“He hides his smile in every school photo,” Jayden’s mother told me as she looked at a photo of her 6-year-old son.
When I first met Jayden (not his real name) at the University of Florida’s Community Dental Outreach Program in Gainesville, he was suffering from severe cavities in his front teeth.
The black spots on his teeth were not only painful, but also a reason for his peers to tease and bully him. As his condition worsened, he began to miss classes frequently.
Because his family lived in a remote rural area and could not find a dentist who accepted Medicaid, his treatment was repeatedly delayed. Jayden stopped smiling.
As a public health professional who has been involved in community dentistry for a long time, I have witnessed firsthand the huge barriers that Florida children face in accessing basic oral health services.
Although cavities are a highly preventable disease, they are still the most common chronic disease among children in the United States, and the situation in Florida is particularly serious.
The current situation of Florida children’s dental health is worrying
Untreated dental problems can cause severe pain, infection, difficulty eating and disrupted sleep. They can also affect children’s attention and learning ability, and even lead to more serious health problems such as heart disease.
According to the Florida Department of Health, about a third of third graders had untreated cavities in the 2021-2022 school year, nearly double the national average of 17%.
Even more worrying is that only 37% of third graders used dental sealants, a simple treatment that can prevent 80% of cavities. Nationally, the use rate of sealants is 51.4%.
For children aged 3 to 6 participating in the Head Start program, data from the 2017-2018 school year showed that 24% had untreated cavities, while the national rate for children aged 2 to 5 was only 11%. Behind these data are countless children like Jaden who are silently suffering.
Expensive emergency rooms and limited dental resources
The 2023 report pointed out that more and more Florida children are flocking to emergency rooms for non-traumatic dental diseases. These emergency rooms are not only expensive, but also only provide short-term pain relief and do not help treat the underlying problem.
Florida is one of the states with the most scarce dental care resources in the country. 65 of the state’s 67 counties are designated as dental shortage areas.
In some areas, there are only 6.6 dentists per 100,000 people, compared to the national average of 60.4. High rates of poverty and low Medicaid acceptance mean that many families simply cannot afford dental care.
Although more than 2 million children are covered by Medicaid, only 18% of Florida dentists accept that insurance.
Families with private insurance often have to pay high out-of-pocket costs, causing many children to miss out on necessary treatment. As a result, Florida ranks 43rd in the nation for the percentage of children who received dental care in the past year.
Lack of awareness and prevention gaps
In addition to a lack of resources, public awareness of children’s oral health is also insufficient. Many parents do not know that children should have a dental checkup on their first birthday or within six months of the first tooth erupting.
An important preventive measure—community water fluoridation—has long been considered one of the most effective public health strategies to reduce the incidence of dental caries.
But in May 2025, the governor of Florida signed a law prohibiting local governments from adding fluoride to drinking water, which will take effect on July 1. This policy change means that parents and communities must rely more on other preventive measures.
Possible preventive measures: What can parents do?
Although fluoridation water policies have encountered challenges, other effective and economical methods of preventing tooth decay can still protect children:
Regular dental examinations: Starting from the age of 1, at least one dental examination per year can help early detection and early treatment.
Use fluoride toothpaste: After the child’s teeth grow, they should brush their teeth twice a day. Use a rice-sized amount of toothpaste for children under 3 years old and a pea-sized amount for children between 3 and 5 years old.
Develop a habit of brushing teeth: Before children can brush their teeth independently at the age of 7 to 8, parents should help them brush their teeth. You can use songs, animations, etc. to make brushing more interesting.
Healthy diet: Reduce sugar intake, choose water and fruits and vegetables as daily snacks, and avoid letting babies fall asleep with bottles or drinking juice frequently.
Ask about preventive treatments, such as sealants and fluoride coatings, especially for children at high risk for tooth decay.
Parents can also seek dental referral resources from their pediatrician or Medicaid website, use the “Find a Pediatric Dentist” tool provided by the American Association of Pediatric Dentists, or contact community health centers and dental mobile clinics for low-cost or free care.
Florida’s children’s dental health crisis is a public health challenge that should not be ignored. Tooth decay is not inevitable.
From policy to individual, we all have a responsibility to ensure that children like Jayden no longer lose their smiles due to toothache.
Timely intervention, reasonable resource allocation and national health awareness can truly make “every child’s smile no longer hidden.”