A collaborative community-based oral care program for school-age children

In Vermont in 2001, less than half of school-age children on Medicaid received dental services. Vermont is a designated resettlement area for refugees, many of whom have never had dental care. A school-based oral health program was designed to meet the needs of this high-risk pediatric population.

A plan was developed to offer dental services to this group of children. Through the efforts of a multidisciplinary committee the Tooth Tutor Program, developed by the Vermont Department of Health, dental care was made available to the children. The Tooth Tutor Program provides cost-effective dental hygienist care to children in the school setting and includes referral to community dentists.

The program was able to provide services to approximately 500 children in the first 2 years with an increase in preventative services and decrease in restorative services from year 1 to year 2. After 3 years, a school-based dental service opened in 1 of the 3 target schools.

A school-based dental service that includes education, screening, and referral can be an effective program for improving oral health among impoverished children.

For the community health clinical nurse specialist, the client is the community. Clinical nurse specialist practice in this community resulted in improved oral health for high-risk school-age children. This program can be adapted for other communities.