soben peter

1. BHAVANA MARRI

2. DEFINITION
School health services are defined as the procedures
established
 To appraise the health status of pupils and school
personnel
 To counsel pupils, parents, and others concerning
appraisal findings
 To encourage the correction of remediable defects
 To assist in the identification and education of
handicapped children
 To help prevent and control disease and
 To provide emergency service for injury or sudden
sickness

3. ASPECTS OF SCHOOL HEALTH
SERVICE
1. Health appraisal
2. Health counseling
3. Emergency care and first aid
4. School health education
5. Maintenance of school health records
6. Curative services

4. OBJECTIVES
 To help every school child appreciate the importance of a
healthy mouth and relationship of dental health to general
health and appearance
 To encourage the observance of dental health practices,
including personal care, professional care, proper diet, and oral
habits
 To enlist the aid of all groups and agencies interested in the
promotion of school health
 To correlate dental health activities with the total school health
program
 To stimulate the development of resources to make dental care
available to al children and youth
 To stimulate dentists to perform adequate health services for
children

5. IDEAL REQUIREMENTS
School health program should be
 Be administratively sound
 Be available to all children
 Provide the facts about dentistry and dental care, especially
about self-care preventive services
 Aid in the development of favorable attitudes toward dental
health
 Provide the environment for the development of psychomotor
skills necessary for tooth brushing and flossing
 Include primary preventive dentistry programs-prophylaxis,
and fluoride programs, and use of pit and fissure sealants
 Provide screening methods for the early identification and
referral of pathology
 Ensure that all discerned pathology is expeditiously treated

6. ADVANTAGES
 School oral health programs can bring comprehensive
dental care
 Students can be accessed during their formative years
 School clinics are less threatening than private offices since
the children are in familiar surroundings
 It will be relatively easy to maintain the dental health of
children in their adult life
 Can facilitate valuable consultation on medico dental
problems
 Expenses involved and time used in transportation can be
saved
 Utilizing dental auxiliaries can further reduce the cost

7. ELEMENTS/COMPONENTS OF SCHOOL
ORAL HEALTH PROGRAM
1. Improving school community relations
2. Conducting dental inspections
3. Conducting dental health education
4. Performing specific programs
5. Referral for dental care
6. Follow-up

8. Improving school community
relation
One of the first steps in organizing a dental health
program is the formation of advisory committee. It
should include broad representation from parents,
teachers, school administrators, dental
professionals, health officers and community
leaders.
The task of these committees is
 To appraise and publicize the dental needs of school
children
 To address the school administration’s concern in
the promotion of oral health
 To make people realize the importance of dental
health

9. Conducting dental inspections
 It serves as a basis for school dental health
instruction.
 Every child unless provide otherwise is considered to
be free from dental disease, the positive findings, on
such children will provide greater motivation
towards dental health
 It builds a positive attitude in the child towards the
dentist and dental care
 The child and the parent are motivated to seek
adequate professional care
 Teacher, students and dentists concerned with
dental health may use the dental inspection as a
fact-finding experience
 Provide information as to the status of dental needs
to plan a sound dental health program

10. Conducting dental health education
 The dentist serves as the expert resource
person to strengthen the teacher’s classroom
education program
 He should give each teacher sincere attention
 This is important in developing proper
attitudes and personal dental health practices
by the teacher which can be passed on to the
classroom

11. Performing specific programs
TOOTH BRUSHING PROGRAMS
 At the end In a classroom, 6-8 children can be taught as a group.
Each is given a cup, a napkin, and a kit containing a disclosing tablet,
a toothbrush, and a tube of fluoride dentifrice.
 The mastery of the 45 degree angulations and the short vibratory
strokes can then be repeated on an oversized dentoform model.
 Next, the children are asked to chew a disclosing tablet and to swish
it around the mouth for 30 seconds.They are then encouraged to
look at each other’s teeth with appropriate emphasis on the fact that
the red stain colors the plaque in which the bacteria live.
 Next a magnifying mirror is passed around so the participants can
note that their teeth are no different from those of their neighbor
i.e. all people have plaque.
 Guided brushing can then begin, with the instructor establishing the
sequence of teeth to be brushed.
 At the end the mirror is again passed around to show that
progress has been made.

12. CLASSROOM BASED FLUORIDE PROGRAMS:
Two effective fluoride programs –
Fluoride moth rinse program:
 A once-a-week mouth rinse can be expected to result in 20% to
40% reduction in dental caries.
 The dispenser is graduated so that 2.0 gm. Of packaged
sodium fluoride powder can be placed in a jug and water is
added to the 1000ml mark.
 The rinse should be non-sweetened and non-flavored to
discourage swallowing.
 Rinsing programs are advised for grades 1 to 12 but not below.
 Five ml of the rinse is dispensed in to each cup and all the
children are instructed to rinse the solution in the mouth for 1
minute, after which they are to spit carefully into the cup.
 The napkin is used to wipe the mouth, after which it is forced
into the bottom of the cup to absorb all fluid.
 Fluoride mouth-rinse programs received official recognition of
safety from the FDA in 1974 and by council on dental
therapeutics of the ADA in 1975.

13. Fluoride tablet program:
 One tablet is given to each student.The student then chews
and swishes the 2.2mg sodium fluoride (1mg fluoride) tablet in
the mouth for a minute and then swallows.The swish-and-
swallow technique provides the optimum systemic benefit
during the period of tooth development and maturation.
 The daily tablet is more effective than the weekly rinse.
School water fluoridation programs:
 The amount of fluoride added to school drinking water must
be greater than that used in communal water supplies, i.e. 4.5
times the optimum concentration since children are in school
for shorter hours and less water is consumed during that time.
 Study have shown a reduction in dental caries prevalence by
about 40% among children attending school that support
school water fluoride programs a major advantage is that
children do not receive benefits until they begin school.

14. Nutrition as apart of school preventive
dentistry programs:
School lunch programs are designed to provide the child
with a intake of nutrients that approximate one third
of the daily intake of essential carbohydrates,
proteins, fat, minerals and vitamins.
Mid day meal program of government of India
 The program of providing hot cooked meal was
introduced in 7 north eastern districts of the state
during 2002-2003
 The scheme consisted of providing free food grains at
3kg per child or per months to children of class 1 to 5
of govt schools on the basis of 80% attendance in a
month
 The scheme was extended from classes 1 to 5 in govt
aided schools from 1-9-2004

15. Sealant placement
 The placement of pit and fissure sealants is
ideally suited for a school program
 1st , 2nd , 6th and 7th standards would be
desirable levels to selectively intervene pits
and fissure lesions
 1st and 2nd standards, because first
permanent molars are sufficiently erupted to
place the sealant. 6th and 7th standards- 2nd
permanent molars.

16. Science fairs
 Science fair not only helps in educating and
motivating the school children to improve
their oral health but also provides an
excellent opportunity for dentistry to
contribute substantially to the building of a
growing reservoir of students who may some
day choose a career in dentistry

17. Referral for dental care
 In few schools dental care is provided at the
school itself. However if only emergency
treatment is provided, for eg: the dental auxiliary
places eugenol-soaked cotton in a child’s cavity
to relieve the pain the parent does not see the
child in pain and might conclude that the school
has taken care of the dental problem.
 Therefore the parent should be informed and
made to understand that such emergency
treatment is not a cure and she will have to visit
the dentist of her choice for proper treatment.

18. Blanket referral
 A program that has proved to be effective in
many schools is blanket referral of all children
to their family dentists
 In this program all children are given referral
cards to take home and subsequently to the
dentist, who sign the cards upon completion
of examination, treatment, or both.
Follow up

19. SCHOOL ORAL HEALTH PROGRAMS
 Learning about your oral health
 Tattletooth program
 ASKOV dental demonstration
 North Carolina statewide preventive dental
health program
 Head start preschool dental health program
 School health additional referral program
 Teenage health education teaching assistants
program
 Colgate’s bright smiles, bright futures
 WHO’s global school health initiative

20. “TATTLETOOTH PROGRAM”- TEXAS
STATEWIDE PREVENTIVE DENTISTRY
PROGRAM
The tattletooth program was developed in 1974-1976
as a cooperative effort between texas dental health
professional organizations.
In 1989 the Bureau of dental health developed a new
program to replace the existing program.This was
called tattletooth II – A New Generation for Grades
K-6.
Separate lesson plans were developed for each grade
and a systems approach was used to develop all
educational material.
 Three video tapes were produced as part of the
teacher-training package

21.  The first video tape familiarizes the teachers
with the lesson format and content
 A second video tape, “brushing and flossing”
was developed for the dual purpose of teacher
training and as an educational unit to be used
by the teacher with students
 A third video tape provides teachers with
additional background information as a means
of preparing them to teach the lessons
 The materials that were developed to aid in the
implementation of the program consisted of
- a brochure that provided an overview of the
program
- a school nurse’s brochure

22. PROGRAM PHILOSOPHY AND GOALS
 The program embraces the six elements of
effective lesson design, anticipatory set,
setting the objective, input modelling,
checking for understanding, guided practice
and independent practice.
 The basic goal of the program is to reduce
dental disease and develop positive dental
habits to last a lifetime.The major thrust of
tattletooth is to convince students that
preventing dental disease is important and
that they can do it.

23. PROGRAM IMPLEMENTATION
TheTexas department of health employs 16 hygienists in the eight
public health regions to implement the tattletooth program.
 The hygienists instruct teachers using videotapes designed for
teacher training and provide them with a copy of the curriculum
 Health promotion activities are encouraged and publicized within
the school community
 Teachers are encouraged to invite a dental professional to
demonstrate brushing and flossing in the classroom
 A field trip to a dental office is strongly recommended for
kindergarten children
 Bulletin board suggestions, a book list, films and videotapes are
available on a free loan for appropriate grade levels
 Other resources used are a list of companies providing
supplementary classroom resources and a comprehensive
glossary of vocabulary words written for the teacher in English or
Spanish that are used in all grade levels

24. PROGRAM EVALUATION
The students in grades 3, 5, 7, 9 and 11 were given
theTexas Assessment of Academic skills [TAAS]
by theTexas education agency, to satisfy the
legislative requirement that student
performance be assessed.
Teacher evaluation is done annually by principals
and supervisors using a 65-item checklist.
A major field test conducted in 1975 studied 15000
children in 18 educational service regions.
Results of single exposure to the program
revealed that-

25.  Dental health knowledge was significantly
increased at all grade levels
 Plaque levels were decreased by
approximately 15% in a randomly selected
sample of 2142 children
 Over 8o% of the teachers judged the
program to be helpful ad effective , but
evaluation questions suggested that they felt
a need for additional technical help in
brushing and flossing

26. INCREMENTAL CARE
 It may be defined as periodic care so spaced that increments
of dental disease are treated at the earliest time cosistent
with proper diagnosis and operating efficiency, in such a
way that there is no accumulation of dental needs beyond
the minimum
 In private practice, six months is the commonest, though
not the only interval between visits. In public health
programs, one year intervals are usually implemented.
 This represents the ideal pattern for care where appreciable
incidence of new dental disease is to be expected each year.
 Treatment programs can be gotten of the ground by taking
the youngest available group the first year and carrying it
forward in subsequent years as far as funds permit, each
year adding a new class of children at the next earliest
available age until an entire child population is being served
to as high an age as available resources permit.

27. Advantages :
 Lesions of dental caries are treated before there
has been a chance for pulpal involvement
 Periodontal disease is intercepted at or near the
beginning
 Topical and other preventive measures are
maintained on a periodic basis
 Bills for dental services are equalized and
regularly spaced
 The program avoids the high expenditure of late
dental care
 It confines dental disease to small early
increments, thus reducing loss of teeth
 It inculcates a habit of periodic return to the
dental office in subsequent years

28. Disadvantages :
 Time consuming
 Attention to deciduous teeth
 Increasing likelihood of interruption in
children’s dental health programs

29. COMPREHENSIVE CARE
Comprehensive dental care is the meeting of
accumulated dental needs at the time a
population group is taken into the program
[initial care] and the detection and correction of
dental disease on a semiannual or other periodic
basis[maintenance care]
Services are provided not only to eliminate pain
and infection but also to
 Restore serviceable teeth to good functional form
 Replace missing teeth
 Provide maintenance care for the control of early lesions of
dental disease
 Provide preventive measures, educational and otherwise,
so that the population may experience a lower prevalence
of disease