Infrastructure Development Tools - Activity 5a - State-Based Programs

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Activity 5a: School-Based/School-Linked Dental Sealant Programs

School-based and school-linked dental sealant programs are recognized as a highly effective approach for preventing tooth decay in children. Some programs provide pit and fissure sealants to children in a school setting, and others see the children in school and then have referral arrangements with private dental practices or public dental clinics that place the sealants.

School-based and school-linked programs in the United States generally target vulnerable populations that may be at greater risk for developing decay and less likely to receive dental care, such as children from low-income families who are eligible for free and reduced lunch programs.
When developing, coordinating, and implementing a school-based/-linked program, a state oral health program should:

Perform a needs assessment to document the number of eligible elementary or secondary schools, the number of children participating in free and reduced-cost lunch programs, and existing related oral health resources.

Develop a statewide strategic dental sealant plan, which includes S.M.A.R.T. (Specific, Measurable, Achievable, Relevant, Time-framed) objectives developed to meet/exceed the state’s Healthy People 2010 goals. At a minimum, programs should report the percentage and number of children in funded programs receiving at least one permanent molar sealant; the proportion of eligible schools participating in the sealant program; and the proportion of children participating in free and reduced-cost lunch programs receiving at least one sealant. In addition, the plan should identify specific activities, resources, and partners required to accomplish program objectives.

Document that infrastructure is in place to coordinate and manage school-based or school-linked dental sealant programs and show collaborative working relationships and formal agreements (e.g., Memorandum of Agreement (MOA), Memorandum of Understanding (MOU), or other written agreement between the state health department and the state educational agency).

Implement and evaluate a demonstration project (if no sealant program currently exists).

Develop school-based or school-linked dental sealant programs targeting elementary or secondary schools that meet established criteria.

Collect appropriate data to evaluate the outcomes, sustainability, efficiency, and effectiveness of school-based/-linked dental sealant programs. Recommended data elements include the following:

The percentage and number of children in funded programs receiving at least one permanent molar sealant;
The proportion of eligible schools participating in program; and
The proportion of children participating in free and reduced-cost lunch program receiving at least one sealant

Conduct an in-depth cost analysis of the school-based or school-linked dental sealant program. SEALS software or its equivalent may be used for the analysis, which should include baseline measures of mean pit and fissure caries prevalence and severity. A cost-analysis report should be published and submitted to the ASTDD Best Practices Project.

States with advanced capacity in this area may:

Enhance school-based or school-linked dental sealant programs statewide to meet and exceed the Healthy People 2010 objective;

Report data analysis demonstrating progress toward reaching or exceeding Healthy People 2010 objective of school-based or school-linked dental sealant programs in all eligible schools in urban and rural areas;

Report data analysis demonstrating significant progress toward increasing the proportion of eligible schools participating in the sealant program; and the proportion of children in funded schools receiving at least one sealant;

Provide leadership in training and technical assistance to community sealant programs, providers, and other types of sealant programs;

Submit sealant best practice approach to ASTDD for sharing with other programs;

Report progress toward sustainability and institutionalization of sealant programs through leveraging of funding, partnership participation, billing Medicaid and/or SCHIP or other sources of support; and

Report analysis of program quality assurance measures, such as sealant retention data.

ADDITIONAL RESOURCES

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