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Dental Public Health Activities: Descriptive Summaries

Smart Smiles in Boston Public Schools - A Preventive Dental Program

Practice Number: 24004
Submitted By: Massachusetts Department of Public Health, Office of Oral Health
Submission Date: January 2005
Last Reviewed: February 2018
Last Updated: February 2018
Best Practice Approach Example -

Established in 2004, the Smart Smiles program provides comprehensive oral health services to students in the Boston Public Schools.  Many of the children attending Boston Public Schools (BPS) do not have access to a regular source of dental care. A statewide survey of children’s oral health conducted in 2006 found that among all 3rd graders in Massachusetts, 17% had untreated decay and 46% had at least one dental sealant.  In Suffolk County, which is comprised of Boston and two other urban communities, 31% of third graders had untreated decay and only 34% had at least one dental sealant. Statewide, lower income and minority children were more likely to have untreated decay.  In BPS, 85% of students are from racial or ethnic minority backgrounds and nearly 60% low income.

Boston public schools who wish to receive dental services are divided between the Tufts and Boston University programs which primarily provide preventive services on time per year at each school. CMOHS visits the schools a second time to provide restorative care to those for whom it is needed and additional preventive care.  This system provides children with two dental visits per school year.

The goal of the Smart Smiles program is to help prevent dental problems among Boston’s children and to identify, treat, or refer for treatment, any student who has existing oral health problems. Using portable dental equipment, the Smart Smiles program provides oral health education, dental screenings, dental sealants, fluoride treatments, and restorations.  The Boston University School of Dental Medicine (BUSDM) School Based Program’ contribution to this partnership included services for student all grades of 30 elementary schools and one high school in Boston. During the ’16-‘17 school year, BUSDM provided education for over 4,000 children and over 1,300 children received preventive dental services.  In addition, 502 restorations were completed for 245 children through BUSDMs portion of the Smart Smiles partnership.

First year dental student from BUSDM join the Smart Smiles dentists in the education and prevention efforts of the Smart Smiles program. Fourth year students join the Smart Smiles dentists in providing restorative care during the pediatric clinical rotation.  These activities expose dental students to the impact of limited access to dental care and disparities in oral health status. By introducing them to community service early in their professional careers, the Smart Smiles Program aims to foster a life-long commitment to public service. 

Smart Smiles is reimbursed through dental insurance for a portion of the children served. In addition each of the partners receives grant funding from their parent organizations to cover the uninsured.  Program costs include salaries of dentists, assistants and billing personnel as well as program supplies and the initial cost of portable equipment.

Lessons Learned:

The Smart Smiles program requires continuous effective communication among the three partners who share the responsibilities of the program.  This collaboration reduces confusion among BPS schools.  They can contact one person to have any question answered about the Smart Smiles program.  By sharing responsibilities and avoiding competition among the dental schools, we can better ensure service coverage in Boston.  Strong collaborative relationships with school administration, nurses, and teachers are also essential. Consent is highest in schools where there is most involvement by school staff.  Turn-over in these roles has a negative effect on parental consent.

Contact Person(s) for Inquiries:

Corinna S. Culler, RDH, DrPH, Director, School-Based Programs, Henry M. Goldman School of Dental Medicine, Global and Population Health, 715 Albany Street, 560, 3rd Floor , Boston, MA 02118 , Phone: 617-638-4918  Email: