Step 3: Implementing the Program

The key components of implementing the school-linked program include:

  • Oral Health Screening or Assessment
  • Oral Health Education
  • Referral to Dental Care

Conducting Oral Health Assessments

Purpose of the oral health assessment

The visual oral assessment is a quick and easy inspection of the mouth to assess the oral health needs of the child. This involves inspection of extraoral and intraoral structures for health and abnormalities. The face and jaws are inspected through palpation for swellings or asymmetry. The intraoral inspection involves observation of the cheeks, tongue, throat, and gums for any soft tissue swelling, gingival health, soft tissue pathology with the use of a tongue depressor or a mouth mirror. Teeth are evaluated closely for presence of dental decay, the extent of decay, eruption status of permanent molars, and evaluation for sealant application.

Process and procedures

On the day of the dental screening, the screening team should work in a well-coordinated manner to screen several classrooms. The personnel involved in the dental screening process must follow local and state infection control guidelines about the prevention of transmissible diseases such as flu, COVID-19, etc.

Photo by Cindy Chew

Oral Health Education

Oral health education is an essential component of a school’s dental program that can positively impact students' knowledge and health behaviors, and ultimately improve oral health. School oral health education efforts must actively engage school teachers and school nurses when possible, as their active involvement can be vital to promoting oral health through repeated reinforcement throughout the school year.

Oral Health Counseling

If time allows, oral health counseling is another avenue for educating, but on an individual basis. Oral health counseling provides tailored oral health education and guidance based on the individual’s needs, followed by oral health recommendations and referral to a dental professional. Oral health counseling taps into the intrinsic ability of every individual to adopt and sustain a behavioral change.

Referring Students to Dental Care

A list of the dental providers participating in the referral pathway, developed in Step 2, must be sent home to the parents/guardians along with the results of the screening. In instances where a school nurse, care coordinator, or case manager is available, their services should be available to help families in finding and accessing care for their students in a timely manner, especially when students have an urgent need or early dental need.

The strategy of the "5As: ask, advise, assess, assist, and arrange" can be utilized to develop a protocol for facilitating the referral to dental care in a school-linked program. The 5As is a framework adopted from tobacco cessation interventions.

In the absence of a designated dental care coordinator, school staff/classroom teachers should be familiarized with the referral pathway to be able to communicate to parents/guardians the urgency to seek dental services for their students with a dental emergency.