The Story Behind Happy Teeth
The First Oral Health Baby Board Bookwith Braille (and More!). Pictured: Seraphina is our sunshine: through any challenge her sweet smile lights up the room. Even though she has difficulty in some areas, she tries her hardest to overcome any adversity (MED13L Syndrome). She adores her brother, daddy, and mama, and is a friend to everyone she meets. She is a marvel and a miracle.
In late winter 2025, new oral health education materials will be available for young children with blindness or low vision. This article tells the story of the creation of those materials—funded by the Delta Dental Foundation and developed by McMillen Health—which are dedicated to oral health equity. The final project resulted not only in developing the first oral health focused baby board book with Braille, but also a range of resources that include caregiver handouts, videos and interactive activities. Dr. Holli Seabury, EdD, the Executive Director of the Delta Dental Foundation, and Nicole Fairchild, CEO of McMillen Health (a non-profit with a mission to provide preventive health education and to develop custom curricula, media, videos, and resources for other organizations) spearheaded the project:
Holli: One of the best parts of my job at the Delta Dental Foundation is when I can be involved in collaborative projects designed to create tailored health resources for underserved populations. The Foundation has a strong focus on oral health access for patients with disabilities. Much of this work is around training the dental workforce, expanding dental benefits and increasing payments to dentists. These are all necessary to increase access, but my background is in education and curriculum development, so when I get to work on a project like this one, it is especially meaningful.
Nicole and I began this project in the summer of 2023 when we toured the Visually Impaired Preschool Services (VIPS) in Indianapolis. VIPS provides early intervention services to Indiana's youngest children with blindness or low vision. We were there at the urging of Dr. Nelly Chawla, the Director of the Division of Oral Health at the Indiana Department of Health. Nelly had asked us to visit after she discovered many of the VIPS parents and caregivers were facing barriers in keeping their young children’s teeth healthy and could not find oral health education materials designed for children with blindness or low vision. Understanding the importance of oral health in childhood development is fundamental. However, for children with blindness or low vision, traditional resources often fail to meet their specific needs.
Holli Seabury. EdD: “Nicole and I began this project in the summer of 2023 when we toured the Visually Impaired Preschool Services (VIPS) in Indianapolis. VIPS provides early intervention services to Indiana's youngest children with blindness or low vision.
As we toured the VIPS Family Resource Center, we were struck by not only the beauty of the design of the new center, but with the struggle their Director of Outreach and Advocacy, Meredith Howell, was facing in finding appropriate oral health education materials. She had even reached out to a large publishing house which publishes baby board books with Braille and asked them if they would print one of their oral health books with Braille. She was told the market for children with blindness or low vision was not large enough for them to create additional Braille books. Meredith, whose daughter has low vision, told us of her struggles trying to brush her daughter’s teeth when she was a toddler and the sensatory difficulties she had with a toothbrush.
As we met with Meredith, we discussed the options for tailored oral health materials that McMillen Health could develop. To ensure that the resources aligned with the actual needs of the families involved, McMillen Health conducted a brief needs assessment among VIPS families. The results were illuminating and underscored the gap in accessible education. Families expressed a desire for:
· Educational information available on mobile devices in a digital format about oral health
· Books that parents could read to their children and learn alongside them
· Gentle reminders in the form of texts sent 1-2 times per month
· Brief videos or a video series teaching the importance of dental health in 1-3-minute clips
With the results of the needs assessment in hand, we got to work. McMillen Health publishes a baby board book on oral health, Happy Teeth, which has been used nationwide with Head Start and WIC and was the perfect book to translate into Braille. The book teaches parents and children all the basics of brushing twice a day, good nutrition, the age one dental visit, and more. We felt strongly that the images of the children in the original book should be replaced with images of children with blindness or low vision. That left only one person to bring to the team, the photographer Rick Guidotti, of Positive Exposure. Rick’s photos celebrate individuals living with genetic, physical, behavioral or intellectual differences.
The collaborative work began with McMillen Health redesigning the board book to incorporate high contrast visuals, having the text translated into Braille, and Rick flying to Indianapolis for a photo shoot with some of the VIPS families. The Delta Dental Foundation has worked with Rick on other photo shoots, and as usual, the photo shoot was filled with Rick’s excitement and lots of laughing children and parents. At one point, I looked over at Meredith and she was tearing up. I asked if she was okay, and she shared that when her daughter was about three, she tried to have a professional family photo shoot. The photographer was extremely rude because her daughter wouldn’t look where he wanted her to, and the family left without getting any family photos. The experience was so upsetting it was years before they tried again. She explained how happy she was to see the families she works with having such a positive experience and knowing how meaningful the photos would be to them.
Nicole Fairchild: “As the project unfolded, team members learned about crucial design principles that improve accessibility, including the differences between high and low contrast images and the necessity for audio descriptions.”
Nicole: The redesign process for Happy Teeth with Braille was a learning journey for McMillen Health’s Creative Services Team. Prior to this initiative, their experience with designing resources specifically for disability communities, was limited. As the project unfolded, team members learned about crucial design principles that improve accessibility, including the differences between high and low contrast images and the necessity for audio descriptions. The redesign was completed with beautiful images of children taken during the photo shoot at VIPS.
“The final project resulted not only in developing the first oral health focused baby board book with Braille, but also a range of resources that include caregiver handouts, videos and interactive activities. ”
A significant aspect of the initiative was McMillen Health’s collaboration with a Professional Advisory Group (PAG), which provided insights and feedback from members with lived experiences in the blind and low vision community. The PAG was composed of parents of children with blindness or low vision, Meredith Howell of VIPS, and Melissa Mathews from American Printing House, the world's largest nonprofit organization creating accessible learning for people who are blind or have low vision. This collaboration was instrumental in ensuring that the resources were genuinely helpful and relevant. The PAG's involvement taught the Creative Services Team to approach their work with an open mind, leading to numerous edits and improvements throughout the project. This iterative process highlighted the importance of humility and receptivity to feedback when creating materials that require adaptability and compassion.
As part of their commitment to ongoing education, McMillen Health plans to invite Melissa Mathews with American Printing House to conduct training for their entire staff over three sessions in the spring. This will not only promote understanding among team members but will also foster community connections, providing invaluable insight into the unique challenges faced by individuals with blindness or low vision.
The impact of this collaborative project on McMillen Health cannot be overstated. The final project resulted not only in developing the first oral health focused baby board book with Braille, but also a range of resources that include caregiver handouts, videos and interactive activities. This project signifies a transformative shift in the organization’s approach to resource development. By emphasizing inclusivity and engaging directly with the community, the Creative Services Team has not just developed essential skills but has also fostered a culture of empathy and continuous improvement, paving the way for a future where all children can enjoy better oral health and enhanced quality of life.
Holli: The road to creating these materials has been longer than we anticipated and has not been without bumps, twists and turns. Now that the book is in the process of being printed and the other materials are being finalized, the Deta Dental Foundation will begin to make them available at no cost to the organizations serving young children who are blind or low vision and to the dentists and dental hygienists who serve these children. Believe me when I say that if I see you at a conference or other meeting, I will be handing you a copy of Happy Teeth with Braille!
PS – You know who makes all their books available with Braille? Dolly Parton’s Imagination Library. As if we needed one more reason to love Dolly!