The 130th Annual Meeting of APHA

Abstract #35204

Kathleen O. Keating, RN, BSN¹, Rebecca MacDonald, RDH², Liz Cobb, RDH³, Barbara L. Frankowski, MD, MPH⁴, Tommy Ivey, DDS, MPH², Cindy Lamb, RDH⁵, Betsy Liley⁶, Nancy Menard, RN, MSA⁷, Christina Melvin, RN, MS, CS⁸, M. Lisa Schilling, RN⁹, and Garry Schaedel¹⁰. (1) Office of Health Improvement, Fletcher Allen Heatlth Care, 199 Main St., Suite 150, Burlimngton, VT 05401, (2) Dental Division, Vermont Department of Health, 108 Cherry Street, PO Box 70, Burlington, VT 05402, (3) Lawrence Barnes School, 129 North Street, Burlington, VT 05401, (4) Professor of Pediatrics, University of Vermont, Health Consultant, Burlington School Department, University Pediatrics, 1 So. Prospect St., Burlington, VT 05401, (5) Flynn Elementary School, 1645 North Avenue, Burlington, VT 05401, (6) Director Grants and Special Projects, Burlington School District, 150 Colchester Ave., Burlington, VT 05401, (7) District Director, Vermont Department of Health, 1193 North Avenue, Burlington, VT 05401, (8) School of Nursing, University of Vermont, 227 Rowell Building, Burlington, VT 05401, 802-656-2622, kathleen.keating@vtmednet.org, (9) Fletcher Allen Health Care, Director, Office of Health Improvement, 199 Main St., Suite 150, Burlington, VT 05401, (10) EPSDT Chief, Vermont Department of Health, 108 Cherry Street, PO Box 70, Burlington, VT 05402

"Poor oral health has been related to decreased school performance, poor social relationships, and less success later in life. Children experiencing pain are distracted and unable to concentrate on schoolwork." (GAO, 2000) School nurses in Vermont deal with these issues on a daily basis. However, they report access to dental care for children with Medicaid/SCHIP as a major barrier to oral health. Many Vermont dentists limit the acceptance of children with Medicaid/SCHIP coverage citing lower than usual and customary fees, high no-show rates, and practices full with private pay-private insurance patients. To address these concerns, the Vermont Department of Health developed the “Tooth Tutor” program.

School-based dental hygienists implement the program. Components include the following: 1) outreach to local dentists, 2) a paper screening process to identify children with no dental care in a year, 3) an optional visual screening of children in this target group to assist in referring a mix of children with preventive, restorative and emergency needs to area dentists 4) contact between the hygienist and local private practice dentists to arrange for care of individual children, and 5) case management to help families with barriers to keeping appointments, such as transportation and language differences, 6) a developmentally appropriate dental health curriculum with take home messages for all children grades K-6.

The Vermont Tooth Tutor program resulted in an increase from 75% of children in 54 participating schools with a dental home at the beginning of school year 2000-2001 to 89% at year's end.

Learning Objectives:

• Describe the six components of a successful statewide school-based dental care access program.
• Identify the rationale for employing school-based dental hygienists primarily in the role of case managers to assure children with Medicaid or SCHIP are linked to dental care homes for preventive, comprehensive, and continuous care
• Identify at least two resources for financing the “Tooth Tutor” program in schools.
• Identify at least two benefits of utilizing a local collaboration to implement the dental access project and as an ongoing advisory body to school-based dental access projects.

Keywords: School-Based Programs, Oral Health

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Vermont Department of Health
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.