Texas Tooth Steps

Texas Oral Health Coalition

The Texas Oral Health Coalition’s perinatal oral health program called Texas Tooth Steps is an innovative train-the-trainer program that provides a specially designed toolkit that includes resources and materials for trained staff to use to educate women around the importance of self-care and the care of infants. The oral health education materials also highlight the importance of oral health during pregnancy and encourages pregnant women to seek prenatal dental checkups and dental care.

Texas Tooth Steps addresses three specific oral health behaviors: a healthy diet for infants, oral hygiene and dental attendance. It also expands knowledge and awareness among perinatal women about oral and systemic health. Further, incorporating positive reinforcement techniques such as text messages, visual cues, slogans, and rewards helps in the retention of and compliance with the oral health messages thus changing to healthier daily behaviors in the home.

Continued reinforcement of good oral health behaviors is necessary for compliance with improved dental, nutritional and other health standards. TxOHC collaborates with Nurse-Family Partnership and other community agencies to promote knowledge and awareness among perinatal women. TxOHC trainers provide training to agency staff members with the complete toolkit to use for target audience members. Partner agencies may also elect to have TxOHC trainers provide oral health education to groups of pregnant women in other settings. The program works directly with perinatal women and teaches them about oral health, healthy habits, and infant oral care. In person training allows participants and their infants, who are at high risk for oral disease, to be educated about preventive oral health practices.

Success was measured via responses to short text message surveys administered over a 24-month period during the survey period 2016-2019. Survey questions were specific to the three-goal behaviors. Success was also supported by continued interaction between the Nursing Family Partners (NFP)/Community Health Workers (CHW) and the client around the topic of oral health. The reinforcement of the original message strengthens the expectation for the behavior change with respect to the three specific oral health behaviors. Quarterly reports provided the partners with information on their client’s compliance and the need for possible re-education.

Testimony, Stories and Sound Bites From Program Participants


TTS babyI never knew baby teeth made a difference. I’m gonna take care of my baby’s teeth. I guess I should see a dentist too. I have gums that bleed. That can’t be good.

Participant from Cadena de Madres
(Driscoll Children’s Hospital)

I’m a college student and thought I was pretty smart about health but I learned a lot today. Thank you. I love the onesies. They are so cute.

Participant from Texas A&M Univ, Title IX program

These outfits are so pretty, I am going to let my baby wear them everywhere. When people ask me, I will tell them take their kids to the dentist and that it’s important.

Participant from Coastal Bend CASA
(Council on Alcohol and Substance Abuse)

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