Promoting Oral in Schools A Resource Guide

Fourth Edition

Prepared by Ruth Barzel, M.A. Katrina Holt, M.P.H., M.S., R.D., FAND Cite as Barzel R, Holt K, eds. 2019. Promoting Oral The following National Maternal and Child Oral Health in Schools: A Resource Guide (4th ed.). Health Resource Center (OHRC) staff members Washington, DC: National Maternal and Child Oral also assisted in the development of this publica- Health Resource Center. tion: Sarah Kolo and Olivia Pickett. Promoting Oral Health in Schools: A Resource Permission is given to photocopy this publication Guide (4th ed.) © 2019 by National Maternal and or to forward it, in its entirety, to others. Requests Child Oral Health Resource Center, Georgetown for permission to use all or part of the information University contained in this publication in other ways should This publication was made possible by coopera- be sent to the address below. tive agreement #U44MC30806 from the Health National Maternal and Child Oral Health Resources and Services Administration (HRSA), Resource Center an operating division of the U.S. Department of Georgetown University Health and (HHS). Its contents Box 571272 are the responsibility of solely the authors and do Washington, DC 20057-1272 not necessarily represent the official view of HRSA (202) 784-9771 or HHS. E-mail: [email protected] Web site: www.mchoralhealth.org Contents

Introduction...... 3 Acknowledgments...... 4 Materials...... 5 Data and Surveillance...... 6 Care...... 12 Dental Sealants ...... 13 Education...... 19 ...... 21 ...... 23 Program Development...... 25 Federally Funded Project Final Reports. . . . 27 Organizations...... 29 Introduction

Schools are ideal settings in which to Students can pass health-promotion messages children and adolescents and, through these on to family members. And schools can take the children and adolescents, families and com- lead in integrating oral health into their general munity members. During childhood and ado- health curricula. lescence, oral health behaviors develop, along The National Maternal and Child Oral Health with beliefs and attitudes. Children and adoles- Resource Center (OHRC) developed this pub- cents are receptive to new information, and the lication, Promoting Oral Health in Schools: A earlier healthy oral habits are established, the Resource Guide (4th edition), to help health greater their impact. Messages about achieving professionals, program administrators, educa- and maintaining good oral health can be rein- tors, parents, and others promote oral health and forced regularly throughout the school years. prevent oral in school-age children and Encouraging children and adolescents to adopt adolescents. healthy oral health habits equips them with skills The resource guide is divided into two sec- enabling them to make healthy decisions and tions. The first section describes materials, such adopt healthy lifestyles. as brochures, fact sheets, guidelines, curricula, Schools can provide supportive environments and reports. The materials listed in this sec- for promoting oral health. A safe physical envi- tion were published from 2015 to 2019. The ronment in the playground and throughout a second section lists federal agencies, national school can help reduce the risk of oral trauma. professional associations, resource centers, and If appropriate policies and practices are in place, national coalitions that may serve as resources. necessary action can be taken in case of a dental Our intent is to share resources that are useful emergency. School policies and practices to and that represent current science and practice. ensure that healthy foods are offered for school For further information, we encourage you to meals, in vending machines, and for school contact the organizations listed. Your state and events promote healthy eating behaviors begin- local departments of health, state and local oral- ning at an early age. More important, schools health-related associations and societies, state or may be a place for children and adolescents at local oral health coalitions, and university-based the highest risk for oral disease to access oral libraries are additional sources of information. health care via school-based or school-linked ser- OHRC will update the resource guide periodi- vices. Schools can also serve as vital channels to cally, and we would appreciate hearing from you communities. School personnel can target health- if you know of any relevant resources that are promotion activities to homes and communities. not included in this edition.

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 3 Acknowledgments

We are grateful to the following experts from contributions to this edition of the resource the Association of State and Territorial Dental guide: Donna Behrens, Nichole Bobo, Terri Directors’ School and Adolescent Oral Health Chandler, Matthew Crespin, Betty Kabel, Debora Committee for their review and numerous Teixeira, and Sandy Tesch.

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 4 Materials Materials

Data and Surveillance 2015–2016 ORAL HEALTH STATUS OF UTAH’S CHILDREN

2013–14 DIGITAL CENSUS REPORT This report presents findings from a statewide oral health screening of 2,000 students in first This report presents findings from a national through fourth grades in 47 elementary schools survey of centers and programs connected with to measure the extent of untreated , schools to document the role of school-based caries experience, prevalence of dental sealants, health centers (SBHCs) in meeting the health care and need for oral health care. Additional topics needs of children and adolescents. The report include dental insurance coverage, time since describes the funding sources that support the last dental visit, unmet needs, and disparities in SBHCs, policies, and characteristics of schools care. The report also contains a comparison of where SBHCs are located. The analysis and data Utah’s oral health status with national goals, the presented in the report include SBHCs that pro- study methodology, information about access to vide primary care. Topics include growth; access; care by race and ethnicity, program resources, comprehensive care, including behavioral health a list of participating schools, and the parent and oral health care; adolescent care; health sys- questionnaire. tem partnerships; sustainability; and accountability. [Funded by the Maternal and Child Health Bureau] Love HL, Schelar E, Taylor K, Schlitt J, Even M, Burns A, Mackey S, Couillard M, Danaux J, Mizzi Love HL, Schelar E, Taylor K, Schlitt J, Even M, A, Surti D, Windham D. 2015. 2015–2016 Oral Burns A, Mackey S, Couillard M, Danaux J, Mizzi A, Health Status of Utah’s Children. 33 pp. Salt Lake 2013–14 Digital Census­ Surti D, Windham D. 2015. City, UT: Utah Department of Health, Oral Health Report. Washington, DC: School-Based Health Program. http://health.utah.gov/oralhealth/ Alliance. 1 v. http://censusreport.sbh4all.org resources/2015-2016%20Oral%20Health%20 Survey.pdf 2014–2015 SCHOOL HEALTH DENTAL SCREENING SURVEILLANCE REPORT 2016 IOWA THIRD GRADE ORAL HEALTH This report provides information from an oral SURVEY REPORT health screening survey of students in 1st, 2nd, This report provides an overview of a survey of 4th, 7th, and 10th grades from 89 schools in 2,470 students in third grade in Iowa. It pres- Nebraska conducted in 2014–2015. The survey ents the survey objectives, protocol, and results, had two primary objectives: (1) measure partici- including oral health status by economic status pation of schools that were providing required and payment sources for oral health care. It also oral health screenings and (2) assess oral health includes a discussion of how to interpret the status among a convenience sample of Nebraska results. schoolchildren. The report discusses surveillance methods, limitations, and results. Characteristics Chickering S, Rodgers T, Kaiser E, Kane D. of respondents are presented, and recommenda- 2016. 2016 Iowa Third Grade Oral Health Sur- tions are included. [Funded by the Maternal and vey Report. Iowa Department of , Child Health Bureau] Bureau of Oral and Health Delivery System. 6 pp. https://idph.iowa.gov/Portals/1/userfiles/163/ Nebraska Department of Health and Human Ser- 2016%20Third%20Grade%20Survey%20FINAL% vices, Maternal, Child, Adolescent Health. 2016. 209_23_16.pdf 2014–2015 School Health Dental Screening Sur- veillance Report. Lincoln, NE: Nebraska Depart- ment of Health and Human Services, Maternal, Child, Adolescent Health. 13 pp. http://dhhs.ne. gov/MCAH/SchoolR-DentalHealthSurveillance Final.pdf

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 6 DENTAL EXAMINATION COMPLIANCE STATUS of participating schools and students and the OF KINDERGARTEN, SECOND, AND SIXTH percentages of children with a history of tooth GRADE CHILDREN IN ILLINOIS FOR SCHOOL decay, untreated decay, and urgent oral health care needs by race and ethnicity. Contents YEAR 2013–2014 include a comparison of oral health indicators This report summarizes statewide dental exami- from 2006 and 2014 and recommendations for nation compliance and oral health status of health professionals. children in kindergarten and second and sixth Montana Department of Health and Human Ser- grades in Illinois. Contents include findings on vices. 2015. Don’t Forget to Brush and Floss: Den- the level of compliance and noncompliance for tal Decay Among Montana’s 3rd Grade Children. all students, public school students, and non- Helena, MT: Montana Department of Health and public-school students. Compliance and health- Human Services. 2 pp. https://dphhs.mt.gov/ status data are reported for the state as a whole, Portals/85/publichealth/documents/OralHealth/ by county, and by grade level. The report also ThirdGradeBSS_2014.pdf discusses implications of the data across the state.

Illinois State Board of Education, Data Analysis FUTURE SMILES: SATISFACTION SURVEY Division. 2015. Dental Examination Compliance Status of Kindergarten, Second, and Sixth Grade These satisfaction surveys are intended for use Children in Illinois for School Year 2013–2014. in implementing a school-based oral pro- Springfield, IL: Illinois State Board of Education. gram that provides preventive oral health services 15 pp. https://www.isbe.net/Documents/dental_ (screenings, dental cleanings, varnish report1314.pdf applications, application, and oral ) for children from families with low incomes in Nevada. Contents include surveys DENTAL HEALTH MATTERS for students, parents, and teachers in English and This infographic focuses on the oral health status Spanish. of children and adolescents in South Dakota. Future Smiles. 2016–. Future Smiles: Satisfaction Topics include untreated tooth decay in chil- Survey. Las Vegas, NV: Future Smiles. 3 items. dren ages 6–8 in South Dakota compared to the http://futuresmiles.net/resources/satisfaction- general U.S. population and ways to prevent survey tooth decay. Contents include the number of high school students who have missed school because of problems with their teeth or mouths, the per- GUIDANCE ON HOW TO ANALYZE DATA FROM centage of students in third grade who have not A SCHOOL-BASED ORAL HEALTH SURVEY visited the in the past 12 months, and the percentage of children who do not have dental This report provides a framework for how to sealants. Information about healthy behaviors appropriately analyze data from a statewide and using products containing fluoride is also school-based oral health survey with a complex provided. sampling design. The report discusses steps to take to prepare for data analysis, statistical South Dakota Department of Health. 2016. packages and program code to use, other things Dental Health Matters. Pierre, SD: South Dakota to consider and be aware of, and where to get Department of Health. 1 p. http://doh.sd.gov/ additional help. documents/statistics/YRBS_Oral_Health.pdf Manz M. 2017. Guidance on How to Analyze Data from a School-Based Oral Health Survey. DON’T FORGET TO BRUSH AND FLOSS: 15 pp. https://www.astdd.org/docs/school- DENTAL DECAY AMONG MONTANA’S 3RD survey-analysis-guidance-july-2017.pdf GRADE CHILDREN

This newsletter issue presents findings from oral health screenings of students in third grade attending public and Bureau of Indian Education schools in Montana. Topics include characteristics

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 7 GUIDANCE ON SELECTING A SAMPLE FOR A sealants. Information about the data source and SCHOOL-BASED ORAL HEALTH SURVEY methods, definitions, and data tables are included.

This document provides sampling guidelines for Arizona Department of Health Services. 2015. state and territorial health agencies and other Healthy Smiles Healthy Bodies Survey 2015: The jurisdictions planning to conduct a school-based Oral Health of Arizona’s Kindergarten and Third oral health survey. Topics include appropriate Grade Children. Phoenix, AZ: Arizona Depart- sampling designs, steps for and examples of the ment of Health Services. 6 pp. http://www.azdhs. sampling process, what to do if a school refuses gov/documents/prevention/womens-childrens- to participate, and information about specialized health/reports-fact-sheets/oral-health/healthy- data-analysis software. smiles-healthy-bodies-data-brief-2015.pdf

Manz M. 2017. Guidance on Selecting a Sample for a School-Based Oral Health Survey. Sparks, IDPH SCHOOL-BASED SEALANT PROGRAM NV: Association of State and Territorial Dental ANNUAL REPORT: SCHOOL YEAR 2015–2016 Directors. 12 pp. https://www.astdd.org/docs/ school-survey-sampling-guidance-july-2017.pdf This chart provides statistics for several school- based dental sealant programs in Iowa during the 2015–2016 school year. Topics include the HAWAII SMILES 2015: THE ORAL HEALTH OF number of children screened, children receiving HAWAII’S CHILDREN sealants, sealants placed, sealants placed on the teeth of children covered by Medicaid, children This report presents key findings from a state- with history of tooth decay, and children covered wide oral-health-screening survey of students in by Medicaid with history of decay. Also included third grade in Hawaii. Topics include tooth decay is the number of children with untreated decay, experience, untreated tooth decay, dental seal- children covered by Medicaid with untreated ants, need for urgent oral health care, oral health decay, children with private insurance, children disparities, and community . with no dental insurance, children covered by The report also describes the importance of good Medicaid, and children covered by Hawk-i. oral health and key strategies to improve oral health, including community-based prevention Iowa Department of Public Health, Oral Health programs, screening and referral services, and Bureau. 2016. IDPH School-Based Sealant Pro- restorative oral health care. gram Annual Report: School Year 2015–2016. Des Moines, IA: Iowa Department of Public Hawaii Department of Health, Oral Health Pro- Health, Oral Health Bureau. Annual. http://www. gram. 2016. Hawaii Smiles 2015: The Oral Health idph.iowa.gov/Portals/1/userfiles/34/ohc_reports/ of Hawaii’s Children. Honolulu, HI: Hawaii school_based_sealant_report_2016.pdf Department of Health, Oral Health Program. 18 pp. http://health.hawaii.gov/about/files/2013/ 06/Hawaii-Smiles-Report.pdf KEEP SMILING VERMONT ORAL HEALTH SURVEY: 2016–2017 HEALTHY SMILES HEALTHY BODIES SURVEY This report provides a summary of key survey 2015: THE ORAL HEALTH OF ARIZONA’S findings on the oral health of children in Vermont KINDERGARTEN AND THIRD GRADE as well as information on the following topics: (1) the Tooth Tutor School-Linked Dental Seal- CHILDREN ant Program, (2) key strategies to improve oral This brief summarizes data from a statewide oral health, and (3) survey methods. Data tables and health screening of children in kindergarten and figures are included. third grade attending Arizona’s public schools. Vermont Department of Health, Dental Health Contents include information on the prevalence of Services. 2017. Keep Smiling Vermont Oral Health tooth decay in the primary and permanent teeth of Survey: 2016 –2017. Burlington, VT: Vermont children in Arizona compared to the general U.S. Department of Health, Dental Health Services. 17 population and dental sealant prevalence. Topics pp. http://www.healthvermont.gov/sites/default/ include oral health disparities in the prevalence files/documents/pdf/oral_health_survey_1617.pdf of decay experience, untreated decay, and dental

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 8 MEDICAID FEE-FOR-SERVICE THE ORAL HEALTH OF MONTANA’S THIRD REIMBURSEMENT RATES FOR CHILD AND GRADE CHILDREN, 2014 ADULT DENTAL CARE SERVICES FOR ALL This data brief presents information about the STATES, 2016 prevalence of decay in the primary and perma- This brief presents findings from an analysis of nent teeth of students in third grade in Montana Medicaid reimbursement rates for oral health and compares data for this population with care in all states and the District of Columbia. data for the general U.S. third grade popula- The brief discusses Medicaid fee-for-service (FFS) tion screened between 2005 and 2010 as part of reimbursement for child and adult services rela- the National Health and Nutrition Examination tive to ’ fees and private dental insurance Survey. The brief also provides information about reimbursement, as well as other aspects of Medic- the prevalence of dental sealants. Topics include aid FFS reimbursement, including reimbursement tooth decay experience, untreated decay, and for adult services in states with extensive adult oral health disparities. benefits within their Medicaid programs. Montana Department of Public Health and Gupta N, Yarbrough C, Vujicic M, Blatz A, Har- Human Services, Oral Health Program. 2015. The rison B. 2017. Medicaid Fee-for-Service Reim- Oral Health of Montana’s Third Grade Children, bursement Rates for Child and Adult Dental 2014. Helena, MT: Montana Department of Care Services for All States, 2016. Chicago, IL: Public Health and Human Services, Oral Health American Dental Association, Program. 4 pp. https://dphhs.mt.gov/Portals/85/ Institute. 15 pp. http://www.ada.org/~/media/ publichealth/documents/OralHealth/ThirdGrade ADA/Science%20and%20Research/HPI/Files/ BSS_2014.pdf HPIBrief_0417_1.pdf ORAL HEALTH OF RHODE ISLAND CHILDREN

OKLAHOMA ORAL HEALTH NEEDS This report presents findings on the oral health ASSESSMENT 2016: THIRD GRADE CHILDREN status of children in third grade in Rhode Island. Contents include school sampling, data manage- This report presents findings from a needs assess- ment and analysis, screening methods, screen- ment for students in third grade in Oklahoma to ing participation, demographic characteristics produce statewide estimates of oral health status of children, and oral health outcomes. Topics indicators. The needs assessment determined include tooth decay, dental sealants, impact of prevalence of dental sealants, untreated dental race and ethnicity, and socioeconomic status. caries, other caries experience, missing teeth, and The report also provides a comparison of the need for care. Report contents include informa- results to Healthy People 2020 objectives and to tion about the research design, results, and a results from earlier surveys. Recommendations discussion. The appendices contain a letter sent are included. to schools and the return postcard; forms for parental consent, data collection, and results; Oh J, Yearwood S, Leonard L. 2015. Oral Health a description of participant characteristics; and of Rhode Island Children. Providence, RI: Rhode a comparison to national objectives and earlier Island Department of Health. 19 pp. http://www. state assessments. health.ri.gov/publications/programreports/2015 OralHealthOfRIChildren.pdf Oklahoma State Department of Health, Dental Health Services. 2016. Oklahoma Oral Health Needs Assessment 2016: Third Grade Children. ORAL HEALTH STATUS OF FLORIDA’S THIRD Oklahoma City, OK: Oklahoma State Department GRADE CHILDREN 2013–2014 of Health, Dental Health Services. 50 pp. https:// www.ok.gov/health2/documents/Dental%20 This report presents oral health screening results Survey%20Final%20Report%202016.pdf for students in third grade in public elementary schools in Florida. Contents include the screening survey methodology, demographic characteristics of participating students, and key findings on oral health indicators. A comparison of the results

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 9 to Healthy People 2020 goals, limitations, and Fleming E, Afful J. 2018. Prevalence of Total and recommendations is also included. Additional Untreated Dental Caries Among Youth: United contents include consent and screening forms; a States, 2015–2016. Hyattsville, MD: National Cen- parent letter and questionnaire; and information ter for Health Statistics. 7 pp. https://www.cdc. about other indicators including , last gov/nchs/data/databriefs/db307.pdf dental visit, reason for last dental visit, need for care, reason for not seeking care, health insur- ance, and dental insurance. PREVENTIVE SERVICES PROGRAM: A REPORT FROM THE 2015–2016 SCHOOL YEAR Vracar C, Holicky A, Wahby J, Janga D. 2016. Oral Health Status of Florida’s Third Grade This report presents accomplishments of the Mis- Children 2013–2014. Tallahassee, FL: Florida souri Department of Health and Senior Services, Department of Health, Public Health Dental Office of Dental Health, Missouri Oral Health Program. 23 pp. http://www.floridahealth.gov/ Preventive Services Program (PSP), during the programs-and-services/community-health/dental- 2015–2016 school year. It also offers findings from health/reports/_documents/oral-health-third- the oral health screening component of the pro- grade-2013-2014.pdf gram. The report provides an overview of PSP and offers general information about program partici- pants as well as participants’ , dental PEDIATRIC ORAL HEALTH DISPARITIES IN sealant status, treated tooth decay, untreated tooth NORTH DAKOTA decay, treatment urgency, and dental caries status. [Funded by the Maternal and Child Health Bureau] This fact sheet provides information about oral health disparities among third grade students, Missouri Department of Health and Senior Ser- middle school students, and high school students vices, Office of Dental Health. 2016.Preventive in North Dakota. Charts present data on tooth Services Program: A Report from the 2015–2016 decay rates by race and National School Lunch School Year. Jefferson City, MO: Missouri Depart- Program status, dental visits in the past 12 months ment of Health and Senior Services, Office of by race, and number of cavities by race. Rec- Dental Health. 15 pp. http://health.mo.gov/blogs/ ommendations for preventing tooth decay and wp-content/uploads/2016/12/psp-report-2015- improving oral health among children and ado- 2016.pdf lescents from minority groups and among those from families with low incomes are included. RESULTS FROM THE SCHOOL HEALTH University of North Dakota School of Medicine POLICIES AND PRACTICES STUDY 2014 and Health Sciences, Center for Rural Health. 2016. Pediatric Oral Health Disparities in North This report provides school- and classroom-level Dakota. Grand Forks, ND: University of North data on each of the following 10 components of Dakota School of Medicine and Health Sciences, the Whole School, Whole Community, Whole Center for Rural Health. 2 pp. https://ruralhealth. Child model: health education, physical educa- und.edu/assets/2507-9202/north-dakota-pediatric- tion and physical activity, nutrition environ- oral-health-disparities.pdf ment and services, health services, counseling, psychological and social services, healthy and safe school environment, physical environment, PREVALENCE OF TOTAL AND UNTREATED employee wellness, family engagement, and DENTAL CARIES AMONG YOUTH: UNITED community involvement. Information about oral STATES, 2015–2016 health education, screening and referral, and pro- fessional development is included. This data brief presents the prevalence of total and untreated caries in primary or permanent National Center for HIV/AIDS, Viral Hepatitis, teeth among children and adolescents ages STD, and TB Prevention, Division of Adolescent 2–19 for 2015–2016 and trends from 2011–2012 and School Health. 2015. Results from the School through 2015–2016. Along with key findings, the Health Policies and Practices Study 2014. Atlanta, brief offers information on prevalence differences GA: Centers for Disease Control and Prevention. by race and Hispanic origin and income level for 165 pp. http://www.cdc.gov/healthyyouth/data/ 2015–2016. shpps/pdf/shpps-508-final_101315.pdf

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 10 SCHOOL ORAL HEALTH SURVEY REPORTS relationship between oral health and academic achievement. Survey results are presented by This report describes the process and results domain, including prevalence of decay experi- of the open-mouth survey of students in third ence, untreated decay, pain and infection, annual grade in Iowa. Topics include the prevalence of dental visits, and insurance coverage. Compari- untreated tooth decay in children and the impact sons to previous statewide surveys, benchmarks of untreated tooth decay on a child’s ability to eat, and national data, and regional and county sleep, and learn in school; the role health insur- highlights are provided. [Funded in part by the ance plays in accessing or obtaining care; and a Maternal and Child Health Bureau] comparison of oral health status to results from earlier surveys. Contents include survey objectives, Arizona Early Childhood Development and methods, results, and a discussion of results. Health Board. 2016. Taking a Bite Out of School Absences: Children’s Oral Health Report 2016. Chickering S, Rodgers T, Kaiser E, Kane D. 2016. Phoenix, AZ: Arizona Early Childhood Develop- School Oral Health Survey Reports. Des Moines, ment and Health Board. 122 pp. http://azftf.gov/ IA: Iowa Department of Public Health, Bureau of WhoWeAre/Board/Documents/FTF_Oral_Health_ Oral and Health Delivery Systems. 6 pp. http:// Report_2016.pdf www.idph.iowa.gov/Portals/1/userfiles/163/2016 %20Third%20Grade%20Survey%20FINAL%20 9_23_16.pdf TEXAS THIRD GRADE ORAL HEALTH BASIC SCREENING SURVEY RESULTS

SMILE SURVEY 2015–2016: A REPORT ON THE This document presents findings from a public- ORAL HEALTH OF WASHINGTON’S CHILDREN school-based screening survey to collect oral health data consistent with national standards. This report presents results from an assessment Topics include percentages of students in third of oral health among children in Head Start and grade with untreated tooth decay, dental sealants, early learning programs and children in kinder­ and urgent need for oral health care. Compari- garten and second and third grade in public sons from two statewide samples against Healthy elementary schools in Washington. Results are People 2020 goals are included. compared with 2010 and 2005 Smile Survey results and with Healthy People 2020 objectives Texas Department of State Health Services, Oral and national averages. Topics include oral disease Health Program. 2015. Texas Third Grade Oral prevalence, decay experience and untreated tooth Health Basic Screening Survey Results. Austin, TX: decay, dental sealants, and oral health disparities. Texas Department of State Health Services, Oral Health Program. 1 p. https://www.dshs.texas. Washington State Department of Health, Oral gov/WorkArea/linkit.aspx?LinkIdentifier=id&Ite Health Program and Surveillance and Evaluation mID=8589998717 Section. 2017. Smile Survey 2015–2016: A Report on the Oral Health of Washington’s Children. Olympia, WA: Washington State Department of TOOTH BE TOLD: COLORADO’S BASIC Health, Oral Health Program and Surveillance SCREENING SURVEY—CHILDREN’S ORAL and Evaluation Section. 56 pp. http://www.doh. HEALTH SCREENING: 2016–17 wa.gov/Portals/1/Documents/Pubs/340-309-2016 SmileSurvey.pdf This report presents data from a survey of stu- dents in kindergarten and third grade in Colorado that included an oral health screening conducted TAKING A BITE OUT OF SCHOOL ABSENCES: during the 2016–2017 school year. The report CHILDREN’S ORAL HEALTH REPORT 2016 provides an introduction to the survey and a summary of main findings; a description of the This report presents survey results on the preva- methodology; and results categorized by caries lence and severity of tooth decay in students experience, untreated decay, treatment urgency, in kindergarten in public schools in Arizona. and sealants. Trends in oral health outcomes and Contents include information about tooth decay in oral health disparities by race/ethnicity and and the impact of poor oral health on children, school-level socioeconomic status are presented. families, and society, with an emphasis on the

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 11 Calanan R, Elzinga-Marshall G, Gry D, Payne CONFRONTING THE CONSENT CONUNDRUM: E, Mauritson K. 2018. Tooth Be Told: Colorado’s LESSONS FROM A SCHOOL ORAL HEALTH Basic Screening Survey—Children’s Oral Health COMMUNITY Screening: 2016–17. Denver, CO: Colorado Department of Public Health and Environment. This document presents ideas that emerged 33 pp. https://www.colorado.gov/pacific/sites/ from the School-Based Health Alliance initiative, default/files/PW_OH_BSSReport.pdf Strengthening School Oral Health Services and Growing the School Oral Health Learning Com- munity, and that resulted in an increase in the USING ORAL HEALTH DATA TO INFORM number of positive parental consents for school DECISIONS AND POLICY DEVELOPMENT oral health services. The initiative encompassed the 10 largest U.S. school districts, which serve This fact sheet provides tips for using complex more than 4 million students, including a signifi- oral health data and for presenting it in a way cant number of students with high needs. The that is understandable and meaningful for a document discusses school engagement, family non-oral-health audience. Selected tips include engagement, community engagement, oral health reporting data in a timely manner, developing an education, and data collection and use. effective written communication plan, human- izing the story, and considering publishing a full- School-Based Health Alliance and Oral Health length report as well as a brief summary. 2020 Network. 2018. Confronting the Consent Conundrum: Lessons from a School Oral Health Association of State and Territorial Dental Direc- Community. Washington, DC: School-Based tors. 2017. Using Oral Health Data to Inform Health Alliance; Boston, MA: Oral Health 2020 Decisions and Policy Development. Sparks, NV: Network. 6 pp. http://www.sbh4all.org/wp- Association of State and Territorial Dental Direc- content/uploads/2018/04/DQF_WP_Consent tors. 3 pp. https://www.astdd.org/www/docs/ Conundrum_F.pdf using-oral-health-data-for-poicy-july-2017.pdf

DENTAL FIRST AID

Care This flip chart, developed for child care providers and school personnel, offers guidance for provid- BASIC EXPECTATIONS FOR SAFE CARE ing temporary assistance and relief during dental TRAINING MODULES emergencies. The chart also discusses basic oral health principles, prevention, and care. It pro- This training series covers the principles of infec- vides information about toothbrushing, teething, tion prevention and control that form the basis of and flossing; dental first aid; oral ulcers and oral Centers for Disease Control and Prevention rec- piercing complications; oral health services in ommendations for oral health settings. The series Maryland; ; nutrition and oral is divided into 10 modules. The series covers the health, child abuse and dental neglect; tooth following topics: introduction, hand hygiene, per- eruption, gum inflammation, and tooth extraction sonal protective equipment, respiratory hygiene complications; dental trauma; fluoride; water test- and cough etiquette, sharps safety, safe injection ing sites; and other related topics. practices, sterilization and disinfection, environ- mental infection prevention and control, dental Maryland Department of Health and Mental unit water quality, and program evaluation. Each Hygiene, Office of Oral Health. 2016.Dental module includes a slide set and speaker notes. First Aid. Baltimore, MD: Maryland Department of Health and Mental Hygiene, Office of Oral National Center for Chronic Disease Prevention Health. 13 pp. https://phpa.health.maryland.gov/ and , Division of Oral Health. oralhealth/Documents/FlipChart.pdf 2018. Basic Expectations for Safe Care Training Modules. Atlanta, GA: Centers for Disease Con- trol and Prevention. 10 modules. https://www. cdc.gov/oralhealth/infectioncontrol/safe-care- modules.htm

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 12 DENTAL TRAUMA DECISION TREE Dental Sealants This tool is designed to aid school nurses, teach- ers, and athletic coaches in treating minor dental ARIZONA SCHOOL-BASED SEALANT emergencies. It provides information about what PROGRAM to do in case of injury to a primary or perma- nent tooth, with different instructions depending This brochure presents information about the on the nature of the injury. General informa- Arizona School-Based Sealant Program, which tion about what to do in a dental emergency is provides dental sealants to students in second included. and sixth grades who qualify. The brochure explains what school-based dental sealant pro- Rhode Island Department of Health, Oral Health grams do and why they are important, provides Program. 2018. Dental Trauma Decision Tree. guidelines for who qualifies for the program, and Providence, RI: Rhode Island Department of offers statistical information about the oral health Health, Oral Health Program. 1 p. http://health. of children in Arizona. ri.gov/publications/guides/DentalTraumaDecision Tree.pdf Arizona Department of Health Services, Office of Oral Health. 2016. Arizona School-Based Sealant Program. Phoenix, AZ: Arizona Department of FUTURE SMILES: PROGRAM FORMS Health Services, Office of Oral Health. 2 pp. http://www.azdhs.gov/documents/prevention/ These forms are intended for use in implement- womens-childrens-health/oral-health/dental- ing a school-based oral hygiene program to pro- programs/arizona-school-based-sealant-program- vide preventive oral health services (screenings, information.pdf cleanings, fluoride varnish applications, dental sealant application, and education) for children from families with low incomes in Nevada. Con- BEST PRACTICE APPROACH: SCHOOL-BASED tents include referral and consent forms and a DENTAL SEALANT PROGRAMS privacy notice in English and Spanish. This report discusses school-based dental seal- Future Smiles. 2016–. Future Smiles: Program ant programs, assesses the strength of evidence Forms. Las Vegas, NV: Future Smiles. 3 items. for the effectiveness of these programs, and uses http://www.futuresmiles.net/resources/program- practice examples to illustrate successful and forms innovative implementation of the programs. The report provides guidelines and recommendations, STATE OF RHODE ISLAND SCHOOL DENTAL research evidence, best practice criteria, and state practice examples. SCREENING FORM Association of State and Territorial Dental Direc- This form for school oral health programs tors. 2017. Best Practice Approach: School-Based includes information to share with parents about Dental Sealant Programs. Reno, NV: Association their child’s oral health screening. In addition to of State and Territorial Dental Directors. 17 pp. space to insert the child’s school, name, grade, https://www.astdd.org/docs/sealant-bpar-update- and classroom, the form allows school oral health 11-2017-final.pdf programs to indicate whether the child has no obvious oral health problems, has problems that should be evaluated by a dentist, or needs CERTIFICATION FOR LOCAL SCHOOL DENTAL immediate care by a dentist. Space for notes and SEALANT PROGRAMS additional comments as well as the screener’s name and screening date is included. This document presents the final text rule requir- ing local school-based dental sealant programs Rhode Island Department of Health. 2016. State (SBSPs) in Oregon to be certified by the Ore- of Rhode Island School Dental Screening Form. gon Health Authority before they can provide Providence, RI: Rhode Island Department of dental sealants. Contents include guidance on Health. 1 p. http://health.ri.gov/forms/screening/ the requirements for certification, the applica- SchoolDental.pdf tion process for certification and recertification,

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 13 monitoring of SBSPs, and decertification or pro- DENTAL SEALANTS KEEP CHILDREN HEALTHY visional certification for programs that are out of & READY TO LEARN compliance. Information about certification and clinical training is also available. This infographic provides information about dental caries (tooth decay) in school-age chil- Oregon Health Authority, Oral Health Program. dren and how dental sealants prevent decay and 2016. Certification for Local School Dental Seal- reduce costs in Florida. Contents include the ant Programs. Portland, OR: Oregon Health percentage of students in third grade who have Authority. 6 pp. https://www.oregon.gov/oha/ untreated decay, the number and cost of caries- PH/PREVENTIONWELLNESS/ORALHEALTH/ related emergency department visits, the costs SCHOOL/Pages/certification-training.aspx of sealants vs. fillings, and the potential return on investment. Information about state programs DENTAL SEALANT PERMISSION SLIP— that provide preventive oral health services is included. TEMPLATE Florida Department of Health, Public Health Den- This dental sealant permission slip template, for tal Program. 2015. Dental Sealants Keep Children use by school-based dental sealant programs, Healthy & Ready to Learn. Tallahassee, FL: Florida can be used to obtain consent from parents or Department of Health, Public Health Dental guardians for students to receive dental sealants Program. 1 p. http://www.floridahealth.gov/ as well as other related preventive oral health programs-and-services/community-health/dental- services. The template can be customized with health/_documents/dental-sealant-roi.pdf the program name and other information. Space to provide additional information that parents or guardians would like the program to know is DENTAL SEALANTS PREVENT CAVITIES: included. The form is written in Arabic, Burmese, EFFECTIVE PROTECTION FOR CHILDREN English, Hmong, and Spanish. This fact sheet describes opportunities to improve Wisconsin Seal-A-Smile. 2016. Dental Sealant Per- oral health in children and adolescents by starting mission Slip —Template. West Allis, WI: Wisconsin or expanding programs that offer dental seal- Seal-A-Smile. 1 p. https://www.chawisconsin.org/ ants in schools. Topics include what sealants are download/dental-sealant-permission-slip and why they are used; disparities in sealant use; what the federal government is doing to promote DENTAL SEALANTS: A RESOURCE GUIDE sealants; and what state officials, health profes- sionals, school administrators, and parents can (4TH EDITION) do to increase the use of sealants. The fact sheet This resource guide provides information to is available in English and Spanish. Additional health professionals about the use and applica- resources including a podcast, a public service tion of dental sealants. The first section describes announcement, descriptions of dental sealant materials, such as brochures, fact sheets, guide- programs, and related materials are available lines, curricula, and reports. The second sec- from the website. tion lists federal agencies, national professional National Center for Chronic Disease Prevention associations, and resource centers that may serve and Health Promotion. 2016. Dental Sealants as resources. [Funded by the Maternal and Child Prevent Cavities: Effective Protection for Children. Health Bureau] Atlanta, GA: Centers for Disease Control and National Maternal and Child Oral Health Resource Prevention. 4 pp. http://www.cdc.gov/vitalsigns/ Center. 2017. Dental Sealants: A Resource Guide dental-sealants/index.html (4th ed.). Washington, DC: National Maternal and Child Oral Health Resource Center. 20 pp. https://www.mchoralhealth.org/PDFs/Dental SealantGuide.pdf

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 14 IMPROVING ORAL HEALTH WITH SCHOOL- guidelines; program requirements; forms, BASED SEALANT PROGRAMS reporting, and recording; and budget and fund- ing information. Sample forms and letters are This self-study course for oral health profession- included. als focuses on the role of school-based dental sealant programs (SBSPs) in reducing dental Iowa Department of Public Health. 2017. I-Smile™ caries incidence and addressing children’s oral @ School: School-Based Oral Health Programs. health needs. Topics include the effectiveness Des Moines, IA: Iowa Department of Public of sealants in caries prevention, defining SBSPs, Health. 1 v. https://idph.iowa.gov/Portals/1/ SBSPs’ success in reducing caries incidence, and userfiles/34/ohc_school-based-sealants/Sealant challenges in implementing SBSPs and strategies %20Manual%20FINAL%20updated%208-2017.pdf for overcoming these challenges.

Crespin M, Gross-Panico M. 2016. Improving MARYLAND MIGHTY TOOTH: DENTAL oral health with school-based sealant programs. SEALANT GUIDELINES AND OPERATIONS Dimensions of Dental Hygiene 14(6):52–55. MANUAL https://dimensionsofdentalhygiene.com/article/ improving-oral-health-with-school-based-sealant- This manual helps school-based dental sealant programs program personnel design new programs and evaluate and update existing ones. Contents include an introduction to the Maryland Mighty I-SMILE™ @ SCHOOL: 2015 REPORT ON THE Tooth Dental Sealant Program, outcomes and IOWA DEPARTMENT OF PUBLIC HEALTH’S evaluation, and best practices; an overview of SCHOOL-BASED SEALANT PROGRAM information and administrative protocols; a sum- mary of how to operate effective community This report describes the services and impact of programs; a discussion of tooth-surface selec- a school-based dental sealant program to pre- tion, materials, and application techniques; an vent oral disease and improve the oral health of overview of assessment and data collection; lists children in Iowa. The program provides students of relevant health curricula, training programs, with onsite screening, sealants, fluoride varnish, and reports; site reviews; and information about education, and care-coordination services. Topics technical assistance. include trends in the number of children who were screened, the number of children who Maryland Department of Health and Mental received sealants, the number of sealants placed, Hygiene, Office of Oral Health. 2016.Maryland and the number of counties served. The report Mighty Tooth: Dental Sealant Guidelines and also documents the number of cavities averted Operations Manual. Baltimore, MD: Maryland due to program services and gives an example of Department of Health and Mental Hygiene, a success story. Office of Oral Health. 57 pp.http://phpa.dhmh. maryland.gov/oralhealth/docs1/Dental-Sealant- Chickering S, Meister S. 2016. I-Smile™ @ School: Guidelines-Operations-Manual.pdf 2015 Report on the Iowa Department of Public Health’s School-Based Sealant Program. Des Moines, IA: Iowa Department of Public Health, MARYLAND MIGHTY TOOTH: SCHOOL- Bureau of Oral and Health Delivery Systems. 4 pp. BASED DENTAL SEALANT TRAINING http://idph.iowa.gov/Portals/1/userfiles/34/ohc_ PROGRAM reports/iss_report_04142016.pdf This training program for school-based dental sealant program (SBSP) staff in Maryland pro- I-SMILE™ @ SCHOOL: SCHOOL-BASED ORAL vides information about the history, operations, HEALTH PROGRAMS and underlying principles of SBSPs. Topics include guidelines for infection control in SBSPs, This manual outlines expectations of agencies tooth selection and assessment for dental seal- receiving grant funds for school-based dental ants, the sealant-application process, and pro- sealant programs (SBSPs) in Iowa to help them gram operations. Self-assessment quizzes are achieve their program goals. It provides an included. introduction to SBSPs and discusses regulatory

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 15 National Maternal and Child Oral Health 6 pp. https://www.thecommunityguide.org/sites/ Resource Center and Maryland Department of default/files/assets/Oral-Health-Caries-School- Health, Office of Oral Health. 2015–.Mary - based-Sealants_0.pdf land Mighty Tooth: School-Based Dental Sealant Training Program. Washington, DC: National Maternal and Child Oral Health Resource Center; REPORT OF THE SEALANT WORK GROUP: Baltimore, MD: Maryland Department of Health, RECOMMENDATIONS & PRODUCTS Office of Oral Health. Multiple items.http:// mightytoothcurriculum.com This report provides work group recommenda- tions for states to strengthen the ability of school- based dental sealant programs to reach more ORAL HEALTH children, especially those at highest risk for den- tal caries. Contents include recommendations in This document provides information about oral- the following priority areas: promoting evidence- health-related programs and activities conducted based and promising practices; communicating by the Iowa Department of Health. Programs with families, the community, and school staff; include I-Smile, which focuses on oral health collecting, analyzing, and reporting data; address- for infants, children, and pregnant women, and ing Medicaid and reporting data; and addressing I-Smile @ School, which helps local public health Medicaid and regulatory hurdles. A summary of organizations provide oral health screenings, the recommendations, an infographic, a ques- fluoride applications, dental sealants, and oral tions-and-answers document, and a communica- health education to children and adolescents in tions plan worksheet are also available. first through eighth grades. Information about how the department measures its progress, why Sealant Work Group. 2017. Report of the Seal- oral health is important to Iowans, and what ant Work Group: Recommendations & Products. Iowans can do to help is included. Washington, DC: Children’s Dental Health Project. 19 pp. https://s3.amazonaws.com/cdhp/sealants/ Iowa Department of Public Health. 2018. Oral SWG+Report.pdf Health. Des Moines, IA: Iowa Department of Public Health. 2 pp. https://idph.iowa.gov/ Portals/1/About_IDPH/Files/82a0ad69-d092- SCHOOL-BASED DENTAL SEALANT PROGRAM 437b-8fb5-235217adcf5a.pdf MANUAL

This manual provides professional recommenda- ORAL HEALTH: PREVENTING DENTAL CARIES, tions and states’ expectations for school-based SCHOOL-BASED DENTAL SEALANT DELIVERY dental sealant programs under the Ohio Depart- PROGRAMS ment of Health (ODH). Contents include local program operations, regulatory compliance, This report presents the Community Preventive compliance with ODH policies, sealant program Services Task Force recommendation for the use eligibility, sample program forms, clinical mate- of school-based dental sealant programs and the rials and methods, retention checks, Medicaid rationale for that recommendation. The report billing and collection, reimbursement guidelines, explains what dental sealants are, how they are health professional enrollment, filing claims, applied, and what school-based dental sealant performance benchmarks and performance programs do. Also addressed are the basis for the standards, reporting, ODH program reviews, and recommendation, applicability and generalizabil- compliance with other ODH requirements. The ity issues, data-quality issues, other benefits and appendices contain sample forms, records, letters, harms, economic evidence, and evidence gaps. and other practice-related materials. Summary evidence tables on the effectiveness of dental sealants and the effectiveness of school- Ohio Department of Health, Bureau of Maternal, based dental sealant programs are included. Child, and Family Health. 2018. School-Based Dental Sealant Program Manual. Columbus, OH: Community Preventive Services Task Force. 2016. Ohio Department of Health, Bureau of Maternal, Oral Health: Preventing Dental Caries, School- Child, and Family Health. 47 pp. https://www. Based Dental Sealant Delivery Programs. Atlanta, astdd.org/docs/ohio-dental-sealant-manual- GA: Community Preventive Services Task Force. february-2018.pdf

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 16 SCHOOL-BASED DENTAL SEALANT Barzel R, Holt K, Kolo S, Siegal M, eds. 2018. PROGRAMS School-Based Dental Sealant Programs (2nd ed.). Washington, DC: National Maternal and Child This fact sheet for consumers presents informa- Oral Health Resource Center. Multiple items. tion on school-based dental sealant programs https://www.mchoralhealth.org/Dental-Sealant (SBSPs). Topics include what dental sealants are, what SBSPs are, evidence showing that the SBSPs work, and recommendations for SBSPs. Links to SCHOOL DENTAL SEALANT PROGRAMS: resources such as national reports, fact sheets, AT A GLANCE best practices, and research papers are included. This infographic provides information about Centers for Disease Control and Prevention, Divi- school-based dental sealant programs. It includes sion of Oral Health. 2015. School-Based Den- statistical information, recommendations for tal Sealant Programs. Atlanta, GA: Centers for action, and information about the Louisiana Seals Disease Control and Prevention. 1 p. http://www. Smiles program. cdc.gov/OralHealth/dental_sealant_program Louisiana Department of Health, Office of Public Health. 2016. School Dental Sealant Programs: SCHOOL-BASED SEALANT PROGRAMS: At a Glance. Baton Rouge, LA: Louisiana Depart- AN INNOVATIVE APPROACH TO IMPROVE ment of Public Health, Office of Public Health. CHILDREN’S ORAL HEALTH 2 pp. http://wellaheadla.com/Portals/0/Oral%20 Health/Sealant%20One%20Pager.pdf?ver=2017-06- This brief explores the impact of dental caries 19-090353-813 on children’s overall health and academic suc- cess and how North Carolina can take steps to SCHOOL DENTAL SEALANT PROGRAMS improve children’s oral health through the use of school-based dental sealant programs (SBSPs). WHITE PAPER Topics include the impact of dental caries on This paper provides information about school- children’s health and well-being, evidence-based based dental sealant programs (SBSPs). It offers solutions, SBSPs, the impact of SBSPs on chil- background information about tooth decay dren’s oral health outcomes, and North Carolina prevalence and dental sealant prevalence among considerations. Recommendations for ways that children and adolescents and Association of State North Carolina can improve children’s oral health and Territorial Dental Directors recommenda- and academic outcomes are included. tions related to SBSPs. The effectiveness of dental Vidrine S, Hamrick A. 2018. School-Based Sealant sealants for preventing tooth decay is discussed, Programs: An Innovative Approach to Improve along with important considerations for SBSPs, Children’s Oral Health. Raleigh, NC: NC Child. including sealant material selection and staffing 10 pp. http://www.ncchild.org/wp-content/ considerations. uploads/2018/03/FINAL-Oral-Health-Report.pdf Association of State and Territorial Dental Direc- tors. 2017. School Dental Sealant Programs White SCHOOL-BASED DENTAL SEALANT Paper. Reno, NV: Association of State and Territo- PROGRAMS (2ND EDITION) rial Dental Directors. 3pp. https://www.astdd.org/ docs/school-dental-sealant-programs.pdf This curriculum is designed to provide school- based dental sealant program (SBSP) staff with SEAL AMERICA: THE PREVENTION INVENTION an understanding of the history, operations, and principles of SBSPs funded by the Ohio Depart- (3RD EDITION) ment of Health (ODH). Contents include guide- This manual is designed to assist health profes- lines for infection control and information about sionals in launching and sustaining school-based tooth selection and assessment for sealants; the dental sealant programs (SBSPs). In addition to sealant-application process; and SBSP operations, offering a step-wise approach for planning and with an emphasis on requirements that apply to implementing SBSPs, the manual addresses issues programs funded by ODH. [Funded by the Mater- related to referring students with unmet oral nal and Child Health Bureau]

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 17 health needs to a dental clinic or office. Health STATE DENTAL SCREENING LAWS FOR professionals working in established SBSPs may CHILDREN: EXAMINING THE TREND AND also find the manual of interest as they work IMPACT—AN UPDATE TO THE 2008 REPORT to improve specific aspects of their programs. [Funded by the Maternal and Child Health Bureau] This report discusses whether state dental screening laws have expanded since the original Carter NL, Lowe E, with the American Association report was published in 2008 and the degree to for Community Dental Programs and the National which these laws are advancing broader goals Maternal and Child Oral Health Resource Center. to improve access to oral health care and reduce 2016. Seal America: The Prevention Invention oral disease. The report provides background (3rd ed.). Washington, DC: National Maternal and information on how dental screening laws Child Oral Health Resource Center. 1 v. http:// can serve as a policy approach to ensure that mchoralhealth.org/seal children are ready for school, reviews meth- ods and results, and offers a discussion and SEAL IN A SMILE recommendations.

This video for children addresses the importance Children’s Dental Health Project. 2019. State of dental sealants. Live action and animation are Dental Screening Laws for Children: Examin- used to demonstrate what sealants are, how they ing the Trend and Impact—An Update to the prevent tooth decay, and how they are applied. 2008 Report. Washington, DC: Children’s Dental Health Project. 17 pp. https://www.cdhp.org/ Ohio Department of Health, Oral Health Pro- resources/341-state-dental-screening-laws-for- gram; Columbus Public Health Dental Sealant children-examining-the-trend-and-impact Program, East Columbus Elementary, Hamilton Local Elementary. 2016. Seal in a Smile. Colum- bus, OH: Ohio Department of Health. 1 video STATES STALLED ON DENTAL SEALANT (4 min., 21 sec.). http://progressive.powerstream. PROGRAMS net/008/00153/Seal_in_a_Smile_2016.mp4 This report presents findings from a survey of dental directors and state dental boards to assess SEAL RI! SCHOOL BASED DENTAL SEALANT progress on four benchmarks reflecting the reach, PROGRAM 2013–14 efficiency, and effectiveness of state school-based dental sealant programs (SBSPs). Topics include This map provides data from SEAL RI!, a partner- the extent to which SBSPs are serving high-need ship between the Rhode Island Department of schools, whether dental hygienists are allowed to Health and community organizations to provide place sealants in SBSPs without a dentist’s prior free oral health services, such as dental sealants, exam, whether states collect data and participate to children in school. Contents are presented in a national database, and the proportion of stu- by school district. Selected topics include the dents receiving sealants across the state. State fact percentage of schools served by SEAL RI!, the sheets are also available. percentage of schools with 50 percent or more students eligible for the National School Lunch Children’s Dental Policy. 2015. States Stalled Program and served by SEAL RI!, the percentage on Dental Sealant Programs. Philadelphia, PA: of students in first through third grades screened Pew Charitable Trusts. 25 pp. http://www. by SEAL RI!, and the percentage of students in pewtrusts.org/~/media/Assets/2015/04/Dental_ first through third grades who received at least SealantReport_Final.pdf one first molar sealant.

Rhode Island Department of Health, SEAL RI! Program. 2015. SEAL RI! School Based Dental Sealant Program 2013 –14. Providence, RI: Rhode Island Department of Health, SEAL RI! Program. 1 p. http://rihealth.maps.arcgis.com/apps/Map Tour/?appid=e4543f8a3d6d431e9cedef37c295832a

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 18 WHEN REGULATIONS BLOCK ACCESS TO Education ORAL HEALTH CARE, CHILDREN AT RISK SUFFER: THE SCHOOL DENTAL SEALANT #MYSMILEMATTERS NATIONAL YOUTH PROGRAM DILEMMA ENGAGEMENT PLAN This brief describes state-based regulations or This document presents a model for helping ado- policies (e.g., related to dental practice acts, oral lescents and adults integrate oral health advocacy, exams, employment requirements, procedures learning, and teaching opportunities into their allowed under general supervision, Medicaid) schools and communities. Contents include activi- that limit or prevent dental hygienists from apply- ties to increase oral by changing ing dental sealants to children’s teeth at school beliefs, activities to change oral health habits by or that create a financial burden for school-based changing behavior, and activities to affect whole dental sealant programs. The brief also discusses populations by changing the environment. The responses from a questionnaire for state dental plan also outlines steps for adolescents and youth directors. groups to become members of the #MySmileMat- Pew Charitable Trusts. 2018. When Regulations ters Youth Movement, a national initiative to Block Access to Oral Health Care, Children at engage adolescents in oral health and wellness. Risk Suffer: The School Dental Sealant Program National Children’s Oral Health Foundation. Dilemma. Philadelphia, PA: Pew Charitable 2016. #MySmileMatters National Youth Engage- Trusts. 12 pp. http://www.pewtrusts.org/en/ ment Plan. Charlotte, NC: National Children’s research-and-analysis/issue-briefs/2018/08/when- Oral Health Foundation. 11 pp. http://bit.ly/ regulations-block-access-to-oral-health-care- YthEngPlan2016 children-at-risk-suffer#0-overview

ADOLESCENT ORAL HEALTH CAMPAIGN WISCONSIN SEAL-A-SMILE ADMINISTRATION FINAL REPORT: 2016–2017 SCHOOL YEAR MANUAL This final report provides information about This manual provides policies and procedures for activities of the Adolescent Oral Health Campaign all Wisconsin Seal-A-Smile (SAS) grantees, with during academic year 2016–2017. The purpose of the goal of helping them administer programs the campaign was to educate students in middle and ensure consistency across programs. The school and high school in Utah, especially along purpose of SAS is to improve the oral health of the Wasatch Front, about oral health. The goal Wisconsin children through school-based dental was to increase positive oral health behaviors sealant programs. Topics include administrative and increase use of oral health services. The and regulatory guidelines; program requirements; report describes the campaign’s goals, objectives, forms, reporting, and recording; and budget and methods, and results. funding information. Information about infection control and safe delivery of oral health care out- Neufeld L, Gero A. 2017. Adolescent Oral Health side the dental office is included in appendices. Campaign Final Report: 2016 –2017 School Year. Salt Lake City, UT: Utah Department of Health, Children’s Health Alliance of Wisconsin. 2018. Oral Health Program. 9 pp. http://health.utah. Wisconsin Seal-A-Smile Administration Manual. gov/oralhealth/resources/reports/2016-2017- Milwaukee, WI: Children’s Health Alliance of Adolescent%20Oral%20Health.pdf Wisconsin. 35 pp. https://www.chawisconsin.org/ download/seal-a-smile-admin-manual CHILDREN’S DENTAL HEALTH BOOKS

This resource lists books about oral health for children under age 7. Topics include self-care, general information about teeth, and visiting the dentist. Spanish-language books and information about the book-review process and the interpro- fessional review team are included, along with an evaluation tool.

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 19 University of Maryland Health Sciences and FROM DROOL TO SCHOOL: CARING FOR Human Services Library Interprofessional Review YOUR CHILD’S ORAL HEALTH FROM THE Team. 2015. Children’s Dental Health Books. DROOL YEARS THROUGH THE SCHOOL YEARS Baltimore, MD: University of Maryland, Health Sciences and Human Services Library. 1 v. http:// This booklet for parents provides information, guides.hshsl.umaryland.edu/dentistry/Dental tips, and resources on how to care for their BooksForChildren infant’s or child’s oral health from birth through the elementary school years. The booklet also includes information about how to find and pay CHILDREN’S ORAL HEALTH for oral health care and activities that parents can These public-awareness-campaign materials do with their child to help them learn together are designed for use during Children’s Dental about the importance of good oral health. The Health Month (February) to encourage good oral booklet is available in Arabic, English, and Span- health for children of all ages. Contents include ish. A brochure and video are also available. activity sheets; a guide for parents; a poster for Delta Dental Foundation, Michigan Dental Asso- displaying in an office waiting room; a certifi- ciation Foundation. 2015. From Drool to School: cate to present to children; tools for classroom Caring for Your Child’s Oral Health from the educators (customizable letter and teacher’s Drool Years Through the School Years. Lansing, guide); and classroom resources, including lesson MI: Delta Dental Plan of Michigan. 56 pp. https:// plans, demos and videos, and frequently asked www.deltadentalmi.com/MediaLibraries/Global/ questions. documents/From-Drool-to-School-Book-DIGITAL. Procter and Gamble Company. 2016. Chil- pdf dren’s Oral Health. Cincinnati, OH: Procter and Gamble Company. Multiple items. https:// ORAL HEALTH FOR CHILDREN AND www.dentalcare.com/en-us/patient-education/ ADOLESCENTS: HOW CAN YOU HELP? childrens-dental-health This document, which is geared toward parents, FEBRUARY IS NATIONAL CHILDREN’S DENTAL explains why oral health is important and how to help prevent dental caries and other oral health HEALTH MONTH problems. The document presents a series of These materials are designed to help health pro- questions about school health services, includ- fessionals and educators raise awareness about ing oral health services, that can help parents the importance of oral health during National support their child’s school’s efforts to address Children’s Dental Health Month (February). oral health. Other questions presented cover oral The 2019 campaign slogan is “Brush and clean health education, bullying prevention, how teach- in between to build a healthy smile.” Contents ers reward students (i.e., with food or nonfood include a program-planning guide, press releases, items), and whether students have access to free broadcasting tips, sample newspaper articles, and clean drinking water, The document explains posters, and activity sheets in English and Span- how to find answers to the questions for those ish for children and adolescents. that don’t know how to answer them.

American Dental Association. 2018. February Centers for Disease Control and Prevention, Is National Children’s Dental Health Month. National Center for Chronic Disease Prevention Chicago, IL: American Dental Association, and Health Promotion. No date. Oral Health for Division of Communications. Multiple items. Children and Adolescents: How Can You Help? http://www.ada.org/en/public-programs/ Atlanta, GA: Centers for Disease Control and national-childrens-dental-health-month Prevention, National Center for Chronic Disease Prevention and Health Promotion. 1 p. https:// www.cdc.gov/healthyschools/parentengagement/ pdf/P4HS_OralHealth.pdf

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 20 SMILE SAVERS ACTIVITY BOOKS Association of State and Territorial Dental Direc- tors. 2018. Best Practice Approach Report: Use These activity books provide information about of Fluoride in Schools. Reno, NV: Association oral health and promote oral health to children. of State and Territorial Dental Directors. 24 pp. One book is for children from kindergarten to https://www.astdd.org/docs/final-approved- fourth grade, and the other is for children in fifth fluoride-in-schools-bpar-july-2018.pdf grade and up. Activities include coloring sheets, crossword puzzles, word games, and comics that can be colored. FLUORIDE MOUTHRINSE PROGRAM MANUAL Alabama Department of Public Health, Oral Health Office with Troy University. 2016.Smile This manual provides school personnel and Savers Activity Books. Montgomery, AL: Alabama volunteers with procedures and requirements for Department of Public Health, Office of Oral administering and implementing a school-based Health. 2 v. http://www.alabamapublichealth. fluoride mouthrinse program in Ohio. Topics gov/oralhealth/education.html include program roles, responsibilities, and oper- ation; administration guidelines; recommenda- tions for teachers; and program implementation YOUR TEENS MAY THINK THAT THEY DON’T and site visits. Forms and procedural options, NEED YOU ANYMORE, BUT THEY’LL ALWAYS including adaptations for students with special NEED THEIR TEETH! health care needs, are included.

These resources for parents provide guidance Ohio Department of Health, Oral Health Pro- on helping adolescents make decisions that gram. 2016. Fluoride Mouthrinse Program affect their oral health and overall health. Top- Manual. Columbus, OH: Ohio Department of ics include toothbrushing, flossing, visiting the Health, Oral Health Program. 28 pp. https://odh. dentist, eating healthy foods, avoiding tobacco, ohio.gov/wps/wcm/connect/gov/d41a40d0-372b- and drinking water with fluoride. The resources 4b03-bbe5-3f1b940336b6/Fluoride+Mouthrinse+ are available in English and Spanish. Program+Manual.pdf?MOD=AJPERES&CONVERT_ TO=url&CACHEID=ROOTWORKSPACE.Z18_M1 American Academy of Pediatrics, Campaign for HGGIK0N0JO00QO9DDDDM3000-d41a40d0- Dental Health. 2017. Your Teens May Think That 372b-4b03-bbe5-3f1b940336b6-mzCAu64 They Don’t Need You Anymore, But They’ll Always Need Their Teeth! Elk Grove Village, IL: American Academy of Pediatrics, Campaign for Dental FLUORIDE VARNISH: AN EVIDENCE-BASED Health. 3 items. http://ilikemyteeth.org/teens- APPROACH—RESEARCH BRIEF may-think-dont-need-anymore-theyll-always- need-teeth This brief presents information to help health professionals design, implement, and evaluate community-based programs that apply fluoride varnish. Topics include a definition of fluo- Fluorides ride varnish and how it prevents tooth decay; the characteristics, effectiveness, and safety of BEST PRACTICE APPROACH REPORT: USE OF fluoride varnish; and recommendations for using FLUORIDE IN SCHOOLS fluoride varnish. The brief also provides tips for selecting cost-effective community and school This report focuses on best practices for the use dental-caries-prevention programs. of fluoride in schools. It discusses fluoride as a measure to prevent tooth decay in children, Association of State and Territorial Dental Direc- different types of programs that provide fluo- tors, Fluorides Committee. 2016. Fluoride Var- ride to children, and different forms of fluoride. nish: An Evidence-Based Approach—Research Evidence for the efficacy of fluoride in prevent- Brief. Reno, NV: Association of State and Ter- ing tooth decay and best practice criteria are ritorial Dental Directors. 19 pp. http://www. provided. The report also includes state practice astdd.org/docs/fl-varnish-brief-september-2014- examples. amended-05-2016.docx

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 21 I LIKE MY TEETH [POSTERS] IL: Illinois Department of Public Health. 3 pp. http://www.dph.illinois.gov/sites/default/files/ These posters for consumers share simple, posi- publications/publicationsohpmsdf-guidance_0.pdf tive messages about brushing children’s teeth with fluoridated , drinking fluoridated water, eating a , and talking to the SDF: GIVING VERY YOUNG CHILDREN dentist or doctor about fluoride treatments for SOMETHING TO SMILE ABOUT children. The posters are available in English and Spanish. This video provides information about using silver diamine fluoride (SDF) to arrest dental caries in National Center on Early Childhood Health and young children. The video provides background Wellness. 2017. I Like My Teeth [posters]. Elk on SDF. It discusses the safety, efficacy, and cost Grove Village, IL: National Center on Early Child- of SDF treatment and the advantages and disad- hood Health and Wellness. 8 items. https://eclkc. vantages of SDF over alternative approaches to ohs.acf.hhs.gov/oral-health/article/oral-health- treating dental caries in young children. The video resources-staff also shows how SDF is applied and provides information about insurance coverage for SDF INFORMED CONSENT FOR SILVER DIAMINE treatment in North Carolina. FLUORIDE Raskin M. 2019. SDF: Giving Very Young Children Something to Smile About. Chapel Hill, NC: Uni- This form is designed to assist oral health profes- versity of North Carolina at Chapel Hill; Raleigh, sionals in obtaining patient consent for use of NC: North Carolina Division of Public Health Oral silver diamine fluoride (SDF) to arrest dental car- Health Section. 1 video (7:53 minutes). http:// ies. Contents include facts about SDF, including toothtalk.org/portfolio-view/sdf-giving-very- potential risks, and alternatives to using SDF. A young-children-something-to-smile-about photo of how teeth may look after SDF treatment is included. The form is available in Chinese, English, and Spanish. SILVER DIAMINE FLUORIDE

San Francisco Department of Public Health, This fact sheet for consumers provides infor- Dental Services. 2016. Informed Consent for mation about silver diamine fluoride (SDF). It Silver Diamine Fluoride. San Francisco, CA: San explains what SDF is, how it is applied, and who Francisco Department of Public Health, Dental should and should not receive SDF treatment. Services. 1 p. http://www.nnoha.org/nnoha- Photographs of teeth before and after SDF appli- content/uploads/2016/11/Consent-SDF-SFDPH- cation are included. Chinese.pdf (Chinese), http://www.nnoha.org/ nnoha-content/uploads/2016/11/Consent-SDF- Apple Tree Dental. 2017. Silver Diamine Fluo- SFDPH-Eng.pdf (English), http://www.nnoha.org/ ride. Rochester, MN: Apple Tree Dental. 1 p. nnoha-content/uploads/2016/11/Consent-SDF- https://www.appletreedental.org/wp-content/ SFDPH-Spanish.pdf (Spanish) uploads/2018/09/Patient-Education-SDF-SILVER- DIAMINE-FLUORIDE-all-ages-2017.pdf PUBLIC HEALTH INTERVENTION: USE OF SILVER DIAMINE FLUORIDE FOR ARRESTING SILVER DIAMINE FLUORIDE: A NEW DENTAL CARIES TREATMENT FOR CAVITIES

This document provides information about silver This brochure provides information about silver diamine fluoride (SDF) and how it can be used diamine fluoride and how it is used to arrest to arrest dental caries. Topics include background dental caries in children and adults. The brochure information, indications for use of SDF in chil- explains what silver diamine fluoride is; provides dren and adults, information about clinical appli- detailed steps for applying it; and discusses indi- cations and safety, and clinical protocols. cations for use, benefits, risks, drawbacks, and contraindications. Illinois Department of Public Health. 2017. Public Health Intervention: Use of Silver Diamine Fluoride for Arresting Dental Caries. Springfield,

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 22 Center of Franklin County. SILVER DIAMINE FLUORIDE (SDF) FACT SHEET No date. Silver Diamine Fluoride: A New Treat- ment for Cavities. Turners Falls, MA: Community This fact sheet defines silver diamine fluoride Health Center of Franklin County. 2 pp. http:// (SDF) and describes the evidence base for using www.chcfc.org/uploads/2/0/9/1/20916560/silver_ it to control dental caries. Topics include indica- diamine_fluoride_brochure.pdf tions, contraindications, and other considerations; recommended protocols; using SDF in addition to fluoride varnish, other professionally applied SILVER DIAMINE FLUORIDE PROTOCOL fluorides, or dental sealants; Medicaid reimburse- ment; and who can apply SDF. This document provides information about silver diamine fluoride (SDF) and how to use it. The Association of State and Territorial Dental Direc- document provides background information and tors. 2017. Silver Diamine Fluoride (SDF) Fact discusses the efficacy and safety of SDF, require- Sheet. Reno, NV: Association of State and Territo- ments for applying it in Iowa, indications and rial Dental Directors. 2 pp. http://www.astdd.org/ contraindications for application in children www/docs/sdf-fact-sheet-09-07-2017.pdf and adults, how to apply SDF, and frequency of application for best results. Iowa Department of Public Health. 2018. Sil- Nutrition ver Diamine Fluoride Protocol. Des Moines, IA: Iowa Department of Public Health. 3 pp. https:// KIDS AND DRINKING WATER: A GLASS HALF idph.iowa.gov/Portals/1/userfiles/222/Silver%20 FULL OR HALF EMPTY? Diamine%20Fluoride%20Protocol_IDPH_8_2018. pdf This paper discusses the importance of children drinking water. Contents include information SILVER DIAMINE FLUORIDE (SDF) about the importance of water consumption in preventing chronic disease; obstacles to ensuring APPLICATION: EVIDENCE-BASED that students have access to clean, safe drink- RECOMMENDATIONS ing water in schools; drinking water challenges in communities; and opportunities for health This video presents recommendations from funders to increase children’s access to and the 2018 American Dental Association clinical consumption of free, safe drinking water. Topics practice guideline on nonrestorative treatments, include improving access, prioritizing education, including silver diamine fluoride (SDF), for cari- funding data collection and research, promot- ous lesions. The safety of SDF is discussed, along ing multisectoral partnerships, and advocating with scientific evidence and recommendations for supportive policies. A policy framework to for its use. Guidance for dentists on how to use support healthy development in all children by a risk-assessment approach to determine whether investing in accessible, safe drinking water is the use of SDF is appropriate for patients is included. provided, along with guidance on how to talk to patients about use of SDF and other treatment Braff-Guajardo E, Hecht K. 2015. Kids and Drink- options. A four-step process for applying SDF is ing Water: A Glass Half Full or Half Empty? Wash- included, along with guidance on how to deter- ington, DC: Grantmakers In Health. 3 pp. http:// mine whether reapplication is needed. www.gih.org/files/FileDownloads/Kids%5Fand% 5FDrinking%5FWater%5FKellogg%5FUC%5FMay Chicago, IL: American Dental Association. 2018. %5F2015.pdf Silver Diamine Fluoride (SDF) Application: Evidence-Based Recommendations. Chicago, IL: American Dental Association. 1 video (5:36 min- utes). https://www.youtube.com/watch?v=a0HH7 GifdM4&feature=youtu.be

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 23 LESSONS IN A LUNCH BOX: HEALTHY TEETH and adults. Information about reading nutrition ESSENTIALS & FACTS ABOUT SNACKS™ labels, limiting juice, and choosing water is pro- vided. A form for ordering a drink display kit is This lunch box provides families with informa- also available. tion about oral health, healthy food choices, and other related topics. The lunch box is illustrated Delta Dental of Michigan, Ohio, and Indiana. with drawings that promote good oral health 2016. Rethink Your Drink, Think Water. Okemos, and good nutrition and contains a “Dental Care MI: Delta Dental Foundation. 2 items. https:// in a Carrot” case made to include a , www.deltadentalmi.com/Hidden-Pages/Rethink- toothpaste, , and a rinse cup. Order- Your-Drink-Brochure-WEB (brochure), http:// ing information; downloadable PDFs, including a www.deltadentalmi.com/MediaLibraries/Global/ description of the program, a 5-day lesson guide documents/Rethink-Your-Drink-Poster.pdf for teachers, and an outline of the lessons; a (poster) video about the program; and other supplemental materials are available on the website. The lunch WATER FIRST: A TOOLKIT FOR PROMOTING box is also available in braille. WATER INTAKE IN COMMUNITY SETTINGS The Children’s Oral Health Institute. No date. Lessons in a Lunch Box: Healthy Teeth Essentials This guide is designed to help communities & Facts About Snacks™. Owings Mills, MD: The prevent dental caries and by promot- Children’s Oral Health Institute. Multiple items. ing drinking water as an alternative to sugar- http://www.mycohi.org/lunchbox.html sweetened beverages. Contents include strategies for building a team and defining and spreading the message in child care facilities, clinics, parks, PARENTS MAKING WAVES: A TOOLKIT FOR schools, and other community-based settings. A PROMOTING DRINKING WATER IN SCHOOLS two-page fact sheet is also available.

This toolkit is designed to help parents improve Hecht A, Buck S, Patel A. 2016. Water First: A access to drinking water at school. Contents Toolkit for Promoting Water Intake in Community include a tip sheet, a sample school-wellness Settings. Battle Creek, MI: W. K. Kellogg Founda- policy and letter to a school administrator, tools tion. 2 items. http://cfpa.net/Water/WaterToolkits/ for conducting a drinking water inventory and Water%20First/WaterFirst%20Toolkit-Final.pdf observing students drinking water, and an action plan checklist. Topics include how to fund a WATER, WATER EVERYWHERE! school water program, ensuring that school water is safe, understanding sources, and This tip sheet provides information about how to promoting water intake in schools. encourage children to drink more water. Topics include overcoming challenges, creative ideas Gutierrez H, Hampton K, Hecht A, Patel A. 2016. for encouraging children to try water, facts about Parents Making Waves: A Toolkit for Promot- water, why it is important for children to drink ing Drinking Water in Schools. San Francisco, water, and the advantages of drinking tap water CA: University of California, San Francisco and vs. bottled water. Links to additional resources California Food Policy Advocates, and Enigami are included. Ventures. 40 pp. http://waterinschools.org/ parents-making-waves Out of School Nutrition and Physical Initiative, Harvard School of Public Health Prevention Water, Water Every- RETHINK YOUR DRINK, THINK WATER Research Center. No date. where! Boston, MA: Out of School Nutrition These resources provide information about sugar- and Physical Initiative, Harvard School of Public sweetened beverages (SSBs) and tips on healthy Health Prevention Research Center. 2 pp. http:// alternatives. Contents include a poster and a bro- www.foodandfun.org/resources/pdf/tips/water. chure. Topics include the potential impact of SSB pdf consumption on oral health; the amount of sugar in different beverages; and recommended daily limits on sugar for infants, children, adolescents,

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 24 Program Development INTEGRATING SUSTAINABLE ORAL HEALTH SERVICES INTO PRIMARY CARE IN SCHOOL- BEST PRACTICE APPROACH: IMPROVING BASED HEALTH CENTERS: A FRAMEWORK CHILDREN’S ORAL HEALTH THROUGH THE This framework offers ideas for school-based WHOLE SCHOOL, WHOLE COMMUNITY, health centers (SBHCs) to consider when inte- WHOLE CHILD (WSCC) MODEL grating sustainable comprehensive oral health services into primary care to improve the quality This report discusses the Whole School, Whole of oral health care of school-age children and Community, Whole Child (WSCC) model, adolescents. The framework presents a descrip- assesses the strength of evidence for the tion of six levels of integration to help SBHCs effectiveness of this model, and uses practice evaluate their current level of integration and 10 examples to illustrate successful and innovative key elements to more fully integrate sustainable implementation of the model. The report pro- comprehensive oral health services into primary vides guidelines and recommendations, support care in SBHCs. [Funded by the Maternal and for the WSCC model, research evidence, best Child Health Bureau] practice criteria, and state practice examples. Lowe E, Barzel R, Holt K. 2016. Integrating Association of State and Territorial Dental Direc- Sustainable Oral Health Services into Primary tors. 2017. Best Practice Approach: Improving Care in School-Based Health Centers: A Frame- Children’s Oral Health Through the Whole School, work. Washington, DC: National Maternal and Whole Community, Whole Child (WSCC) Model. Child Oral Health Resource Center. 1 v. http:// Reno, NV: Association of State and Territorial mchoralhealth.org/framework Dental Directors. 27 pp. https://www.astdd.org/ bestpractices/wscc-bpar-final-3-2017.pdf PROMOTING HEALTHY SMILES THROUGH EDUCATION AND PREVENTION: PREVENTIVE IMPROVING LIFETIME ORAL HEALTH: SERVICES PROGRAM 2017–2018—FINAL POLICY OPTIONS AND INNOVATIONS SCHOOL YEAR REPORT

This brief highlights targeted state policy options This report provides information about the Mis- for improving oral health for children, adoles- souri Oral Health Preventive Services Program cents, and adults and system-level reforms to (PSP). The report includes background informa- improve oral health care and reduce its cost for tion about the importance of oral health; PSP everyone. Topics include assessing and screen- participant numbers and demographics; and ing in primary care settings, expanding access to information about participants’ oral hygiene, school-based prevention and care, raising aware- untreated tooth decay, and dental sealant status ness about healthy behaviors, expanding cover- and about their access to community fluoridated age for adults with low incomes, and ensuring water. Follow-up care recommendations are an adequate oral health work force. Additional included. Statistical information is presented in topics include improving oral health care access charts throughout the report. for pregnant women, coordinating primary care and oral health, expanding access to providers Missouri Department of Health and Senior Ser- through teledentistry, understanding the state role vices, Oral Health Program. 2018. Promoting in community water fluoridation, and maximizing Healthy Smiles Through Education and Preven- data. tion: Preventive Services Program 2017–2018 — Final School Year Report. Jefferson City, MO: Improving Lifetime Johnson T, Goodwin K. 2016. Missouri Department of Health and Senior Ser- Oral Health: Policy Options and Innovations. vices, Oral Health Program. 36 pp. https://health. Denver, CO: National Conference of State Leg- mo.gov/blogs/wp-content/uploads/2019/05/psp- islatures. 11 pp. http://www.ncsl.org/Portals/1/ report.pdf Documents/Health/LifetimeOralHealthpub2016. pdf

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 25 REPORT ON PROGRESS TOWARDS THE 2018 SMART MOUTHS, SMART KIDS: IMPROVING MILESTONES DENTAL HEALTH FOR COLORADO STUDENTS

This report presents Oral Health Progress and This toolkit provides information and resources Equity Network (OPEN)—a network working on assessing the feasibility of initiating school- toward framing oral health as health and focus- linked oral health services and designing and ing on oral health across the lifespan—2018 building a sustainable school oral health pro- milestones set to serve as indicators of prog- gram. Contents include resources for generating ress toward fulfillment of its 2020 targets. The ideas, assessing community needs, creating a report discusses the importance of each target to budget, developing a business plan, providing achieving oral health and overall health across a rationale for activities, framing an idea, build- the lifespan and describes progress toward each ing a program, and maintaining and sustaining a milestone. The report also includes an introduc- successful school oral health program. The toolkit tion to OPEN, discusses methodology, and pres- also includes a data application (a targeted and ents findings of the 2018 milestone assessment in focused electronic health record) that can be the following areas: children, schools, Medicare, used to monitor children’s oral health status over Medicaid, measurement, person-centered care, time. and public perception. Oral Health Colorado. 2015. Smart Mouths, Smart Chazin S, Bond M. 2018. Report on Progress Kids: Improving Dental Health for Colorado Stu- Towards the 2018 Milestones. Boston, MA: Oral dents. Nederland, CO: Oral Health Colorado. 1 v. Health Progress and Equity Network. 61 pp. http://smartmouthssmartkids.org http://www.oralhealth.network/d/do/1092 SMILECONNECT SCHOOL ORAL HEALTH: AN ORGANIZATIONAL FRAMEWORK TO This integrated care model emphasizes multidisci- plinary service delivery through provider educa- IMPROVE OUTCOMES FOR CHILDREN AND tion, information technology, and community ADOLESCENTS outreach to improve access to oral health care for children. Users can create an account and request This paper presents a framework for how oral health curricula, classroom materials, and communities can achieve improved and more supplies; screening and preventive services; and equitable oral health outcomes. The framework educational materials for children and parents. includes five components: oral health education, The application also provides news, statistics on oral health screening, preventive oral health care, children’s oral health, information and resources care coordination and linkage to community- about the impact of oral health on overall health, based care, and preventive oral health care and and links to organizations that may serve as oral health treatment in schools. Data collection resources. Information for volunteers (dental and sustainability are discussed, and next steps school and dental hygiene program administra- are presented. tors and students, oral health professionals) and School-Based Health Alliance and Oral Health organizational sponsor-donors is also provided. 2020 Network. 2018. School Oral Health: An Altarum Institute. 2016–. SmileConnect. Ann Organizational Framework to Improve Out- Arbor, MI: Altarum Institute. Multiple items. comes for Children and Adolescents. Washing- https://www.smileconnect.org ton, DC: School-Based Health Alliance; Oral Health 2020 Network. 9 pp. http://www.sbh4all. org/wp-content/uploads/2018/04/DQF_WP_ SchoolOralHealth_F.pdf

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 26 Federally Funded Project CHILDREN’S ORAL HEALTHCARE ACCESS PROGRAM [FINAL REPORT] Final Reports This report describes a project to expand preven- tive school-based oral health services to include CHILDREN’S ORAL HEALTHCARE ACCESS restorative care in four high-need rural school PROGRAM [FINAL REPORT] districts in New York. Topics include delivery-sys- tem design, interdisciplinary care, client/commu- This report describes a project to build a dental nity education, continuous quality improvement, clinic and provide comprehensive oral health sustainability, evaluation, and resources and services to students attending a combined capabilities. Appendices include the project ser- elementary and middle school (kindergarten vices timeline, a risk-assessment tool, a workflow through eighth grade) in Lemon Grove, CA. Top- diagram, enrollment and consent forms, posters, ics include delivery-system design, interdisciplin- a brochure, video links, promotional materials, ary care, client/community education, continuous a satisfaction survey, and a press release. The quality improvement, sustainability, evaluation, process, outcome, and impact indicators/minimal and resources and capabilities. Appendices data set is also provided. [Funded by the Mater- include an announcement about the clinic nal and Child Health Bureau] opening, sample forms in English and Spanish, a needs-assessment cover letter and survey, a Hamilton J. 2016. Children’s Oral Healthcare program brochure, and a memorandum of under- Access Program [final report]. Cooperstown, NY: standing between the university and the school Mary Imogene Bassett Hospital. 22 pp. http:// district. The process, outcome, and impact indica- mchoralhealth.org/projects/sbcohs.php tors/minimal data set is also provided. [Funded by the Maternal and Child Health Bureau] CHILDREN’S ORAL HEALTHCARE ACCESS Anastos E. 2016. Children’s Oral Healthcare PROGRAM [FINAL REPORT] Access Program [final report]. Lemon Grove, CA: Lemon Grove School District. 16 pp., including This report describes a project to expand a attachments. http://mchoralhealth.org/projects/ school-based health center oral health program in sbcohs.php East Hartford, CT. Topics include delivery-system design, interdisciplinary care, client/community education, continuous quality improvement, sus- CHILDREN’S ORAL HEALTHCARE ACCESS tainability, evaluation, and resources and capabil- PROGRAM [FINAL REPORT] ities. The appendices include parent permission forms for screening and treatment in English and This report describes a project to implement Spanish, a program brochure, a referral list and comprehensive oral health services in two forms, and a sterilization log. The process, out- school-based health centers operating in the Los come, and impact indicators/minimal data set is Angeles Unified School District. Topics include also provided. [Funded by the Maternal and Child delivery-system design, interdisciplinary care, Health Bureau] client/community education, continuous qual- ity improvement (CQI), sustainability, evalua- Poerio D. 2016. Children’s Oral Healthcare Access tion, and resources and capabilities. Appendices Program [final report]. East Hartford, CT: Inte- include the CQI plan, integration report, opera- grated Health Services. 16 pp. http://mchoral tions manual, and spatial analysis. A break-even health.org/projects/sbcohs.php analysis and process, outcome, and impact indicators/minimal data set are also provided. [Funded by the Maternal and Child Health Bureau]

Barzaga C. 2016. Children’s Oral Healthcare Access Program [final report]. Pomona, CA: Cen- ter for Oral Health. 19 pp., including appendices. http://mchoralhealth.org/projects/sbcohs.php

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 27 CHILDREN’S ORAL HEALTHCARE ACCESS SCHOOL BASED COMPREHENSIVE ORAL PROGRAM [FINAL REPORT] HEALTH SERVICES GRANT PROGRAM FINAL REPORT This report describes a project to integrate com- prehensive oral health care into a school-based This report describes a project to provide access health center in Minneapolis, MN. Topics include to preventive and restorative oral health care, delivery-system design, interdisciplinary care, demonstrate a decrease in dental caries inci- client/community education, continuous quality dence, show an increase in oral health literacy, improvement (CQI), sustainability, evaluation, and create a financially sustainable oral health and resources and capabilities. A project bro- program for children in Summit County, CO. Top- chure; a CQI plan; a memorandum of under- ics include delivery-system design, interdisciplin- standing template; a permission form; and the ary care, client/community education, continuous process, outcome, and impact indicators/minimal quality improvement, sustainability, evaluation, data set are also available. [Funded by the Mater- and resources and capabilities. Appendices nal and Child Health Bureau] include a memorandum of understanding, enroll- ment and send-home forms, a permission form Children’s Oral Healthcare Wovcha S. 2016. in English and Spanish, a screening survey tool, a Access Program [final report]. Minneapolis, MN: student quiz, and a list of advisory board mem- Children’s Dental Services. 26 pp., including bers. The process, outcome, and impact indica- appendices. http://mchoralhealth.org/projects/ tors/minimal data set is also provided. [Funded sbcohs.php by the Maternal and Child Health Bureau]

Major E. 2016. School Based Comprehensive Oral NYS SCHOOL-BASED COMPREHENSIVE Health Services Grant Program Final Report. ORAL HEALTHCARE SERVICES PROJECT: Frisco, CO: Summit Community Care Clinic. 17 pp. FINAL REPORT 2011–2015 http://mchoralhealth.org/projects/sbcohs.php This report describes a project to improve the oral health of school-age children in an area in SCHOOL BASED COMPREHENSIVE ORAL New York where there is a health professional HEALTH SERVICES GRANT PROGRAM FINAL shortage and most residents have low incomes. REPORT Topics include delivery-system design, inter- disciplinary care, client/community education, This report describes a community health cen- continuous quality improvement, sustainability, ter–university partnership to establish accessible, evaluation, and resources and capabilities. Links affordable, high-quality oral health care for stu- to a cover letter and combined enrollment form; dents by operationalizing a mobile dental van on links to video programs; and the process, out- school property. Topics include delivery-system come, and impact indicators/minimal data set are design, interdisciplinary care, client/community also provided. [Funded by the Maternal and Child education, continuous quality improvement Health Bureau] (CQI), sustainability, evaluation, and resources and capabilities. Appendices include the CQI NYS School- Greenberg B, Saglimbeni M. 2016. plan, a memorandum of understanding, a presen- Based Comprehensive Oral Healthcare Services tation, informed consent forms, and marketing Project: Final Report 2011–2015. Albany, NY: and outreach materials. The process, outcome, New York State Department of Health; Menands, and impact indicators/minimal data set is also NY: Health Research. 25 pp., including appendi- provided. [Funded by the Maternal and Child ces. http://mchoralhealth.org/projects/sbcohs.php Health Bureau]

Sherer E. 2016. School Based Comprehensive Oral Health Services Grant Program Final Report. Den- ver, CO: University of Colorado Denver, College of Nursing. 15 pp., including appendix. http:// mchoralhealth.org/projects/sbcohs.php

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 28 Organizations Organizations

AMERICAN ACADEMY OF FAMILY Section on Oral Health PHYSICIANS Website: https://www.aap.org/en-us/about-the- 11400 Tomahawk Creek Parkway aap/Sections/Section-on-Oral-Health/Pages/ Leawood, KS 66211-2680 SOOH.aspx Telephone: (800) 274-2237 AAP’s Section on Oral Health employs mul- E-mail: [email protected] tiple forums to educate pediatricians; pediat- Website: http://www.aafp.org/home.html ric dentists; physician assistants; allied health The American Academy of Family Physicians professionals including dental hygienists, dental works to transform health care and improve the assistants, nurses, and nurse practitioners; health of individuals, families, and communities pediatric residents; and pediatric dental resi- by serving the needs of family physicians. dents. The section also focuses on advocacy for children’s oral health and on improving rela- tionships and communication between dental AMERICAN ACADEMY OF PEDIATRIC homes and medical homes. 211 East Chicago Avenue, Suite 1600 AMERICAN ASSOCIATION OF PUBLIC Chicago, IL 60611-2637 HEALTH DENTISTRY Telephone: (312) 337-2169 Website: http://www.aapd.org P.O. Box 7317 Springfield, IL 62791-7317 The American Academy of Website: http://www.aaphd.org (AAPD) works to achieve optimal oral health for all children and adolescents, including those with The American Association of Public Health special health care needs. AAPD serves primary Dentistry works to improve health for all citizens care and pediatric dentists, as well as through the development and support of effec- general dentists who treat children and adoles- tive oral-health-promotion and disease-prevention cents in their practices. programs.

AMERICAN ACADEMY OF PEDIATRICS AMERICAN DENTAL ASSOCIATION 345 Park Boulevard 211 East Chicago Avenue Itasca, IL 60143 Chicago, IL 60611-2678 Website: http://www.aap.org Telephone: (312) 440-2500 Website: http://www.ada.org; http://www.mouth Campaign for Dental Health healthy.org E-mail: [email protected] Website: http://ilikemyteeth.org The American Dental Association provides oral health information to dentists and consumers and The American Academy of Pediatrics (AAP’s) works to advance the dental profession at the Campaign for Dental Health (CDH) is a broad national, state, and local levels. network of oral health advocates, health pro- fessionals, child and family organizations, and scientists who are working together to preserve the nation’s oral health gains. CDH shares facts about oral health and strategies, such as community water fluoridation, to prevent oral disease.

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 30 AMERICAN DENTAL HYGIENISTS’ enhancing efforts to monitor oral disease, con- ASSOCIATION tributing to the scientific knowledge base related to oral health and oral disease, and guiding infec- 444 North Michigan Avenue, Suite 3400 tion control in dentistry. Chicago, IL 60611 Telephone: (312) 440-8900 Website: http://www.adha.org CENTERS FOR MEDICARE & MEDICAID The American Dental Hygienists’ Association SERVICES (ADHA) works to ensure access to high-quality 7500 Security Boulevard oral health care; promote dental hygiene educa- Baltimore, MD 21244 tion, licensure, practice, and research; and repre- Website: https://www.cms.gov sent the legislative interests of dental hygienists at the local, state, and federal levels. ADHA The Centers for Medicare & Medicaid Services serves dental hygienists with the goal of helping administers Medicare, Medicaid, the Children’s them achieve their full potential as they seek to Health Insurance Program, and the Health Insur- improve the public’s oral health. ance Marketplace.

ASSOCIATION OF STATE AND TERRITORIAL DENTAQUEST: PARTNERSHIP FOR ORAL DENTAL DIRECTORS HEALTH ADVANCEMENT 3858 Cashill Boulevard 465 Medford Street Reno, NV 89509 Boston, MA 02129-1454 Telephone: (775) 626-5008 Website: https://www.dentaquestpartnership.org Website: http://www.astdd.org Dentaquest: Partnership for Oral Health Advance- The Association of State and Territorial Den- ment works to improve oral health by expanding tal Directors promotes the establishment of access to oral health care, making oral health national policy, assists state care more affordable, and shifting the focus from oral health programs in the development and treating oral disease to preventing it. Coming implementation of programs and policies for from a belief that business and social impact go preventing oral disease, builds awareness and hand in hand, the organization focuses on align- strengthens public health professionals’ knowl- ing incentives to drive better outcomes and lower edge and skills by developing position papers costs. and policy statements, provides information on oral health to health officials and policymakers, INDIAN HEALTH SERVICE and conducts conferences for the dental public 5600 Fishers Lane health community. Rockville, MD 20857 Website: https://www.ihs.gov/index.cfm CENTERS FOR DISEASE CONTROL AND Dental portal: https://www.ihs.gov/DOH PREVENTION The Indian Health Service (IHS) is responsible for 1600 Clifton Road providing federal health services, including oral Atlanta, GA 30329-4027 health services, to American Indians and Alaska Telephone: (800) 232-4636 Natives. The IHS dental portal serves as a cen- Website: http://www.cdc.gov tralized location where staff who work in Indian Division of Oral Health: http://www.cdc.gov/ health care can locate resources to support the oralhealth operation of effective clinical and community oral health programs. The Centers for Disease Control and Prevention works to combat disease and supports commu- nities and citizens to do the same. The Division of Oral Health works to improve oral health and reduce oral health disparities by helping states improve their oral health programs, extending the use of proven strategies to prevent oral disease,

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 31 MATERNAL AND CHILD HEALTH BUREAU NATIONAL ASSOCIATION OF SCHOOL Health Resources and Services Administration NURSES 5600 Fishers Lane 1100 Wayne Avenue, Suite 925 Parklawn Building Silver Spring, MD 20910-5669 Rockville, MD 20857 Telephone: (240) 821-1130 E-mail: [email protected] Website: http://www.nasn.org Website: http://www.mchb.hrsa.gov http://www.oralhealthconnections.org

The Maternal and Child Health Bureau provides The National Association of School Nurses leadership, in partnership with stakeholders, to (NASN) serves school nurses by developing edu- improve the physical, mental, and oral health; cational programs, resources, and research and safety; and well-being of the maternal and child by working to influence stakeholders’ support for health population, which includes all women, school nursing through advocacy. NASN sup- infants, children, and adolescents and their ports school nurse objectives by publishing issue families. briefs and position statements on subjects affect- ing student health and school nursing to keep members updated on issues affecting their school MEDICAID | MEDICARE | CHIP SERVICES communities. DENTAL ASSOCIATION 4411 Connecticut Avenue, N.W., #104 Washington, DC 20008 NATIONAL MATERNAL AND CHILD ORAL Website: http://www.medicaiddental.org HEALTH RESOURCE CENTER Georgetown University The Medicaid | Medicare | CHIP Services Dental Box 571272 Association works to optimize the oral health Washington, DC 20057-1272 of public health beneficiaries by providing state Telephone: (202) 784-9771 and national leadership in the development of E-mail: [email protected] Medicaid and State Children’s Health Insurance Website: http://www.mchoralhealth.org Program (CHIP) oral health policy, providing a support system, encouraging innovation and The National Maternal and Child Oral Health collaboration, promoting the integration of oral Resource Center responds to the needs of profes- health and primary care in Medicaid/CHIP pro- sionals working in states and communities with grams, and promoting a balance between preven- the goal of improving oral health services for tion and treatment of oral disease. pregnant women, infants, children, and adoles- cents, including those with special health care needs, and their families—the maternal and NATIONAL ASSOCIATION OF CHRONIC child health (MCH) population. The resource DISEASE DIRECTORS center collaborates with government agencies, 325 Swanton Way professional associations, foundations, policy and Decatur, GA 30030 research centers, and voluntary organizations to E-mail: [email protected] gather, develop, and share information and mate- Website: http://www.chronicdisease.org rials to promote sustainable oral health services for the MCH population. The National Association of Chronic Disease Directors (NACDD) serves the chronic disease program directors of each state and jurisdic- tion, connecting them to advocate for preventive health policies and programs, encourage knowl- edge sharing, and develop partnerships for health promotion. NACDD works to mobilize efforts to reduce chronic and their associated risk factors through state and community-based prevention strategies.

PROMOTING ORAL HEALTH IN SCHOOLS: A RESOURCE GUIDE 32 NATIONAL NETWORK FOR ORAL HEALTH ACCESS 181 East 56th Avenue, Suite 401 Denver, CO 80216 Telephone: (303) 957-0635 E-mail: [email protected] Website: http://www.nnoha.org

The National Network for Oral Health Access provides oral health professionals working in safety net programs with resources, learning opportunities, and advocacy with the goal of improving the oral health and overall health of populations that are underserved.

SCHOOL-BASED HEALTH ALLIANCE 1010 Vermont Ave, N.W., Suite 600 Washington, DC 20005 Telephone: (202) 638-5872 E-mail: [email protected] Website: http://www.sbh4all.org

The School-Based Health Alliance (SBHA) works to improve the health status of children and ado- lescents by advocating for school-based health care. SBHA supports the field of school-based health care with common standards, measures, data, and research to effectively demonstrate the value of school-based health care. SBHA engages members in experiential and collaborative learn- ing to lead, test, and spread innovations in the field; help children and adolescents take owner- ship of their health; and advocate at the federal, state, and local levels for the concept of health and education partnerships—and the school- based health center model in particular—to help students succeed.

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