According to the Nevada Department of Health and Human Services, all 17 counties across the state don't have enough health-care professionals, including dentists.

February is Children's Dental Health Month, and dentist Dr. Paul McConnell, dental director at UnitedHealthcare, said families don't have to sacrifice their children's dental health if they can't find a provider. He contended it's all about teaching kids good oral hygiene habits as early as possible, which they'll carry with them throughout their lives.

"You're going to want to start as soon as your baby is born, so cleaning your baby's gums with water and a soft cloth, starting from birth to one year old," he said. "Then, as those teeth do start to emerge, you're going to use a soft-bristle toothbrush and a small dab of fluoride toothpaste - and then, you'll still continue to brush twice a day."

McConnell said that as children get older, from age four and up, parents will still need to assist to ensure effective cleaning - and baby teeth should still be cared for despite not being permanent. If they start to decay, he said, they can negatively affect the teeth developing underneath. According to the Centers for Disease Control and Prevention, untreated cavities can cause discomfort, but also lead to issues with eating, speaking and learning.

McConnell encouraged families to look to their nearest community health centers for local dental hygiene programs that could offer reduced fees for children. In Northern Nevada, the "Healthy Smile Healthy Child" program can provide no-cost to low-cost dental care to kids younger than age 18.

McConnell warned that poor dental health can lead to other health issues down the line.

"The condition of the teeth and gums, to affecting other situations - such as development of pneumonia, increased risks of heart disease," he said, "and it can actually affect pregnant women and cause or be related to lower birthweight or other birth complications."

He said starting young is vital, since it's harder to develop healthy dental habits when children are older. And once good brushing habitats have been established, he said, don't forget about the importance of flossing.

Concerned parents are pushing the authorities to help parks and day cares remove sand from sandboxes contaminated with ash after the Los Angeles fires.

The City of Pasadena sent crews to remove the top two inches of sand from sandboxes in local parks. Los Angeles County recommended the same thing but so far is not funding the remediation.

Juana Sanchez, a mother of two toddlers in Eagle Rock, said she has been calling authorities, to little avail.

"I called my local park to hear what steps were taken to remediate ash," Sanchez explained. "I was told, well, our park has been raking the sand daily and power washing all durable surfaces. That just effectively disturbs ash so that it's no longer visible."

When asked about sand removal, the Los Angeles County Department of Health said no one was available for an interview. Sen. Sasha Perez, D-Los Angeles, who represents areas affected by the Eaton fire, has called for more soil testing.

Sanchez pointed out small day cares that survived the fire may not be able to afford to clean up their sandboxes and play yards.

"Can someone quarterback this? Can someone show leadership on this issue?" Sanchez asked. "My concern is that right now, it's like a political hot potato that nobody wants to touch and that we'd rather pretend doesn't exist."

Cristina Alvarado, executive director of the Child Care Alliance of Los Angeles, said many small day cares serving low-income communities of color are facing big bills in their quest to reopen safely.

"In terms of cleaning, there are some grants available," Alvarado noted. "We are also going to be giving some stipends, you know, to child care providers, as much as we were able to obtain from donors. I think that there, there are efforts to help them clean. I know that we've been talking to some of the big toy manufacturers to see if they can donate sand for the sandboxes."

The Child Care Alliance has also distributed buckets of cleaning supplies and air purifiers to day cares downwind of the fire zone.


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Many Tennessee families cannot afford child care and providers cannot afford to pay their staff fair wages, according to a new report.

The nonpartisan ThinkTennessee found families spend 41% of their income on child care, forcing tough choices for many.

Erin Hafkenschiel, president of the group, said child care is a major affordability issue, alongside housing and health care. With 165,000 job openings each month and 50,000 unfilled, she pointed out the child care shortage makes it harder for companies to find and keep workers.

"We are hearing from parents that they are not able to stay in the workforce, return to the workforce after having kids," Hafkenschiel reported. "Or even if there's some other sort of life change that happens, they're not able to stay in the workforce because it's simply unaffordable."

She added a lack of affordable child care costs the state more than $2 billion annually in lost earnings, productivity and tax revenue. The report also found 32% of parents had to turn down a promotion, raise or job opportunity because of child care issues.

Hafkenschiel noted child care providers face licensing and zoning hurdles, making it tough to open new facilities.

"One of the examples that we explore in our brief are zoning regulations," Hafkenschiel explained. "There might be a zoning regulation in a city that is keeping a child care center from being open in more of a residential neighborhood."

ThinkTennessee is looking at other states for ways to cut child care costs. Hafkenschiel emphasized one idea is to put child care centers in workplaces or schools, where rents could be more reasonable and savings could be passed along to families.

"Another example that we've seen that's worked really well in other states, not yet here in Tennessee, but is what's called a Tri Share Program, where you essentially are sharing the cost," Hafkenschiel outlined. "An employer could potentially contribute. The family, of course, contributes. And then either the state and/or local government contributes."

The report laid out four recommendations to expand child care and support workers. It suggested easing regulations to allow more centers to open, encouraging businesses to offer child care, find ways to improve job quality for child care workers and invest in affordable care for low-income families.


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A Pennsylvania nonprofit is praising Gov. Josh Shapiro's new budget proposal, which includes a funding increase for early childhood education.

The budget boosts support for child care, pre-K, early intervention, and other programs - and addresses staffing shortages.

Pennsylvania Partnerships for Children President and CEO Kari King said low wages fuel child care worker shortages, with pay of just over $15 an hour.

She said she hopes the governor's proposed $55 million funding package for child care workers will strengthen programs statewide.

"It's actually a new appropriation that's being referred to as the 'child care workforce recruitment and retention fund,'" said King. "The estimate is that about that $55 million would provide just about $1,000 to child care workers that would qualify."

The budget proposal contains an additional $17 million for Pre-K Counts, while funding for the Head Start Supplemental Assistance Program would remain unchanged.

The state House and Senate must vote on the budget by June 30.

King noted that her group appreciates the Shapiro budget proposal, which includes an increase of just over $16 million for what's known as Early Intervention Part C.

She explained it's for families regardless of income, and it supports physical and language development from infancy through a child's entry into Kindergarten.

"We're focused on, right now, kind of the earliest part of that, what we refer to as infant and toddler early intervention," said King. "This is where you can have services for your child, if you're seeing they're not physically developing as you would expect - some things like walking or being able to sit up, [or] as their language develops."

King added that $10 million in the budget is specific to helping the child care sector and its workforce through a rate increase. And the budget for Early Intervention Part B, for toddlers ages 3 to 5, includes a proposed increase of more than $14 million.