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School-Based Model

Rural communities are implementing school-based oral health programs that provide fluoride varnish and dental sealants to children. In school-based dental programs, dentists, dental hygienists, and community health workers deliver preventive dental services.

A rural oral health program in South Dakota utilizes dental hygienists 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 deliver fluoride varnishes to 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.

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).

Implementation considerations

Oral health programs implementing school-based models must 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 stakeholders, such as the health department, state office of rural health, universities, and state dental and dental hygienists associations.

Resources to Learn More

Enrollment Forms and Manuals

Seal America: The Prevention Intervention, Second Edition, Revised
This manual for health professionals provides steps to launching and sustaining school-based dental sealant programs to prevent dental caries in children and adolescents.
Author(s): Carter, N.
Date: 2016

More Information about School-Based Programs

Northeast Oral Health Project
Provides an overview of the Northeast Oral Health Project that promotes the health of school children by employing a school based dental sealant program, providing dental screenings and providing oral health education on proper brushing and hygiene.
Organization(s): Northeast Colorado Health Department

Dental Caries (Cavities): School-Based Dental Sealant Delivery Programs
These programs provide direct delivery of dental sealants to children in school-based or school-linked settings. The Community Preventive Services Task Force recommends school-based and school-linked dental sealant delivery programs based on strong evidence of effectiveness in preventing or reducing tooth decay among children.
Organization(s): Community Preventive Services Task Force
Date: 4/2013

Reaching New Heights in Health with School-Based Oral Health Programs
A white paper to help understand new regulations, school-based oral health program models, and effective strategies for preventing tooth decay.
Organization(s): Massachusetts Coalition for Oral Health
Date: 2011

School-Based Dental Sealant Programs
Provides information about the evidence supporting school-based sealant programs, as well as recommendations for implementation.
Organization(s): Centers for Disease Control and Prevention

Survey of School-Based Oral Health Programs Operated by Health Centers: Descriptive Findings
Presents the results of a national online survey of Health Centers that National Network for Oral Health Access (NNOHA) conducted in June 2013 to obtain information about school-based oral health programs located in school-based health centers (SBHCs) and operated by Health Centers.
Organization(s): National Network for Oral Health Access
Date: 7/2014

Use of Fluoride: School-based Fluoride Mouthrinse and Supplement Programs
This Best Practice Approach Report describes the effectiveness of school-based fluoride mouth rinse and supplement programs with examples to illustrate successful implementation.
Organization(s): Association of State and Territorial Dental Directors
Date: 6/2003

More Information about Clinical Recommendations for Fluoride Varnish

Professionally Applied Topical Fluoride: Evidence-Based Clinical Recommendations
This is a summary of evidence-based clinical recommendations developed by an expert panel established by the American Dental Association Council on Scientific Affairs that evaluated the effectiveness of professionally applied topical fluoride for preventing caries.
Organization(s): American Dental Association Council on Scientific Affairs
Date: 8/2006

Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States
Presents recommendations intended to guide dental providers, other healthcare providers, policymakers, and public health officials on using fluoride to protect against dental caries. Also presents recommendations regarding the efficient use of resources.
Organization(s): Centers for Disease Control and Prevention
Date: 8/2001

Fluoride Varnishes for Preventing Dental Caries in Children and Adolescents
This review of trials found that fluoride varnish can substantially reduce tooth decay in both milk teeth and permanent teeth.
Authors(s): Marinho, V.C.C., Worthington, H., Walsh, T., & Clarkson, J.
Organization(s): Cochrane Database of Systematic Reviews
Date: 7/2013