Incorporating dental screening into school health days: A best practice for oral health surveillance

Background: Screening and surveillance for dental conditions are essential for identifying problems, planning programs, and monitoring population oral health. However, such programs may burden schools and be logistically difficult. We describe a countywide oral health screening and surveillance approach that minimized burden on schools, families, and the public health system. Methods: Before 2011, there were no data on the oral health status of children in Alachua County, FL. Schools screened children for height/weight/BMI, vision, hearing, and scoliosis; each screening disrupted the normal school day, a situation further compounded by addition of influenza vaccination. In 2011, the Alachua County Oral Health Coalition worked with school health officials to develop School Health Days at every public elementary school that included dental Basic Screening Survey. Each school devoted 1 day to screening and flu vaccination. Parents/guardians were informed of the screenings and could opt out; vaccination required active consent. Results: Nearly 100% of 3rd graders participated in dental screening in 2011-12 and 2012-13 (~1,800 each year). Prevalence of untreated cavities was 30.5% in 2012; range: 13.3%-45.7% among 23 elementary schools; 6.9% of 3rd graders had urgent need for dental care. Findings were widely disseminated and were successfully used to plan, advocate and obtain funding for dental sealant and other prevention programs. Dental screening is now institutionalized in the school district. Conclusions: Scheduling dental screening to coincide with required health screenings may be an effective and efficient approach to conduct oral health surveillance, minimize the burden to schools, and enable oral health program development.