What's at stake in children's oral health? We may think it's just a pretty smile, but in reality, dental disease is one of the most prevalent chronic illnesses affecting children's overall health, responsible for children missing 52 million hours of school each year. The problem is especially acute for low-income children who have poor access to preventive dental care.

The release of the Surgeon General's report on Oral Health in May 2000 represents an opportunity for children's health advocates to raise the profile of this issue with media and to prioritize it for the public. This requires a thoughtful communications strategy that assesses what the public already knows and thinks about children's oral health, how the issue is likely to be covered by the media, and how this coverage will influence support for solutions involving public policy.

Susan Bales, founding editor of Connect for Kids and president of FrameWorks Institute, outlines a communications strategy in a framing memo based on a study of the conceptual frameworks that people use to reason about children's oral health. In the memo, Bales, who designs and manages communications research on social issues, analyzes the news coverage of this topic and promotional materials provided by children's oral health professionals. She puts forth recommendations for advocates on how to address already-existing public attitudes.

The memo recommends oral health advocates position oral health as a social problem that requires public health measures—not a cosmetic issue or an individual problem. Bales urges advocates to debunk the notion that primary responsibility lies with parents, and urge support of public policies that prevention and protection for all children.

Here are some do's and don'ts based on the communications research:

DO

• Prepare and learn soundbites based on the research.
• Bridge from any question posed by a reporter to the five key points you want to make.
• Talk about disease, not cosmetic appearance and self-esteem.
• Find common, mainstream ways to dramatize the ultimate health consequences of neglecting children's health.
• Talk about what new medical research (sealants, fluoride) allows us to do for all our children to prevent long-term health problems.
• Tell the public why this is not happening and who is responsible.
• Use messengers that convey "health" and public/community responsibility.
• Emphasize solutions, especially those that can be done by reforming insurance, legislation or other community measures.

DON'T

• Provide the media with spokespersons who have not been briefed and trained on the research.
• Allow reporter's questions to divert you from the five key points you've developed.
• Permit the issue to be framed as a beauty or confidence issue.
• Use vivid case examples of children who have facial deformities.
• Talk about cavities and toothbrushes.
• Allow responsibility to be assigned to the parent because you did not explain a public solution.
• Use parents and children as messengers and visuals, and consumer information as the answer.
• Deliver a message that calls for more dental care for children as the solution; the solution involves less dentistry and more prevention and protection.
• Use dentists as messengers in isolation from other health professionals.

Watch for the Surgeon General's oral health report to be posted at their virtual office.