Module 1: Introduction
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School-Based Dental Sealant Programs

1.3 Principles of Programs Funded by Ohio Department of Health

ODH provides grants to school-based dental sealant programs that enable them to provide dental sealants to students (with parental consent) at no charge to parents in participating schools. (See module 5 for details on the quality-assurance aspects of the program.) Key elements of ODH’s approach are to make sure that programs 1

  • Use a community-based approach to dental caries prevention
  • Target children at high risk for dental cariesb
  • Operate efficiently
  • Ensure quality
  • Maximize the use of public funding

Using a Community-Based Approach

Children in school cafeteria

ODH’s school-based dental sealant program is a community-based public health approach to preventing dental caries. The program was developed based on Ohio caries data and requires those who operate sealant programs to work with the community (e.g., schools, private dental offices, safety net clinics). Although program goals are accomplished one child at a time, ODH focuses on the health of the population and on reducing disparities.

Targeting Children at High Risk for Dental Caries

Programs provide dental sealants primarily to the most decay-prone teeth and tooth surfaces (i.e., the pits and fissures of permanent molar teeth) of children at higher risk for dental caries. For the purpose of ODH-funded dental sealant programs, children at higher risk are those who are eligible for FRPM or Medicaid or who do not have dental insurance and did not have a dental visit in the past year.23 Because of schools’ unwillingness to make the program available to children based on income criteria, the program operates in schools in which a certain percentage of students participate in FRPM. As a result, three out of four children who receive sealants in Ohio sealant programs are at higher risk for dental caries, based on income criteria.24

Operating Efficiently

School-based dental sealant programs place dental sealants in the least expensive and most productive manner possible while delivering a quality product. Experienced program teams can generally provide sealants for 15 or more children per day, and some report providing sealants for over 20 children per day. Programs are designed to maximize productivity while minimizing cost.

Ensuring Quality

sample dental sealant program data dashboard

ODH adheres to its School-Based Dental Sealant Program Performance Improvement Plan that calls for ODH to

  • Provide information about dental sealants and school-based dental sealant programs to ODH-funded programs to keep them abreast of the state of the science.
  • Set evidence-based standards for both program design and clinical operations.
  • Communicate standards, guidelines, and program performance expectations to ODH-funded programs.
  • Maintain a system for reporting by ODH-funded programs (see module 5).
    • Programs report to ODH’s Oral Health Section (OHS) on a quarterly basis, online, using the ODH Subgrantee Performance Evaluation System.
    • OHS compiles reports into a dashboard report for each program and creates comparison graphs to allow programs to view all programs’ performances against program benchmarks.
  • Evaluate program performance against standards, guidelines, and performance expectations through a review of program reports and other communications, including site visits, as appropriate.
    • Schedule a comprehensive site visit with each program every 3 years, and schedule focused site visits as necessary.
  • As necessary, directly provide or approve plans for technical assistance that programs need to meet performance expectations or otherwise improve their operations.
  • Analyze OHS school oral health survey data to assess the impact of school-based dental sealant programs.

Maximizing the Use of Public Funding

ODH requires all funded school-based dental sealant programs to identify Medicaid participants for whom it provides dental sealants and to bill the appropriate Medicaid managed care plan or the Ohio Department of Job and Family Services. In so doing, public funding originating from the federal Title V Maternal and Child Health Services Block Grant that ODH awards can be used for the maximum number of children at high risk for dental caries with no identifiable funding source.

To promote the best use of public funding, ODH does not permit its programs to bill Medicaid for services that are of little or no value to children in the context of school-based dental sealant programs where children typically have one to two visits over a 2-year period and there are no treatment options beyond dental sealant placement. Examples of such services include

  • Diagnostic services, such as oral examinations and X-rays. (These should be provided only by a dentist who is equipped to provide treatment services, such as restorations or extractions.)
  • A single topical fluoride treatment (e.g., fluoride varnish).

b. In this curriculum, “children and adolescents at high risk for dental caries” refers to children and adolescents from families with low incomes who are at higher risk for dental caries than their counterparts from families with higher incomes.