Exemplary School-Based Dental Program Models

The following resources describe exemplary school-based dental program models with a national, statewide, and local focus.  The models include sealant programs, hygiene programs, restorative programs, and mixed service models.  There are many successful school-based dental programs; the following models are provided for guidance as you design your program based on community needs.

National Models:

http://www.nnoha.org/nnoha-content/uploads/2014/07/SBHC-Report-FINAL_2014-07-28.pdf   The final report represents the results of a national online survey of community health centers conducted in June 2013 by the National Network for Oral Health Access (NNOHA) to obtain information about oral health programs located in school-based health centers.

https://www.mchoralhealth.org/seal/  Seal America: The Prevention Invention assists health professionals in launching and sustaining school-based dental sealant programs. In addition to offering a step-wise approach for planning and implementing school-based dental sealant programs, this manual addresses issues related to referring students with unmet oral health needs to a dental clinic or office.

https://www.astdd.org/docs/sealant-bpar-update-11-2017-final.pdf  This report from the Association of State and Territorial Dental Directors highlights best practice approaches and exemplary state examples for state and community school-based oral health programs.

http://www.sbh4all.org/wp-content/uploads/2018/04/DQF_WP_SchoolOralHealth_F.pdf: School Oral Health: An Organizational Framework to Improve Outcomes for Children and Adolescents provides a framework that addresses the five major components of school-based oral health programs that span education, preventive services, and treatment services.

State Models:

https://www.dhs.wisconsin.gov/oral-health/programs/seal-smile.htm Wisconsin Seal-A-Smile (SAS) is a collaborative effort between the Wisconsin Department of Health Services, Delta Dental of Wisconsin, and Children’s Health Alliance of Wisconsin. The program’s mission is to improve the oral health of Wisconsin children by providing school-based dental sealants. Each year, SAS provides funding to local programs to implement school-based oral health services. Grantees include local health departments, dentists, dental hygienists, schools, hospitals, community health centers, and non-profit safety net dental clinics.

https://www.michigan.gov/mdhhs/0,5885,7-339-73971_4911_4912_6226-279800–,00.html  The Michigan Department of Community Health‘s SEAL! Michigan dental sealant program works to prevent dental disease through prevention. SEAL! Michigan provides dental sealants, fluoride varnish, and oral health education to students in Michigan in their school settings. By utilizing Registered Dental Hygienists who travel to schools to provide prevention services onsite, cost-saving is realized. The SEAL! Michigan program delivers dental sealants, fluoride varnish, and oral health education to children for less than $100 per student.

https://paoralhealth.org/courses/oral-health-for-community-health-workers/  The Pennsylvania Oral Health Coalition offers online oral health training courses for Community Health Workers. CHWs can help to improve oral health because they are already trusted members of the community and understand community needs; they promote prevention and manage chronic diseases for the rest of the body. Since CHWs have regular, consistent contact with individuals and families, they are able to be valuable resources for oral health information.

www.futuresmiles.net Future Smiles is determined to end oral pain and suffering among Nevada’s neediest children by partnering with the community to deliver essential preventive, restorative, and educational services. Services provided at the local schools include preventive oral health care screenings and education, dental cleanings, protective sealants, and fluoride varnish. Future Smiles operates EPOD (Education and Prevention of Oral Disease) at school-based locations throughout Southern Nevada. School-based care is a unique delivery system that provides essential preventive oral health services and education. They address oral health at the earliest preventive stages to decrease the incidence of oral disease.

http://wellaheadla.com/LouisianaSealsSmiles State level dental sealant program with six steps to implementing the Louisiana Seals Smiles in your school or community.

http://smartmouthssmartkids.org/?page_id=426  This short video describes maintaining a successful mobile/portable school-based dental program in multiple schools and counties in Colorado, and how to sustain the program for maximum impact.

Local Models:

https://onlinelibrary.wiley.com/doi/abs/10.1111/jphd.12216 This article describes the implementation of a scalable and sustainable school-based oral health program in the Los Angeles Unified School District for low-income urban children using a public health model to reduce oral health disparities.

https://www.hartfordschools.org/dental-program/  The Hartford Public Schools Dental Program is sponsored by the Hartford Board of Education and provides comprehensive dental services in 17 urban schools. The Dental Department provides high quality, full-service dental care to school children in the city to ensure they are healthy participants in the educational process. Full service dental care is provided in 17 in-school dental clinics, servings students from Pre-K through 12th Grade, including those who are uninsured.

https://www.readysetsmile.org/ Ready Set Smile (RSS) is a community-based organization whose mission is to prepare and empower all children to care for their oral health through education and preventive services. RSS provides on-site non-traumatic dental services and classroom education for under-resourced children in twenty-seven Minneapolis schools serving children from pre-K through 8th grade. The clinical team includes community health workers (CHWs) to serve as dental assistants, teach in the classrooms, and serve as the liaisons to school staff and parents. CHWs and others can access our oral health training modules to understand better dental caries, fluoride, nutrition, motivational interviewing, and more. The newly licensed midlevel dental practitioner, the dental therapist, also is employed in our clinics.

Dental Sealants:

Dental sealants provide a protective covering that keeps food from collecting, and plaque from developing, in the grooves of teeth. Sealants are a coating applied to the chewing surfaces of molars and premolars (back teeth), which hardens to provide a protective cover over the tooth’s surface. Sealants reduce the risk of decay on the chewing surfaces of permanent molars. Research strongly supports the application of sealants.

https://www.thecommunityguide.org/sites/default/files/assets/OnePager-OralHealth-School-Sealants.pdf  A fact-filled page on dental sealants, major findings, with links to national organizations for more information.

https://www.mchoralhealth.org/Dental-Sealant/  The Maternal Child Health Oral Health website – Dental Sealant section focuses on a series of modules designed to ensure that school-based dental sealant program staff have a thorough understanding of the history, operations, and underlying principles of these programs.

https://www.cdc.gov/oralhealth/dental_sealant_program/implementation-of-school-sealant-programs.htm  The Community Preventive Services Task Force strongly recommends school-based sealant delivery programs to prevent cavities among children. The link provides guidelines and recommendations and a review of the evidence.

https://www.mchoralhealth.org/seal/  SEAL AMERICA – The Prevention Invention assists health professionals in launching and sustaining school-based dental sealant programs. The manual includes a step-wise approach for planning and implementing school-based dental sealant programs, addressing issues relating to referral to a dental clinic.  The manual is a good source for improving the quality of an existing sealant program.

https://www.mchoralhealth.org/Dental-Sealant/  School-Based Dental Sealant Program Learning Modules are a series of modules designed to ensure that school-based dental sealant program staff have a thorough understanding of the history, operations, and underlying principles of these programs. The modules provide detailed guidelines for infection control in school-based programs; discuss tooth selection and assessment for dental sealants; review the dental-sealant-application process; and provide information about program operations, with an emphasis on the specific requirements that apply to programs funded by the Ohio Department of Health.

Silver Diamine Fluoride:

Silver Diamine Fluoride is a topical, minimally invasive treatment used to prevent and arrest tooth decay and decrease tooth sensitivity. It can be used on children and adults and is very cost-effective, using only one drop to treat multiple teeth. Silver Diamine Fluoride is an FDA-approved antibiotic liquid clinically applied to control active dental caries and prevent further progression of oral disease.

https://depts.washington.edu/nwbfch/silver-diamine-fluoride-SDF-for-children-cavities  Silver Diamine Fluoride (SDF) is a cost-effective way to stop the process of decay instantly. The author explores the treatment effectiveness and addresses why providers and policymakers are slow to adopt SDF.

https://www.aappublications.org/news/2016/08/05/SilverDiamine080516 Two dentists write about the drawbacks to SDF.

Fluoride Varnish

Fluoride varnish is a safe and effective way to strengthen tooth enamel and prevent tooth decay. Due to its sticky form and the small amount used per application, the risk of swallowing is very low. It is safe to apply fluoride varnish as early as the eruption of the first baby tooth and throughout a person’s lifetime. Fluoride varnish offers an additional opportunity toward improving the prevention and control of dental caries along with the cornerstones of dental sealants, fluoridated water, and fluoridated toothpastes.

https://www.astdd.org/www/docs/fl-varnish-research-brief.pdf  The research brief includes 2014 updated information on such topics as fluoride varnish, effectiveness, safety and community, and school programs.

https://www.cdc.gov/fluoridation/faqs/index.htm  FAQ about fluoride and water fluoridation.

Community Health Worker:

https://ahecwest.org/health-right/  The Western Maryland Area Health Education Center utilizes community health workers to provide oral health education to residents of the rural area of the state.

https://www.ruralhealthinfo.org/rural-monitor/chw-oral-health/  The recent spotlight on gaps in rural dental access has encouraged the creation of oral health training programs for community health workers in multiple states. This article highlights work in rural Maryland to reduce oral health disparities.

https://familiesusa.org/our-work/c-h-w/  The Community Health Worker Sustainability Collaborative was developed to expand the use of community health workers (CHWs). The Collaborative promotes strategies for securing sustainable funding for CHW programs and better integrating CHWs into the health care system.

https://www.cthealth.org/wp-content/uploads/2015/07/CHW-Brief-Final-Final.pdf   This issue brief describes how community health workers (CHWs) can help clinicians fill the gap between current practice and new expectations. CHWs can help improve health outcomes and contain costs.

https://nashp.org/expanding-the-oral-health-workforce-to-promote-overall-health-minnesota-deploys-community-health-workers-and-dental-therapists-to-advance-equity/  Minnesota is working to increase access and advance oral health equity through the adoption of emerging health professionals, including community health workers (CHWs) and dental therapists (DTs) and advanced dental therapists (ADTs).