Questions and Answers on
School Oral Health Programs
Presented by the ASTDD, School and Adolescent Oral Health Committee
in conjunction with the National Association of School Nurses
Content
This webinar will focus on:
• Access to oral health care
• Delivery of dental services
• Emergency care
• Oral health resources
The questions featured in this webinar were provided by school nurses
from across the country and will be answered by professionals with
knowledge and experience in the delivery of dental services in the
school setting.
Presenters
• Jill Moore, RDH, BSDH, MHA – Oral Health Coordinator
Michigan Dept. of Community Health
• Martha Bergren, DNS, RN, NCSN, FNASN, FASHA
NASN Special Projects and faculty, UIC College of Nursing
• Nicole Breton, BS, RDH – Public Health Educator
Maine Centers for Disease Control, Oral Health Program
• Rudy Blea, BA - Director
Office of Oral Health, New Mexico Department of Health
Access to Oral Health Care
Jill Moore
Access to Oral Health Care
• Oral Health is included in
Healthy People 2020 and
is a Leading Health
Indicator
• All children should have
access to the oral health
care system
Photo courtesy of: Jill Moore
• Multiple barriers
I spend a lot of time on the phone trying to find dental
care for the students in my school. Is there a published
list of dental professionals and clinics that accept
Medicaid or a website I might go to?
Access to dental care can be challenging for every school
nurse, in some areas of the country, such as rural areas it may
be even more challenging.
• Why are only certain grades
targeted by a school-based
program, for instance 2nd and
3rd grade or 6th and 7th
grade?
• Financial assistance to pay
for dental care for children
without insurance seems very
limited or non-existent. How
can I learn about the
resources in my community?
As a school nurse, I
understand why oral health
is important. What is the
best way to address this
with my school’s
administrators and
teachers to help them
understand why the dental
needs of our students’
needs to be addressed and
why oral health needs to be
part of our school’s
curriculum?
Oral Health
Education
Access to
Dental Care
Injury
Prevention
Mouthguard
Use
Oral Health
Promotion
for School
Staff
School
Environment
Promoting
Oral Health
School-based
Dental
Services
Social
Services &
Relationship
w/ Oral Health
Nutrition
Services
Improving Children’s Oral Health Through Coordinated School Health Programs
www.astdd.org/docs/BPASchoolCSHP.pdf
Resources and Access
www.mchoralhealth.org
www.michigan.gov/oralhealth
I would like to coordinate a program in my
community that helps parents and students
receive dental care.
Are there any communities that have
worked collaboratively to create
successful programs like this?
Where would I find out more
information about these
programs?
Delivery of Dental Services
Martha Dewey Bergren
Oral Health Education
Where can school nurses get more education about oral
health and how to deliver oral health care in school?
Visit NASN’s Oral Health Connections, an interactive website for quick and
easy school oral health links.
Funded by the DentaQuest Foundation, this site includes:
– Oral health knowledge interactive self assessment
– Links to NYU’s Smiles for Life Oral Health Curriculum and other
curricula for health providers
– NASN Radio Program: Nurse's Guide to Student Oral Health
– Online Continuing Education: Oral Health 101 for School Nurses
– Annual Conference information offering oral health educational
sessions
What does the delivery of oral health care
look like in a school setting?
There are many different options available for the delivery of oral
healthcare in a school. It can range from screening to actual restorative
treatment. Although some school nurses do administer screenings and
fluoride rinses in schools, most partner with regional and community
agencies to provide care.
The first resource to tap into is your state’s oral health program: www.astdd.org/stateprograms/
For school nurses who want to start an oral health initiative in their school:
www.astdd.org/school-and-adolescent-oral-health-committee/
• Oral Health Education for Students/Parents
• Prevention Services: Fluoride Rinses, Cleanings, Sealants, Varnish
• Comprehensive Restorative Services
Consent for Oral Health Care
Receiving parent/guardian consent is difficult for so many types
of health care in school settings. What are some of the
recommended models for getting written consents for oral health
care in schools?
School nurses and oral health champions across the country are experimenting
with models aimed at collecting written parent/guardian consent for the
delivery of oral health care. Some of the strategies reported by members
of NASN and ASTDD’s School and Adolescent Health Committee are:
 Include the forms in the “back to school” packets with all of the
paperwork that parents return to school at the beginning of the year.
 Provide downloadable consent forms on the School District’s Health or
School Nurse’s webpage.
 Be present at Back-to-School Nights, Parent/Teacher Conferences,
PTA/PTO meetings to promote the OH program and distribute forms.
Consent Form’s cont’d
 Provide oral health education programming for parents prior to the
date the school oral health program is scheduled to provide services
at the school.
 Provide in class oral health programming for students prior to the
scheduled school oral health program start-date.
 Request that ALL forms be returned, allowing parents to check a
YES or NO if their child is participating. Create student AND
teacher incentives (gift cards, electric toothbrush, etc.) for classes
who return 100% of forms.
Do you know an innovative and successful model for the return of signed
consent forms for any health purpose in schools? If so, please email
mbergren@nasn.org
Dental Emergencies
Nicole Breton
What is a dental emergency?
A dental emergency can be easily described as:
• Any abnormal oral condition that causes pain
or concern;
• An abscess (infection) toothache can cause
pain, swelling or fever; or
• An injury to the teeth, gums or other oral
structures.
What might a dental emergency look like?
Facial Swelling
Tooth Decay
Abscess/Fistula
Fractured Tooth
Gum Laceration
Trauma from Piercing
Avulsed Tooth
What might a school nurse have available if
there is a dental emergency?
•
•
•
•
•
•
•
•
•
Contact Info for Local Dentist(s)/Dental Clinic(s)
Saline Solution
Dental Floss
Tweezers
Flashlight
Dental (Paraffin) Wax
Gauze Squares
Cold Compress/Popsicles
Small Containers w/ Lids/Coin Envelopes
http://www.deardoctor.com/dental-injuries/dental-injuries-guide1.pdf
http://www.iadt-dentaltrauma.org/images/save_your_tooth.jpg
Downloadable in Seven
Languages other than
English
Oral Health Resources
Rudy Blea
There are so many other issues that teachers deal with during
the day besides oral health. What resources can guide us in this
process?
Your school’s health manual could provide some direction and
information. It’s important for school administrators to
support your efforts. A well child will learn without
difficulties and stay in school.
Additional resources are:
•
ASTDD’s School Health Policy:
www.astdd.org/docs/Coordinated_School_Oral_Health_Policy_April_5_2011.pdf
•
A study published by the University of Southern California School of Dentistry linking how a
child performs in school when they are well or ill.
http://dentistry.usc.edu/2012/08/10/poor-oral-health-can-mean-missed-school-lowergrades
What are the best oral health prevention strategies
for children and adolescents?
1. Dental sealants, fluorides and fluoridation, and education and nutrition
are key prevention strategies. School-linked or a school-based
prevention programs are the first line of defense for the prevention of
tooth decay in the school setting, as well as securing a “dental home”.
2. Oral health education is important to teach students how and why
hygiene practices are important.
3. Nutrition is important, this includes limiting the consumption of sugar
and drinking fluoridated water.
4. Developing a school oral health policy is important as well as having the
policy adopted and enforced throughout all school activities and
curriculum.
5. Including dental professionals on your school’s Wellness Committee.
Water fluoridation has been a topic in the news and also discussed at
community meetings in my town. As a school nurse, I want to understand
the truth about fluoridation and why it’s important for preventing tooth
decay. Are there water fluoridation resources available that are
credible and easy to understand?
There are many resources available on the
internet and that can be a problem. A word of
caution… many of the websites don’t offer
credible information about fluoridation and will print anything to sway your
opinion against its benefits.
Most of that research is unscientific and has
been conducted in other countries where the fluoride levels are ten times
higher than they are in the US.
Community Water Fluoridation Resources
• Centers for Disease Control and Prevention:
http://www.cdc.gov/fluoridation/index.htm.
• American Dental Association: http://www.ada.org/fluoride.aspx.
• American Academy of Pediatrics: http://www2.aap.org/oralhealth
• I Like My Teeth: www.ilikemyteeth.org
• The Community Guide – Oral Health - Preventing Dental Caries:
http://www.thecommunityguide.org/about/task-force-members.html
Where can a school nurse find resources about oral health
programs, the importance of school sealant programs, how to
do a dental screening, and other related topics? Where can I
find out what oral health programs and resources are available
in my community and/or in my state?
Oral Health Resources
•
Association of State and Territorial Dental Directors www.astdd.org
•
Division of Oral Health, US Centers for Disease Control and Prevention
www.cdc.gov/OralHealth/
•
Maternal and Child Oral Health Resource Center: (202) 784-9551 or
www.mchoralhealth.org
•
Maternal and Child Oral Health Resources for Head Start Programs
www.mchoralhealth.org/HeadStart/index.html
•
American Dental Association’s “Mouth Healthy” Resources
www.mouthhealthy.org
Oral Health Resources
•
Bright Futures Oral Health Pocket Guide (AAP):
http://brightfutures.aap.org/materials.html
•
Child Oral Health Resources for Primary Care Providers (Center for Health
Care Strategies):
www.chcs.org/publications3960/publications_show.htm?doc_id=1200397
•
Reaching New Heights in Health with School Based Oral Health Programs
(Massachusetts Coalition for Oral Health):
http://www.masscoalitionfororalhealth.org/files/2009/06/9134_WhitePaper_r5aPROOF.pdf
•
Medline Plus: www.nlm.nih.gov/medlineplus/childdentalhealth.html
Community Water Fluoridation Resources
• Centers for Disease Control and Prevention:
http://www.cdc.gov/fluoridation/index.htm.
• American Dental Association: http://www.ada.org/fluoride.aspx.
• American Academy of Pediatrics: http://www2.aap.org/oralhealth
• I Like My Teeth: www.ilikemyteeth.org
• The Community Guide – Oral Health - Preventing Dental Caries:
http://www.thecommunityguide.org/about/task-force-members.html
Dental Emergency Resources
Manuals
• Dental First Aid Emergencies (Colorado Dept. of Public Health and Environment):
scha-mi.org/emergencydentalflipchart.pdf
• School Nurses’s Guide to Oral Health (Georgia Oral Health Prevention Program):
http://health.state.ga.us/pdfs/familyhealth/oral/ohscreeningmanual_Revised0612.pdf
Webinar
• Managing and Preventing Dental Emergencies in the School Setting
(Massachusetts School Health Institute):
www.neushi.org/show-program.pl?type=online&id=493
Poster
• Dental Emergency Guide (New Jersey Dept. of Health and Senior Services):
www.nj.gov/health/fhs/oral/documents/dental_emergency_guide.pdf
Resources from NASN
“ORAL HEALTH CONNECTIONS”: www.oralhealthconnections.org
– Oral health knowledge interactive self assessment
www.oralhealthconnections.org/Home/SelfAssessment
– NYU’s Smiles for Life Oral Health Curriculum and other curricula for
health providers
http://smilesforlifeoralhealth.org/default.aspx?tut=555&pagekey=629
48&s1=2127993
– NASN Radio Program: Nurse's Guide to Student Oral Health
www.jackstreet.com/jackstreet/WNASN.HayesZacharski.cfm
– Online Continuing Education: Oral Health 101 for School Nurses
www.nasn.org/ContinuingEducation/OnlineContinuingEducation
– NASN’s Annual Conference offers oral health educational sessions
www.nasn.org
Thank you for joining us
Questions and Answers on
School Oral Health Programs
Presented by the ASTDD School and Adolescent Oral Health Committee in
conjunction with the National Association of School Nurses