Association‌ of‌ State‌ &‌ Territorial‌ Dental‌ Directors
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Dental Public Health Activities: Descriptive Summaries

Improving Oral Health in Schools in Georgia through Effective Collaborations

Practice Number: 12007
Submitted By: Georgia Department of Public Health, Oral Health Program
Submission Date: December 2012
Last Reviewed: May 2017
Last Updated: May 2017
Best Practice Approach Example -

An estimated 51 million school hours per year are lost because of dental-related illness. Children with dental problems are more likely to have problems at school, miss school, and are less likely to do all required homework.1 Children from families with low incomes have nearly 12 times as many restricted-activity days (e.g., days of missed school) because of dental problems as did children from families with higher incomes. School-based oral health education programs and preventive dental services can reduce serious and costly dental problems, as well as school absences.

For many years, the Georgia Department of Public Health, the Oral Health Program and the Georgia Association of School Nurses (GASN) have partnered to develop an Oral Health Task Force (OHTF). This task force focuses on effectively activating all Georgia School Nurses to promote good oral health practices among children in Pre-K through 12th grade. The OHTF want to reduce the proportion of children and adolescents who experience dental caries in their primary or permanent teeth.

The OHTF developed educational/training resources, materials, newsletters, and an oral health pocket guide. The resources target parents/caregivers and the interdisciplinary providers who work with school children. The goal is to enhance knowledge and awareness of the importance of proper oral health. The training class “Oral Health Education for School Nurses” incorporates pertinent oral health topics that the Georgia Oral Health Prevention Program (GOHPP) developed to meet the varying needs of school nurses. Topics include dental decay and the link between oral diseases and systemic diseases. The language used was simplified yet comprehensive enough that providers with limited oral health knowledge could adequately convey oral health information.

The “Oral Health Pocket Guide” was developed to assist school nurses in identifying oral conditions from the early stage white lesions through the development of more serious carious lesions. The GOHPP felt that pictures that school nurses could view along with the pocket guide would be very valuable and would initiate a better oral health assessment.

The “GA School Smiles” is an outstanding newsletter that one of the members of the OHTF has produced for all school nurses.

Since 2011 the resources have been presented at the Annual GASN Conference in Peachtree City, GA. Participants representing numerous school districts provided valuable input related to effective messaging that they felt would help to strengthen their knowledge. To augment the educational/training resources the partnership between GOHPP and OHTF continues to provide onsite training and technical assistance to school nurses in oral health risk assessment and referral mechanisms based on the urgency of school children needs, anticipatory guidance and the benefits of oral health education.

The oral health staff contributed to the Children’s Healthcare of Atlanta Hospital school nurse manual for the oral health section.

The oral health program’s goals and objectives from 2013-2016 were as follows:

  • Objective 1: To support School-linked Fluoride Programs for high-risk children by providing fluoride mouth rinse or fluoride varnish treatments to children lacking an adequate source of fluoride. In fiscal year (FY) 2014, approximately 8,530 school age children received fluoride treatments.
  • Objective 2: To provide Dental Health Education sessions in which Public Health dental hygienists teach school children the importance of proper brushing, flossing, and good nutrition for good dental health. In FY 2014, More than 80,000 school children were reached.
  • Objective 3: Partner with private practice to provide dental prevention and treatment services. In general, the program’s first priority for treatment is given to children who need emergency dental services because of pain or infection, and who are eligible for the Free and Reduced Meal Program (185% Federal Poverty Level). Basic dental treatment services include: Exams, cleanings, dental sealants, silver (amalgam) and tooth colored (composite) fillings, stainless steel crowns, minor nerve treatments and, extractions. In FY 2014, 180,107 dental prevention and treatment services were provided by DPH dental clinics.

Over the years, collaboration with school nurses has been very beneficial, particularly with school sealant programs and our 3rd grade survey. The goal of the 3rd grade survey is to screen teeth in children enrolled in 3rd grade in public Georgia elementary schools with more than 25 students in the 3rd grade.  Additionally, children’s caretakers were also interviewed regarding the child’s dental care and behaviors. The 3rd grade survey began in Fall 2016 and was funded by the Centers for Disease Control and Prevention (CDC).

During the data collection period, dentists and dental hygienists working with the Georgia Department of Public Health completed the screenings using the Association‌ of‌ State‌ &‌ Territorial‌ Dental‌ Directors (ASTDD) diagnostic criteria.

Overall, the collaborations with the Georgia Oral Health Program, Georgia School Nurses, and dentists and dental hygienists working in at the district level within the Georgia Department of Public Health has resulted in a remarkable level of coordination and partnership.  As a result, the OHTF has been able to remain focused on the goal to promote good oral health practices in schools and thereby reduce the proportion of children and adolescents who have dental caries experience in their primary or permanent teeth. The long term outcome will be an improved quality of life for many school children in Georgia.


  1. Guarnizo-Herreño CC1, Wehby GL. Children's dental health, school performance, and psychosocial well-being. J Pediatr. 2012 Dec;161(6):1153-9. Epub 2012 Jun 23.

Contact Person(s) for Inquiries:

Carol C. Smith, RDH, MSHA, Senior Manager, Oral Health Prevention Program, Maternal and Child Health, Georgia Department of Public Health, 2 Peachtree St., NW, Atlanta, GA, 30303-3142, Email: