West Virginia children are more likely than others to develop cavities or suffer from tooth pain, according to the U.S. Surgeon General's report. This month especially, local dentists are trying to fight those odds.
In the dental clinic at the Monongalia County Health Department, nine year old Amy settles into the exam chair.
"I'm going to go ahead and sit you back and make your teeth all shiny, ok?" the denial hygienist reassures her.
Amy doesn't have much to worry about on this visit. She takes better care of her mouth than most kids and adults.
When asked how many times a day she brushes her teeth, she said "just two times" during the week, "but usually on the weekends I brush three times."
In another exam room, Amy's six year old sister Sally is getting her teeth cleaned too. Their mom, Rui Yang, said she grew up in China and didn't have access to dental care like this. Now, she wants to make sure her children know how important it is to take care of their teeth.
The U.S. Surgeon General's report found more than a third of adults in West Virginia have lost at least six teeth from tooth decay, which is more than twice the national average, and completely preventable. Health officials say it all starts when you're young.
"A lot of parents would wait until children had all of their baby teeth or they would wait until something started to hurt to bring a child in for their first visit," said Dan Carrier, DDS, at the MCHD.
He said if parents wait that long, kids can develop bad habits and a fear of the dentist.
Wilson-Martino Dental plans to reach more than 4,000 kids beyond the exam room this spring to teach healthy habits in schools and daycares with a free educational program.
"It includes how to floss, how to brush, good food choices for healthy teeth," said Wendy Boyce, marketing manager for Wilson Martino and TLC Dental. "We take a little dinosaur puppet, his name is Dudley, and all the kids get to meet him. We watch a video about what happens at the dentist office because for many, that's their first introduction to dental care."
Carrier recommends parents take their kids for their first appointment when they're just a year old.
"I always tell our parents that the first visit is more for them than it is the child," Carrier said.
Wilson Martino Dental even offers a free visit for kids younger than 5.
"The parents can bring them in if they're not quite sure they're ready for a dental visit," Boyce said. "We give them a little ride in the chair, let them look at all the instruments and the doctor takes a quick peek in their mouth. Nothing too demanding."
For parents worried about the cost, Carrier emphasized that West Virginia Medicaid covers dental care starting at one year old, and many dental offices will work with their clients to make sure a healthy mouth isn't outside of a child's reach.