School Dental Programs Improve Oral Health and Increase Access to Oral Care

According to the Centers for Disease Control and Prevention, by age 9, half of children have had cavities in their primary (baby) or permanent teeth. Children aged 6 to 9 from lower-income households were more than twice as likely to have untreated cavities than children from higher-income households.

Untreated cavities can cause infections and pain that can affect a child’s sleep, nutrition, academic performance, and social-emotional development (AAP). Children with poor dental health may also miss more school days than children with good dental health.

Good Oral Health at an Early Age is Essential

Children with good oral health may be less likely to develop infections or other serious health conditions, and may have an easier time eating, speaking, and even sleeping through the night without toothaches. They may also have better school attendance, stay focused while in school, and, in turn, achieve better grades due to better oral health (Smile, California).

What is a School-Based Dental Program?

A school-based dental program is an effective method to help reduce dental disease by providing clinical and preventive dental services in a school setting. It also helps connect children to a dental home for continued oral care. They are designed to prevent dental disease, increase access to oral care, and help reduce school absences.

What Dental Services Are Provided?

On-site school-based dental care services include:

Dental screenings. An oral health assessment can detect signs of dental decay and identify children who need urgent dental care.
Oral health education. This may include proper brushing and flossing techniques, as well as healthy dental care habits.
Application of preventive treatments. This includes topical fluoride varnish and dental sealants.
Care coordination. Ensuring children with urgent dental care needs are linked to a dental home, helping families find a local dental care provider, and providing referrals as needed.

Who Provides the School Dental Program Services?

The dental services are provided by licensed or registered dental health professionals, including dentists, registered dental hygienists (RDHs), and registered dental hygienists in alternative practice (RDHAPs). Registered dental assistants can provide services with the direct supervision of a dentist. Dental schools can also send their students to provide services to schools under faculty supervision.

A school-based dental program is primarily coordinated by the school district’s lead nurse or administrators and partners directly with local community health centers, dental providers, and dental schools. Services may be provided in school buildings and /or mobile units operating on school grounds.

Why are School Dental Programs Beneficial for Families and Schools?

Tooth decay is the most chronic yet preventable health care need among California’s children. Missed school days due to dental decay can negatively impact academic performance and are costly for school districts.

According to the California Health Interview Survey (CHIS) 2022, an estimated 351,000 California children and teens missed one or more school days due to dental problems in 2021. Also, 869,202 missed school days in a year due to dental problems cost school districts approximately $60 million.

Kindergarten Oral Health Assessment (KOHA) reporting from the 2024 – 2025 school year in Orange County indicated 56% of eligible kindergartners had proof of a dental assessment; however, 44% of eligible kindergarten students, more than 13,000 children, were not assessed. Students in Title I schools are most likely to face barriers to dental care, resulting in untreated dental disease.

Schools are among the most effective settings for early identification of need and for connecting children to preventive and restorative dental care. They can have the greatest impact on students without access to dental care. A school-based dental program involving nearly 7,000 elementary school students reduced cavities by more than 50 percent (nyu.edu).

Strengthening School Dental Programs Through Community Partners

Some schools have a dental program, but many schools do not. Schools and community partners, including dental providers and community health centers, can collaborate to reduce dental decay and improve access to oral care for high-risk children. Below are examples of how local partners can support a school-based dental program.

Schools. If you are interested in implementing a school-based dental program, please contact local dental providers, dental schools, and community health centers to help establish one at your school. Visit the School Oral Health Programs & KOHA resource page from the California Oral Health Technical Assistance Center for helpful information and resources to help you get started. You can also contact the Orange County Local Oral Health Program for more information, Lohp@ochca.com.

Dental providers and community health centers. Local dental providers can offer on-site screenings and preventive treatments, such as fluoride varnish or dental sealants. They can accept referrals for children needing urgent dental care or serve as a dental home, providing children with long-term oral care. Contact a school district near your dental office or community health center.

Dental schools. Dental students, under the direct supervision of licensed faculty, can provide preventive services such as screenings, fluoride varnish, and dental sealants on school grounds. Contact a local school district nurse to learn how your dental students can provide services.

PTA members. Members can help advocate for a school-based dental program, especially in underserved communities. PTA members can help increase parent/caregiver communication and consent. They can provide volunteer support for on-site dental clinic days. Speak with your school nurse and invite them to join a PTA meeting to discuss the topic.

Pediatricians. Pediatricians can promote children’s oral health by collaborating with school district nurses to advocate for comprehensive school oral health programs. Contact an Orange County School District Coordinating Nurse.

Orange County Local Oral Health Program. A list of providers who can support a school-based dental program is in development. The list will be shared with school districts that do not have a program. If you would like to be included on the list, please contact the Local Oral Health Program at Lohp@ochca.com.