Gaining and sustaining community support is key to implementing a successful Louisiana Seals Smiles program in a school in your community.  Remember to consider all community members and organizations that could provide financial, in-kind, or volunteer support for the program.  

Choose an elementary school in your community in which at least 50% of students qualify for the federal or Louisiana free or reduced meal programs.  Schools that are also located in dental healthcare provider shortage area or located in an area without community water fluoridation should be given first priority.  Remember, all students who participate in the Louisiana Seals Smiles program should be between the ages of 6 and 14.  

Contact the school principal, nurse, or teacher.  You can do this by email, phone, or an in-person meeting!  Always be sure your communication is clear and connects with school staff and administrators.  Use the materials below to get the conversation started! 

• Introduction letter or email to school principal, nurse, or teacher.  This can be used to introduce Louisiana Seals Smiles to the school.  
• Dental sealant fact sheet.  This can be used to communicate the importance of dental sealants.    
• School participation form.  This can be used to track responses.  
• HPSA map

Once a school has agreed to participate, be sure to identify a primary contact that can help you launch and implement your program! 

Depending on whether you'd like to implement a school-based or school-linked program, there are options for applying dental sealants in a school setting.  

1. Set up a dental clinic within a school-based health center
2. Outfit or utilize a mobile van with dental equipment
3. Use portable dental equipment 

Well-Ahead Louisiana has all portable dental equipment needed to implement a Louisiana Seals Smiles program.  This equipment will be provided to partners upon request. Portable dental equipment includes the following: 

• Portable dental sealant unit.  This should include: an air/water syringe, a clean self-contained water system, a compressed air system, an air filter/dryer, and a low volume vacuum system. 
• Portable operator stools 
• Portable LED standing lights 
• Portable patient chair 
• Sealant curing lights 

If you'd like to utilize Well-Ahead's equipment, please email wellahead@la.gov to make a request.  If you have access to your own equipment, it can be used, as long as it includes all required elements to conduct the program.  If you have access to a mobile van, it can also be used! 

You will also need patient supplies to conduct the program.  Connect with a local dental provider for a recommendation on sourcing and sterilizing supplies.  There are several resources online to order supplies.   

For a complete checklist of equipment and supplies needed, click here.  

Before a Louisiana Seals Smiles program is implemented at your chosen school, you must complete the following launch tasks with your program's staff, school, and parents.

If you are implementing a school-based dental sealant program, its efficiency will depend upon preparations made to transport and setup dental equipment and supplies.  Be sure your equipment and supplies are well organized so they can be unpacked and setup quickly!  Tip: Label your storage containers to identify their contents!  

Either on the day before the program is scheduled to begin, or early in the morning on the same day, dental equipment should be delivered to the school and placed in the area where the program will operate. It is recommended that all equipment setup and breakdown, sterilization, instrument-tray preparation, and paperwork should occur before and after school. 

A group of ten students (or less) are excused from class at a time.  Students are screened for tooth decay, untreated cavities, and dental sealants.  This process should take between two to three minutes per student.  

Placing dental sealants generally takes between 10 and 15 minutes.   To apply, the tooth's surface is cleaned with a pumice and prophy cup, then rinsed and dried.  The tooth is then isolated using dry angles and cotton rolls and the enamel surface is etched.  The tooth is rinsed and dried again.  The sealant material is then applied to the grooves of the tooth using a micro-brush to ensure even distribution.  The sealant is then light-cured.  Last, a final check ensures the sealant is intact, covers the surface of the tooth, and does not have any bubbles or voids.  

Remember to explain to the student that their teeth may "feel too tall" for a little while, but that will go away soon! Be sure to tell them they should not eat anything sticky or hard for the rest of the day.  

After the treatment is complete, the Clinic Charting Form and Dental Report Card should be completed.  The Dental Report Card should be used to share screening results and sealant application information with parents/guardians. If an organization other than a safety net clinic is implementing Louisiana Seals Smiles, the organization should ensure proper referral to a dental provider.  This information can be added to the Dental Report Card or could be provided separately.  

RETENTION CHECKS 

Retention checks are one of the most important aspects of dental sealant delivery. After sealant placement, you should have a plan in place to return to the school to determine if the sealants are retained. You should use a random sampling process of the students. This helps to accurately determine the retention rate. A random sample gives each student an equal chance to be selected, regardless of their characteristics, such as which school they go to or which provider served them.

SPECIAL CONSIDERATIONS 

• Please reference the Louisiana Dental Practice Act.  Be sure to adhere to all Portable and Mobile Dentistry Statues.  
• Please reference recommendations from the CDC's Guidelines for Infection Control in Dental Health-Care Settings. 
• Services provided through Louisiana Seals Smiles are able to be reimbursed through Medicaid and LaCHIP.  The consent form provides a space for the student's identification number for reimbursement.  
• The Health Information Portability and Accountability Act requires that all health information be kept confidential.  Information regarding screening, sealant placement, etc.  should be kept in strict confidence with only the staff providing treatment, school personnel, and parents.  If the information is stored digitally, it should be encrypted, locked or password protected.  
• If any program staff suspects child abuse or neglect, it is mandatory that he or she report the suspicion to the school administration and proper authorities.  

Applying high-quality dental sealants to as many students as cost-effectively as possible is the goal of Louisiana Seals Smiles.  To determine whether a program is operating effectively and efficiently requires evaluating the program on a regular basis. 

To evaluate your program, about a week after the clinic, send the School Evaluation Form to your primary contact at the school.  In addition, send the survey link to the dental professionals that participated in your program.  

• School Evaluation Form
• Dental Professional Survey