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oral health, refugee children, impoverished children, school-based dental services, community health clinical nurse specialist





Purpose/Objectives: In Vermont in 2001, less than half of school-age children on Medicaid received dental services. Vermont is a designated resettlement area for refugees, many of whom have never had dental care. A school-based oral health program was designed to meet the needs of this high-risk pediatric population.


Program: A plan was developed to offer dental services to this group of children. Through the efforts of a multidisciplinary committee the Tooth Tutor Program, developed by the Vermont Department of Health, dental care was made available to the children. The Tooth Tutor Program provides cost-effective dental hygienist care to children in the school setting and includes referral to community dentists.


Outcome: The program was able to provide services to approximately 500 children in the first 2 years with an increase in preventative services and decrease in restorative services from year 1 to year 2. After 3 years, a school-based dental service opened in 1 of the 3 target schools.


Conclusion: A school-based dental service that includes education, screening, and referral can be an effective program for improving oral health among impoverished children.


Implications for Nursing Practice: For the community health clinical nurse specialist, the client is the community. Clinical nurse specialist practice in this community resulted in improved oral health for high-risk school-age children. This program can be adapted for other communities.