School-based health centers (SBHCs) provide high-quality, affordable dental health services, including both preventive and restorative care, thereby improving children’s oral health. Research shows that SBHCs a reach children at high risk of oral disease by providing education, prevention and treatment.(1) Furthermore, when it comes to Oral Health, SBHCs can be more effective than community-based dental clinics, across a wide range of indicators, and “provide a natural location [for] preventive and responsive dental care.”(2).
Below are resources for SBHCs, Parents/Caregivers tand Students to review to learn more about the importance of oral health.
Resources for SBHCs and Staff
- Integrating Sustainable Oral Health Services into Primary Care in School-Based Health Centers: A Framework: This framework offers ideas for school-based health centers (SBHCs) to consider when integrating sustainable comprehensive oral health services into primary care.
- School-Based Comprehensive Oral Health Services Grant Program: The School-Based Comprehensive Oral Health Services (SBCOHS) grant program’s purpose was to demonstrate successful integration of comprehensive oral health services into primary care in an existing school-based health center (SBHC).
- Oral Health Integration Implementation Project: The “Oral Health Integration Implementation Guide” provides an action plan to implement screening for oral health risk factors and active disease, initiate appropriate preventive interventions, and coordinate dental care for those with active disease.
- National Network for Oral Health Access Toolkit: NNOHA has developed this toolkit as a guide for health centers to use in their efforts towards infrastructure enhancements that provide new or enhance existing integrated oral health services.
- Bright Futures: Oral Health—Pocket Guide: This pocket guide is designed to be a useful tool for health professionals, including dentists, dental hygienists, physicians, physician assistants, nurse practitioners, nurses, dietitians, and others, in addressing the oral health needs of pregnant and postpartum women, infants, children, and adolescents.
- Clinical Guidelines on Fluoride Therapy: The American Academy of Pediatric Dentistry provides fluoride guidelines to help practitioners and parents/caregivers make decisions about the appropriate use of fluoride as part of the comprehensive oral health care of infants, children, adolescents, and persons with special health care needs.
- Innovation in School-Based Oral Health Services: an initiative by the National School-Based Health Alliance incorporating oral health into the education system of the nation’s 10 largest school districts. In partnership with DentaQuest, they have created the School Oral Health Playbook that guides individuals and communities to help improve oral health services and outcomes for the school-age population.
Resources for Parents/Caregivers
- National Association of School Nurses’ Oral Health Guidance for Parents of Young Children
- Healthy Teeth Begin at Birth Fact Sheet
- Parent Education Brochures from American Academy of Pediatric Dentistry
- CDC Tips on Protecting Your Child’s Teeth
- Brushing Up on Oral Health: Never Too Early to Start and Dental Health & Hygiene for Young Children from the American Academy of Pediatrics
Resources for Students
- Smile!: In this CDC podcast for kids, the Kidtastics talk about how to keep our teeth and mouth healthy.
- Potter the Otter: A Tale About Water Children’s Storybook: Explore this book to help parents and early childhood education staff talk with young children about making healthy drink choices.
- Mouth Healthy: Start building good oral health habits early with these fun activities and lesson plans for children of all ages!
- ToothFairy 101 Community Education Kit: 5 Core Lessons to help children and youth learn more about how to take care of their teeth and gums.
Literature on SBHCs and Oral Health
For a full database on published literature related to School-based health centers and Oral Health visit the SBHC Literature Database built by the National School-Based Health Alliance. Below are some papers we believe highlight the important role of SBHCs in providing Oral Health services to students.
Oral Health Status and Academic Performance Among Ohio Third-Graders, 2009-2010
Objective: This analysis sought to determine the association between academic performance and untreated caries controlling for other school-level health and demographic characteristics, including presence of a school-based dental sealant program (SBSP), among Ohio’s third-grade children.
Finding: This research supports previous findings that health indicators are significant predictors of academic achievement and school performance. The prevalence of untreated caries was found to be significantly inversely associated with school performance, but only in schools without SBSPs after controlling for school-level characteristics (income, race, geography, and size). Controlling for school-level characteristics in schools with school-based health centers (SBHCs) eliminated any significant association between untreated caries and school performance. Additionally, further analysis of the state-funded SBSPs indicates a 15 percent reduction in the number of students who needed dental care between the treatment year and the follow-up year.
Children’s Dental Health, School Performance, and Psychosocial Well-Being
Objective: This study evaluates the effects of child dental health on school performance and psychosocial well-being in a large, nationally representative US sample of children aged 6-17 years.
Finding: We found that poorer child dental health is significantly associated with reduced school performance and psychosocial well-being, and that larger associations between dental problems and psychosocial outcomes for adolescents exist. Children with dental problems are more likely to have problems at school, and are less likely to do all required homework. On average, children with a dental problem miss almost one school day per year more than other children. Similarly, very good/excellent dental health is associated with less shyness and more friendliness. In contrast, poor/fair dental health is associated with more shyness and feeling worthless/inferior and unhappy/sad/depressed.
Effectiveness of an Alternative Dental Workforce Model on the Oral Health of Low-Income Children in a School-Based Setting
Objective: Researchers evaluated the effect of an alternative dental workforce program—Kansas’s Extended Care Permit (ECP) program—as a function of changes in oral health.
Finding: The number of encounters with the ECP dental hygienist had a statistically significant effect on changes in decay (P = .014), restorations (P = .002), and treatment urgency (P = .038). Based on Pearson correlations, as encounters increased, there was a significant decrease in decay (–0.12), increase in restorations (0.21), and decrease in treatment urgency (–0.15). Increasing numbers of encounters with alternative providers (ECP dental hygienists), such as with school-based oral health programs, can improve the oral health status of low-income children who would not otherwise have received oral health services.
Evaluation of a Comprehensive Oral Health Services Program in School-Based Health Centers
Objective: To investigate program efficacy, integration, and sustainability of an MCHB 4-year grant to increase access to and assure the delivery of quality oral health preventive and restorative services to children.
Finding: Students had great need for comprehensive services: on average, 45% had dental caries at enrollment. Enrollment increased from 5000 to more than 9700, and the percent receiving preventive services increased from 58 to 88%. Results of the analytically weighted linear regression show statistically significant increases in the proportion of enrollees who had their teeth cleaned in the past year (t(4) = 5.19, _ = 8.85, p < 0.05) and those receiving overall preventive services (t(4) = 13.52, _ = 10.93, p < 0.01). Grantees integrated into existing programs using clear, consistent, and open communication. Grantees sustained the full suite of services beyond the grant period by increasing billing and insurance claims while still offering free and reduced-cost services to those uninsured or otherwise unable to pay.
Models for Delivering School-Based Dental Care
Objective: This report provides a description of the models, reasons for selection, and sustainability of the school-based health centers (SBHCs) in New York City that provide a dental component, sponsored by the Children’s Aid Society and Columbia University.
Finding: In summary, it is important that SBHCs are complemented by dedicated program directors who collaborate with parents, community-members, school administrators, principals, district supervisors, and other healthcare providers to ensure program longevity. These relationships ensure successful implementation of paradigms and are key to program success in obtaining valid patient-parental consents and permission to bring children to the dental health center. Staff commitment to program goals is also essential to program success.