Vermont Department of Health - Oral Health and 3 more... less...

Oral health in schools

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Tooth Tutor

# of students participating in Vermont's 802 Smiles Network of School Dental Health Programs receiving oral health services

Current Value

3,000

2023

Definition

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Story Behind the Curve

Last Updated: March 21, 2023

Author: Office of Oral Health, Vermont Department of Health

The way the Vermont Department of Health approaches school dental health services transitioned in the 2018-2019 school year, as shown in the data. From the 2015-2016 through the 2017-2018 school year, we focused solely on the collection of “Tooth Tutor School-Linked Sealant Program” (TTSP) data. We only collected data from this program because this was the only program that we had a formal connection with. This program was considered a school-linked (vs. school-based) program because hygienists (previously referred to as “Tooth Tutors”) would develop a target group of students who may not have accessed dental care in the past year based on their health records, and work throughout the year to connect those students with a local dental practice where they would ideally receive dental sealants (an evidence-based strategy to prevent dental decay on molar teeth).

Based on a formal evaluation of the program, we are now supporting the expansion of school-based dental health programs (a number of which already existed in VT). Rather than just linking children with care, school-based programs provide dental health care services on site in school settings. Students are still referred to local dental homes where they can receive both preventive and restorative dental care, as needed. This is because school-based dental health programs are an evidence-based strategy to improve population oral health indicators such as treated and untreated decay and dental sealant rates (something we did not see with the TTSP evaluation).

This transition involved the development of a network of school dental health programs in Vermont (both school-linked and school-based). This network is the 802 Smiles Network of School Dental Health Programs. Starting in the 2018-2019 school year, we expanded our data collection to include students from all the programs in the 802 Smiles Network. The change in data collection is why the number of students who received dental sealants rose so dramatically during the 2018-2019 school year.

The 2019-2020 and 2020-2021 school years were challenging for the 802 Smiles Network due to impacts of the COVID-19 pandemic, including school closures, remote learning, and health guidance. Limited activities and services resumed in the 2021-2022 school year.

We look forward to working with our partners and the 802 Smiles Network to “turn the curve” toward our pre-pandemic goals and increasing the number of Vermont’s children receiving necessary oral health services.

Partners

What Works

According to our data, the most common reason why children did not access dental care through the Tooth Tutor School-Linked Sealant Program was “the parent did not follow through” (e.g., parent didn't make an appointment, or parent didn't enroll child in Medicaid/Doctor Dynasaur, etc.). Although access to a dental home (a place where the child can receive comprehensive and ongoing oral health care) is ideal, this is not a reality for many Vermont children. For various reasons, simply making referrals to local dental practices has not been enough: for example, it can be very difficult for some families to take time off from work to take their children to health care appointments. For many children, receiving preventive care at the school may be all they need. All 802 Smiles programs include a care coordination component to support families in connecting with a dental home, when necessary.

School-based dental sealant programs are an evidence-based strategy to prevent dental cavities in children. These programs provide many benefits to the children and to the school, such as less missed school time, as the child will only be absent from class during their appointment time (because there is no transportation time involved). Children with good oral health can better concentrate in class, sleep better at home, and eat a nutritious diet. They also have better self-confidence and self-esteem. They increase the number of children who get sealants, resulting in less tooth decay among these children. These programs are an important way to bring clinical care to low-income families and children at high risk for tooth decay.

Action Plan

We will continue to monitor the percentage of students who receive at least one sealant through the program as a measure of success. This not only allows us to provide extra support for 802 Smiles Providers whose percentages are below average, but it also tells us who is achieving above average success, so that we can learn about what they are doing well.
We will continue to provide trainings to support 802 Smiles not only in clinical skills, but also communication, cultural competency, care coordination, and motivational interviewing skills.
We will continue to support implementation of school-based dental health programs that can provide dental sealants and other preventive services in high-need schools.

Notes on Methodology

This measure is calculated annually, based on the school year calendar. 802 Smiles Providers report the number of students who received oral health services.

References

Information included on this page drew from research and the established literature. For more information, please see:

Flynn P, Acharya A, Schwei K, VanWormer J, Skrsypcak K. Assessing dental hygienists' communication techniques for use with low oral health literacy patients. Journal of Dental Hygiene. 2016;90(3):162-169.
Horowitz AM, Kleinman DV. Oral health literacy: The new imperative to better oral health. Dental Clinics of North America. 2008;52(2):333-344.
Mohammadi TM, Hajizamani A, Bozorgmehr E. Improving oral health status of preschool children using motivational interviewing method. Dental Research Journal. 2015;12(5):476-481.
U.S. Department of Health and Human Services. Dental Caries (Cavities): School-Based Dental Sealant Delivery Programs. https://www.thecommunityguide.org/findings/dental-caries-cavities-school-based-dental-sealant-delivery-programs. Accessed March 20, 2023.
Centers for Disease Control and Prevention. School Sealant Programs. https://www.cdc.gov/oralhealth/dental_sealant_program/school-sealant-programs.htm. Accessed March 20, 2023.

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