School-Based Model

In school-based models, oral health programs provide evidence-based oral healthcare services like screening, fluoride varnish, and dental sealants to children. Dentists, dental hygienists, and community health workers deliver preventive dental services within schools.

School-based programs offer an opportunity to introduce dental hygiene students to the needs of rural populations, and can increase the rural oral health workforce in the long-term (see Workforce Models). For example, a rural oral health program in South Dakota uses dental hygiene students to perform screenings, fluoride varnish, dental sealants, oral health education to students, and if needed, refer patients to local dentists that have agreed to treat more complex cases. Dental hygiene students and their professors travel to rural school sites to deliver services.

Another program in rural Montana utilizes a community health advisor to apply fluoride varnishes for school children during dental screenings. Also, a program in rural Louisiana is educating medical and allied health professionals about how to apply fluoride varnish in schools.

For an example of a school-based model, see School-Based Health Center Dental Outreach in the Rural Health Models and Innovations section.

Implementation Considerations

There is strong evidence that school-based oral health programs prevent cavities, particularly among children from families with lower incomes. School-based programs improve access to oral healthcare and are cost-effective since they may combine several services in one visit (for example, performing a screening and applying varnish in the same visit). In addition, the use of dental hygienists instead of dentists can reduce the cost of services.

Oral health programs implementing school-based models must create consent forms to obtain the appropriate permissions from parents and school administrators to work with school-aged children. A school nurse or school counselor may serve as an outreach coordinator that can assist the dentist in coordinating the program. Rural oral health programs implementing school-based models may have support from community partners, such as the health department, state office of rural health, universities, and state dental and dental hygienists associations.

Resources to Learn More

Fluoride Varnishes for Preventing Dental Caries in Children and Adolescents
Document
Presents the findings from 22 trials where 12,455 children and adolescents were treated with fluoride varnish or a placebo/no treatment to determine if fluoride varnish can effectively reduce tooth decay in both primary and permanent teeth.
Authors(s): Marinho, V., Worthington, H., Walsh, T., & Clarkson, J.
Citation: Cochrane Database of Systematic Reviews, 13,(7)
Date: 7/2013