Healthy Smiles: Impact of a dental screening program

Background: Dental decay is the most prevalent chronic infectious disease among children in the US. Third grade children present with mixed dentition and thus provide an opportunity for assessing dental health status. In order to evaluate the Cambridge Public Health Department's (CPHD) dental screening program (Healthy Smiles), we looked at the association between prior history of a school-based dental screening and findings of decay among third graders. Methods: Healthy Smiles, implemented in 1997, provides education, visual dental screenings, and referrals in preschool through grade 4 in Cambridge, MA. Between the 1999-00 and 2008-09 school years, 2,625 third graders participated in the program. Data were entered into MS Access and analyzed using SAS. Results: Of the 556 third graders who were screened by CPHD for the first time in third grade, 9.7% were diagnosed as Triage III, in immediate need of dental attention (serious decay and/or abscesses). This compares to 7.4% (N=785) of third graders who received one prior screening from CPHD and 3.8% (N=1,284) of third graders who had received at least two prior screenings from CPHD. The odds of being diagnosed as Triage III among third graders who received at least two prior screenings from CPHD were less than half that of students who had not received prior screenings by CPHD (OR=0.37, 95%CI=0.25,0.55). Conclusions: Our work suggests that school-based screening programs are associated with reduced findings of untreated tooth decay. Furthermore, frequent and/or early dental screenings can have an increased positive impact on the oral health of children.