ABSTRACT
Background: School-based health centers (SBHC) offer health services to children who are primarily of low socioeconomic status. During the COVID-19 pandemic and the subsequent lockdown of schools, the capacity of school-based health centers to provide oral health services was decreased or discontinued completely. A grant was awarded by Delta Dental of Colorado to the University of Colorado School of Dental Medicine via the Colorado Association for School-Based Health Care (CASBHC). The grant goals were to identify SBHCs that had either decreased or reduced oral health (OH) services due to the COVID-19 pandemic, understand their OH service goals upon post-pandemic reopening, and provide educational resources for staff, students, and families that increase student OH outcomes upon reopening. Methods: A survey of Colorado's 65 SBHC was conducted to understand their capacity to offer OH services and to evaluate readiness and commitment to project goals. Of the five SBHC that were selected, two were rural and one was without any dental services. Individual interviews were conducted to understand which OH services the SBHC wanted to offer upon reopening and determine the specific educational resources needed to ensure services were implemented successfully. After the interviews, a virtual convening with all five SBHC was conducted to discuss the results of the interviews, provide details and answer questions about the project, share the topics of the resources that would be created, and discuss how these resources could be accessed. Results: The results of the individual SBHC interviews and the convening revealed the need for educational tools;videos and written materials created in English and in Spanish designed for a variety of audiences, including medical and dental providers, students, and families. The resources, developed by faculty and students at the University of Colorado School of Dental Medicine, cover an array of OH topics, including how to treat common dental emergencies, children's oral health, fluoride varnish application, and the importance of healthy food choices. The providers of the participating SBHC were asked to complete a pre-and post-survey of the content of the educational videos created, these results are forthcoming. Conclusion: The COVID-19 pandemic further exacerbated problems of access to care that SBHCs strive to diminish. This project sought out the needs of five SBHC (both rural and urban) that were greatly affected by the pandemic. Educational resources were developed to help improve the OH of children and families, boost the confidence of providers, as well as help the SBHC to re-integrate and increase their OH services. These resources are for providers, students, and parents and can be utilized by all SBHCs.
ABSTRACT
Background: The United States Preventive Services Task Force recommends that medical providers apply fluoride varnish (FV) to the teeth of all children under 6 years of age, but fewer than 10% of eligible children receive FV as recommended. Prior studies suggest that variation in clinical guidelines is associated with low uptake of other evidence-based health-related interventions, but consistency of national guidelines for the delivery of FV in medical settings is unknown. Methods: Eligible guidelines for application of FV in medical settings for children under 6 years of age were published in the past 10 years by national pediatric or dental professional organizations or by national public health entities. Guidelines were identified using the search terms fluoride varnish + [application; guidelines, or recommendations; children or pediatric; American Academy of Pediatrics (AAP); American Academy of Pediatric Dentistry] and a search of Guideline Central. Details of the guidelines were extracted and compared. Results: Ten guidelines met inclusion criteria. Guidelines differed in terms of periodicity recommendations and whether FV was indicated for children with a dental home or level of risk of dental caries. Conclusion: Numerous recommendations about FV delivery in medical settings are available to pediatric medical providers. Further study is warranted to determine whether the variation across current guidelines detected in this study may contribute to low FV application rates in medical settings.