School nurses and dentists team up for oral health

As a school nurse for 23 years, Sandi Delack has witnessed first-hand the needs of children who don’t have a dentist or receive regular dental or oral health care.

“On a daily basis we have kids at school who say they can’t concentrate because they have a toothache or who’ve had pain for a while but say haven’t seen a dentist because their parents can’t afford it,” said Delack, who is president of the National Association of School Nurses (NASN) based in Silver Spring, Md.

That’s why Delack and others in the fields of school nursing and dentistry welcome a new partnership between the NASN and the American Dental Association, which have launched a campaign to give school nurses the tools they need to better promote oral health among students. The Empowering School Nurses to Change Oral Health Perceptions is funded by a $160,000 grant from the DentaQuest Foundation.

“The ADA looks forward to collaborating with school nurses to help children and their parents understand that oral health is an important part of overall health,” said Raymond F. Gist, president of the American Dental Association.

“We focus so much on general health that oral health gets lost,” added Maria Lopez Howell, a dentist in San Antonio and a consumer advisor for the ADA. “This will bring the oral health piece into the framework for school nurses.”

Statistics from the Centers for Disease Control show that more than two-thirds or 68 percent of children have decay in their permanent teeth. Poor oral health is linked to ear and sinus infections, weakened immune systems, as well as diabetes, and heart and lung disease.

Studies also have found that children with oral health restricted their activities and miss more than 51 million of school hours each year, according to a report from Children International at the University of Arkansas, an organization that provides educational enrichment and health and dental care to children in the Little Rock area.

Tapping into this network of nurses to better address oral health among children makes good sense, said Amy Garcia, executive director of NASN. She said that 98 percent of children spend their days at school and school nurses are a natural conduit for reaching them with the message about the importance of oral health. The school nurses association has 50,000 members nationwide.

“We have a strong reach into the communities we serve,” Garcia said.  “School nurses know which families are struggling, which children need better hygiene or correctives or which parents might need help with an issue like bottle mouth.”

The campaign is starting with a needs assessment that is already underway. A survey is being developed to be sent to school nurses to begin to understand what tools they need to better promote oral health and what problems they encounter among students.  

“We’d like to know how often they see students with oral health needs and what they do when they see a problem,” Garcia said.

Campaign organizers also want to know what educational resources nurses would find useful. New resources, whether they are informational fliers, posters or brochures may be developed, but Garcia said some of these materials already exist.

“We want to make those credible resources more available and extend the reach to students who don’t have a regular dental provider and need one,” Garcia said. “Since many of these materials are for parents we want to be sure they are in a format that makes it into the home.”

An important part of the project will be developing a website that nurses can access to find avenues for connecting a child with a dentist. Garcia said the website will have links to foundations and non-profit organizations that dentists work with to provide dental care to children who need, but can’t afford it.

“A school nurse could go on the website to find help or a dentist could go on to the site to find a school nurse,” said Garcia, who hopes to have the website operational by the summer.

Gist said the partnership will lead to greater recognition of the importance of oral health.

“School nurses and dentists can help raise awareness about the need for good oral hygiene, good nutrition and regular dental visits in order to prevent dental disease,” Gist said. 

Howell said it is never too early to try to tackle a problem that can have devastating implications for children.

“Severe tooth decay can affect how children learn and their self-esteem,” Howell said. “Some children don’t want to smile. But tooth decay is so preventable.”

Delack, who works at Nicholas J. Ferri Middle School in Johnston, Rhode Island, and Garcia are excited about the campaign’s potential to improve oral health among students, and make it a lifelong priority for young people.

“I think it’s one of the smarter programs I’ve seen in a while because it builds on existing resources,” Garcia said. “We can really impact the lives of students.”