title: Are state child care regulations meeting national oral health and nutritional standards?
abstract: OBJECTIVE
  The purpose of this study was to review of US state child care center regulations on oral health and nutrition as related to early childhood caries (ECC).
  
  
  METHODS
  Child care center regulations for the 50 states and the District of Columbia, as of April 2010, were audited for their inclusion of 8 oral health and 11 nutrition topics related to the development of or care for ECC. The topics are based on selected recommended standards from Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Out-of-Home Child Care Programs.
  
  
  RESULTS
  On average, states had 2.6 (±1.7 SD; range=0-6) of the oral health standards and 5.9 (±2.5; range=1-11) of the nutritional standards included in their regulations. States varied greatly on the content covered. Seven states did not include any of the reviewed oral health topics. The 2 least covered regulations for oral health were "toothbrush maintenance" (4 states) and "oral health screening" (5 states).
  
  
  CONCLUSIONS
  The weakness of coverage in child care center regulations for early childhood caries prevention calls to strengthen these policies for their potential to improve the oral health and obesity status of US children.
authors.affiliation: Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Champaign, Ill, USA. juheekim@illinois.edu
authors.forename: Juhee
authors.initials: J
authors.lastname: Kim
authors.forename: Linda M
authors.initials: LM
authors.lastname: Kaste
authors.forename: Shahrbanoo
authors.initials: S
authors.lastname: Fadavi
authors.forename: Sara E
authors.initials: SE
authors.lastname: Benjamin Neelon
mesh_terms: D002648:Child; D002654:Child Care; D006291:Health Policy; D006801:Humans; D009752:Nutritional Status; D009909:Oral Health; D014481:United States