Extending Oral Health Care Services to Underserved Children through a School–Based Collaboration: Part 1 – A Descriptive Overview

Abstract

Purpose: The purpose of this report is to describe the process and outcomes of a collaborative, comprehensive preventive oral health program between the University of Missouri-Kansas City School of Dentistry, the Olathe School District and an Extended Care Permit I dental hygienist. The report describes the programs collectively working to provide school-based services to disadvantaged children in 4 Title I schools using the community collaborative practice oral health model and tele-dentistry.

Methods: The “Miles of Smiles” clinic was assembled in 4 elementary schools using portable dental equipment. Dental hygiene students, supervised by a dental hygiene faculty member with an extended care permit, provided comprehensive preventive oral health care to unserved and underserved children.

Results: Twenty-eight dental hygiene students provided prophylaxis, radiographs, sealants, fluoride varnish, oral health education and nutritional counseling to 339 children in the Miles of Smiles clinic during the 2008 to 2009 academic year. Sixty-three percent of children had decay and were referred to a dentist. Upon re-evaluating at the end of the school year, 11% had begun the transition process of seeking restorative care at a safety net clinic or from a local dentist.

Conclusion: School based oral health models, using dental hygienists with expanded scopes of practice to provide preventive oral health services and referrals, can serve as one approach to overcoming barriers and reaching vulnerable children that desperately need oral health care. However, transitioning children outside of their school to a safety net clinic or local dentist to receive restorative care was found to be problematic.

This study supports the NDHRA priority area, Health Services Research: Investigate how alternative models of dental hygiene care delivery can reduce health care inequities.