CATCH Healthy Smiles: Transforming Children's Oral Health through Healthy Nutrition and Dental Care

Published: March 22, 2024

By Alejandra Garcia-Quintanilla, DDS, MPH

In the bustling heart of Houston, Texas, a groundbreaking study is taking place in the realm of children's oral health. Approximately seven out of ten entering kindergarteners in Texas have experienced tooth decay, largely due to inadequate dental hygiene, and a diet high in added sugars starting at a young age (Texas Health Steps, 2011)^[1]. UTHealth Houston School of Public Health's CATCH Healthy Smiles program transforms smiles through nutrition. As we celebrate National Nutrition Month this March, it's the perfect time to shine a light on this initiative that is revolutionizing the landscape of health for young children in grades K-2. By integrating toothbrushing and nutrition education into the curriculum, CATCH Healthy Smiles paves the way to improving oral health- a key component of one’s overall health (CDC, 2020)^[2].  

CATCH Healthy Smiles has demonstrated high feasibility within schools serving under-resourced children and families with increased fidelity and acceptability (Sharma et al, 2022)^[3]. Currently, through funding from the National Institutes of Health and in partnership with Harris County Public Health and CATCH Global Foundation, the UTHealth Houston School of Public Health is conducting a randomized control trial across thirty-four elementary schools, predominantly serving under-resourced families in the Greater Houston area to determine its effectiveness in impacting the risk of tooth decay. But what sets this program apart isn't just its implementation—it's the scientific foundation behind it. Investigators across three research centers at the School of Public Health are collaborating on this project, including the Center for Health Equity, the Michael & Susan Dell Center for Healthy Living, and the Coordinating Center for Clinical Trials. 

Grounded in the Social Cognitive Theory, CATCH Healthy Smiles recognizes that people's surroundings and environment impact their decisions. The program instills knowledge, skills, self-efficacy, and social support in its design to encourage long-term behavioral change. From the importance of regular dental care to proper toothbrushing techniques, healthy eating habits, and the relationship between nutrition and oral wellness, CATCH Healthy Smiles uses a coordinated school health approach to train teachers to integrate these components into their routine and to bring oral health resources to the parents at home. CATCH Healthy Smiles impacts the school and home environments strategically. The program begins with fostering the belief that healthy behaviors started today build one’s capability to change long-term behaviors. By teaching participants healthy habits, they establish a foundation that lasts for a lifetime, empowering both children and their caregivers to embrace oral health as a priority. By promoting toothbrushing, flossing, engaging in regular dental care, increasing consumption of fruits, vegetables and water, while reducing sugary snacks, drinks and sticky foods, the program charts a course toward improved oral behaviors and overall health outcomes. It is not just about brighter smiles; it's about enhancing health equity and quality of life.  

The impact of programs such as CATCH Healthy Smiles extends far beyond the confines of the school walls or homes. It is a ripple effect that resonates within communities, shaping healthier generations in years to come. State policy makers have prioritized oral health as well. In the 83rd legislative session in 2013, Texas added oral health as a required topic in the state education code. As we delve deeper into National Nutrition Month, we highlight programs like CATCH Healthy Smiles that embody the spirit of holistic health promotion and pave the way for brighter, healthier futures for our children. 

Collaborators on this project from UTHealth Houston School of Public Health include Shreela Sharma, PhD, RDN, LD, Principal Investigator; Steve Kelder, PhD, MPH, Co-Investigator; Courtney Byrd-Williams, PhD, Co-Investigator; Jose-Miguel Yamal, PhD, Co-Investigator; Ru-Jye Chuang, DrPH, MS Co-Investigator, Project Director; Alejandra Garcia Quintana, DDS, MPH,  Research Coordinator; Karen Mejia, MPH, Research Coordinator; Kateria Crichlow, Research Coordinator; and Sibi Mathew, Quality Management. Graduate research assistants Fathimath Shamna, BDS; Harsh Chauhan, BDS; Bipin Singh, MPH; Bhavikkumar Trivedi; Olivia Harding; Jeanette Deason, MPH; Zhang Li; and Jiaqi Jiang aided on this project. 

Collaborators from Harris County Public Health include Kila Johnson, DDS, and Shalisa Garner, DDS.  

^[1] Texas Health Steps. (2011). Section 5: Dental Caries and Early Childhood Caries. Oral Evaluations and Fluoride Varnish. https://www.txhealthsteps.com/static/warehouse/1076-2011-May-19-jc2793r9g4wwve3nc1m6/section_5.html 

^[2]CDC. (2020, November 19). Oral Health Fast Facts. https://www.cdc.gov/oralhealth/fast-facts/index.html 

^[3] Sharma, S. V., Kelder, S., Yamal, J. M., Chuang, R. J., Byrd-Williams, C., Bona, G., Bajaj, N., Brito, F., & Neumann, A. S. (2022). Development and Feasibility Testing of CATCH Healthy Smiles, an Oral Health Promotion Intervention for Prevention of Dental Caries Among Elementary School Children. The Journal of school health, 92(1), 20–30. https://doi.org/10.1111/josh.13100 

Alejandra Garcia Quintanilla, DDS, MPH, is deeply committed to advancing oral health through preventive strategies that not only promote education and research but also foster leadership and interdisciplinary collaboration within the healthcare sector. Presently serving as a Research Coordinator on the CATCH Healthy Smiles project, she facilitates data presentation, collection, and analysis. Furthermore, she actively contributes to the implementation of oral health education in elementary schools K-2 across the Greater Houston area.