Children’s Health Care System for well-child visits ages 0 to 3. Children in the pilot project who screen positive are connected with the community health worker. Other opportunities to scale-up and implement new solutions for year two include streamlining pilot data collection and analysis, refining criteria for patient referrals to the community health worker and examining system-wide dental screening data.

In the first 10 months of the pilot, more than 1,000 patients responded to dental screening questions during a well-child check and subsequently scheduled a dental appointment at Renaissance. Of those, 429 patients completed initial dental appointments at Renaissance. In that same time, Valles attempted or completed contact with families 247 times and provided tailored oral health instruction in person or by phone to 50 families.

“That's the beauty of this program and having a community health worker,” Dr. Fuqua said. “It's not as simple as just saying, ‘Oh, your kid needs help and here's where to go.’ These families have so many barriers and so many reasons why they haven't gotten a child to the dentist, but Juanita and this program make a way for them.”

About Cook Children's Neighborhood Clinic Renaissance

At Cook Children's Neighborhood Clinic Renaissance, we're here to help you raise a healthy child from infancy through the transition to adulthood. We offer well checks, immunizations, school and sports physicals, injury treatment, and care for both short-term illnesses and longer-lasting conditions.

If your child needs additional help, we can connect you with more than 60 Cook Children's specialty clinics. We're always ready to answer questions and share resources. Feel free to reach out. We're looking forward to your visit with us in Fort Worth. Learn more about our pediatricians, services and support here.

About Save-A-Smile – Cook Children's Center For Community Health

Save a Smile was founded in 2003 by Cook Children’s to address a gap in oral health services for underserved children. Save a Smile is an innovative, nationally recognized, collaborative program dedicated to providing restorative and preventive dental care to children from low-income families in the community through volunteer dentists. Children eligible for the program are pre-kindergarten through sixth grade at high risk for dental disease from schools pre-selected by the Save a Smile program and participating school districts. 

Once per semester, Save a Smile patients receive free treatments from hygiene and dental assistant students at the college while professional dentists also volunteer their time at the event.

The patients received treatments including scaling, polishing, X-rays, fluoride treatment and sealants, plus education on taking care of their dental health at home. If patients needed further treatment, they were identified and will receive referrals for services from volunteer dentists.

Save a Smile has more than 86 volunteer dentists who provide children with comprehensive treatment as needed, whether it’s fillings, surgery, root canals, orthodontics, etc.

Tonya K. Fuqua, D.D.S., is the Director of Child Oral Health under the Center for Children’s Health, Children’s Oral Health Coalition and Save a Smile program.

“We’re excited to partner with such an awesome community organization like Tarrant County College Hygiene School,” Dr. Fuqua said. “We’re seeing about 50 kids today that need our help.”

Depending on the severity of the problem, the age of the child, translation requirements and financial/insurance status, a referral is made to the appropriate volunteer dental provider. Dental care is given in the volunteer dentists' private offices, free of charge to the families. Children with CHIP or Medicaid are connected with a Medicaid/CHIP provider selected through their coverage.

“Usually when we contact the families, the first question they ask us is ‘how much money do I have to pay’ and we tell them this is completely free,” said Lourdes Ramos, Community Health Worker. “Volunteer dentists will volunteer their time and work and it’s completely free.”

Media partners may use this content for news stories and broadcasts with credit to Cook Children's.

RELATED:

Save a Smile Provides Life-Changing Dental Work for 3 Girls (checkupnewsroom.com)

A Bright Smile Begins With A Healthy Mindset: The Overlooked Link Between Dental and Mental Health (checkupnewsroom.com)

I have more than once used the "you don't want to be the kid that smells" tactic on my kids and once they are school age it usually works to get them to brush their teeth. In elementary school most kids don't care about life long health but they do care about friends and teachers. I prefer not to use star or sticker charts as I find they are more work for parents--but if this works in your family go for it.

Toddlers are another creature entirely. I suggest that parents start cleaning babies teeth early not only for health but to get them used to it. Under 1 year it can be as simple as wiping the teeth with a wet washcloth, but at 1 year I have families starry using a toothbrush. There are lots of little tricks out there to keep toddlers brushing. My favorites are singing or counting while brushing--same song every night--they love routine. Once toddlers get into the "I can do it myself now" stage, get 2 toothbrushes. Let the toddler "brush" with one and the parent can use the other at the same time to really brush. Does all of this fail sometimes--yes. I have I held my toddlers down to brush their teeth--yes. Have I skipped teeth brushing--yes.

For all kids one of the most important things a parent can do to protect the teeth is to keep kids off of sweet drinks--that means no juice--and not letting them fall asleep with a bottle or cup of milk after age 1 year.

I have seen many toddlers and young children over the years require anesthesia and surgery to repair decayed teeth. This is entirely preventable with good dental care. Please ask your pediatrician if you need help in carting for your childs teeth or contact one of the Cook Children's dentists.

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