In school-based models, oral health programs provide evidence-based
oral healthcare services like screening, fluoride varnish, and dental sealants
to children. Dentists, dental hygienists, and community health workers deliver preventive dental services within
School-based programs offer an opportunity to introduce dental hygiene students to the needs of rural
populations, and can increase the rural oral health workforce in the long-term (see Workforce Models). For example, a rural oral health
program in South Dakota uses dental hygiene students to perform screenings, fluoride varnish, dental sealants, oral
health education to students, and if needed, refer patients to local dentists that have agreed to treat more
complex cases. Dental hygiene students and their professors travel to rural school sites to deliver services.
Another program in rural Montana utilizes a community health advisor to apply fluoride varnishes for school
children during dental screenings. Also, a program in rural Louisiana is educating medical and allied health
professionals about how to apply fluoride varnish in schools.
The Northeast Oral Health Project in Sterling, Colorado promotes
the health of school children by employing a school-based dental sealant program, providing dental screenings
and oral health education on proper brushing and hygiene.
For an example of a school-based model, see School-Based Health Center Dental
Outreach in the Rural Health Models and Innovations section.
There is strong
evidence that school-based oral health programs prevent cavities, particularly among children from
families with lower incomes. School-based programs improve access to oral healthcare and are cost-effective
since they may combine several services in one visit (for example, performing a screening and applying varnish
in the same visit). In addition, the use of dental hygienists instead of dentists can reduce the cost of
Oral health programs implementing school-based models must create consent forms to obtain the appropriate
permissions from parents and school administrators to work with school-aged children. A school nurse or school
counselor may serve as an outreach coordinator that can assist the dentist in coordinating the program. Rural
oral health programs implementing school-based models may have support from community partners, such as the
health department, state office of rural health, universities, and state dental and dental hygienists
Resources to Learn More
Caries (Cavities): School-Based Dental Sealant Delivery Programs
Promotes school-based and school-linked dental sealant delivery programs as recommended by the federal
government's Community Preventive Services Task Force (CPSTF) and based on evidence of effectiveness in
preventing or reducing tooth decay among children.
Organization(s): Community Preventive Services Task Force
Varnishes for Preventing Dental Caries in Children and Adolescents
Presents the findings from 22 trials where 12,455 children and adolescents were treated with fluoride varnish or
a placebo/no treatment to determine if fluoride varnish can effectively reduce tooth decay in both primary and
Authors(s): Marinho, V., Worthington, H., Walsh, T., & Clarkson, J.
Citation: Cochrane Database of Systematic Reviews, 13,(7)
School-Linked Dental Sealant Programs
Provides evidence supporting school-based sealant programs as effective strategies for the prevention of tooth
decay in children, and includes recommendations for implementing sealant programs in schools.
Organization(s): Centers for Disease Control and Prevention (CDC)
Seal America: The Prevention Intervention, Third Edition
A step-by-step curriculum for health professionals when developing and implementing sustainable school-based
dental sealant programs for the prevention of dental caries in children and adolescents.
Author(s): Carter, N. & Lowe, E.
Organization(s): National Maternal and Child Oral Health Resource Center
of School-Based Oral Health Programs Operated by Health Centers: Descriptive Findings
Presents the results of a national online survey of 62 School-Based Health Centers (SBHC) in 29 states,
conducted in 2013, to obtain information about their school-based oral health programs.
Organization(s): National Network for Oral Health Access (NNOHA)