Vermont Department of Health - Oral Health and 3 more...less...

Oral health in schools


Tooth Tutor

# of students participating in Vermont's 802Smiles Network of School Dental Health Programs receiving oral health services


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Story Behind the Curve

Last Updated: September, 2019

Author: Oral Health Program, Vermont Department of Health

The way the Vermont Department of Health approaches school dental health services is in the midst of a transition; this is apparent in the data shown here. From the 2015-2016 to the 2017-2018 school year we focused solely on the collection of “Tooth Tutor School-Linked Sealant Program” (TTSP) data. We only collected data from this program because this was the only program that we had a formal connection with. This program was considered a school-linked  (vs. school-based) program because hygienists (referred to as “Tooth Tutors”) would develop a target group of students who may not have accessed dental care in the past year based on their health records, and work throughout the year to connect those students with a local dental practice. 

Based on a formal evaluation of the program, we are now focusing on the expansion of school-based dental health programs (a number of which already exist in Vermont) which provide dental health care services on site in school settings in addition to referring students to local dental homes where they can receive both preventive and restorative dental care. This is because school-based dental health programs, where dental health services are provided on site, are an evidence-based strategy to improve population oral health indicators (something we were not seeing with the TTSP evaluation). 

This transition involved the development of a network of school dental health programs in Vermont (both school-linked and school-based). We are referring to this as the 802 Smiles Network of School Dental Health Programs. Starting in the 2018-2019 school year, we are including our data collection to include students from all the programs in the 802 Smiles Network. This is why the number of students who received oral health care services rose so dramatically during the 2018-2019 school year whereas previously it had remained fairly stagnant. 

We look forward to working with our partners and the 802 Smiles Network of programs to “turn the curve” in the right direction in regard to our statewide oral health indicators (i.e., treated and untreated dental decay and dental sealant rates). 

What Works

According to Tooth Tutor data, the most common reason children do not access dental care through the program is because the “parent did not follow through” (e.g., parent didn't make an appointment, or parent didn't enroll child in Medicaid/Doctor Dynasaur, etc.). When Tooth Tutors resonate with parents, they (parents) are open to working with the Tooth Tutor to establish a “dental home" for their child; effective communication with parents is the key to turning this curve. Consequently, providing Tooth Tutors with opportunities to gain skills in effective communication and cultural competency will continue to be a major focus at the Vermont Department of Health.

School-based dental sealant programs are an evidence-based strategy to prevent dental cavities in children. “Sealant delivery programs can be an important way to reach children from low-income families who are at higher risk for caries and less likely to access clinical care.” (Community Preventive Services Task Force, 2013; County Health Rankings and Roadmaps, 2017)

Action Plan
  • We will monitor the percentage of students in the target group who access care through the program as a measure of success. Focusing on this group at an individual Tooth Tutor level not only allows us to provide extra support for Tooth Tutors who whose numbers are below average, but it also tells us who is achieving above average success so that we can learn about what they are doing well.
  • We will continue to focus on effective communication, cultural competency, care coordination, and motivational interviewing skills at Tooth Tutor meetings.
  • We will explore the feasibility of implementing school-based dental health programs to deliver dental sealants and other preventive services in high-need schools (those with higher percentages of students eligible for free or reduced-cost meals).
Notes on Methodology

This measure is calculated annually, based on the school year calendar.

Scorecard Result Container Indicator Measure Action Actual Value Target Value Tag S R I P PM A m/d/yy m/d/yyyy