Louisiana Seals Smiles

Many school sealant programs have been suspended due to COVID-19. Review CDC’s Considerations for School Sealant Programs During COVID-19.

Louisiana Seals Smiles (LaSS) is a statewide oral health school-based and school-linked program aimed at improving the dental hygiene and health of children 6-14 years old. By connecting with key providers throughout the state to provide dental sealants, fluoride varnish applications and oral health education to eligible children free of charge.

School Sealant Programs

Increase Access to Dental Sealant Services

Well-Ahead Louisiana works with partners across the state to promote, coordinate, implement and evaluate School Sealant Programs in elementary and middle schools located in dental health professional shortage areas (HPSAs) in which at least 50% of students qualify for federal or state free/reduced meal programs. Our partners include Federally Qualified Health Centers (FQHCs) with dental services, School Based Health Centers (SBHCs), Area Health Education Centers (AHECs), state hygiene schools, nonprofit and grassroots organizations. School Sealant Programs deliver dental sealants—which are thin, colorless, plastic coatings placed on molar teeth to prevent cavities—to children who are less likely to receive dental care. School sealant programs can be school-based or school-linked. Effective school sealant programs result in measurable population-level oral health impacts and economic savings. The expansion of the program will ultimately reduce the prevalence of dental cavities and disparities in oral health within Louisiana.
Well-Ahead Louisiana works with partners across the state to promote, coordinate, implement and evaluate School Sealant Programs in elementary and middle schools located in dental health professional shortage areas (HPSAs)  in which at least 50% of students qualify for federal or state free/reduced meal programs. Our partners include Federally Qualified Health Centers (FQHCs) with dental services, School Based Health Centers (SBHCs), Area Health Education Centers (AHECs), state hygiene schools, nonprofit and grassroots organizations. School Sealant Programs deliver dental sealants—which are thin, colorless, plastic coatings placed on molar teeth to prevent cavities—to children who are less likely to receive dental care. School sealant programs can be school-based or school-linked. Effective school sealant programs result in measurable population-level oral health impacts and economic savings. The expansion of the program will ultimately reduce the prevalence of dental cavities and disparities in oral health within Louisiana.

Louisiana Seals Smiles During COVID-19

Many school sealant programs have been suspended due to COVID-19. As programs are restarted, please be sure to review CDC’s Considerations for School Sealant Programs During COVID-19.

All School Sealant Programs should adhere to the CDC’s Interim Infection Prevention and Control Guidelines for Dental Settings during the COVID-19 as well as the Infection Control Guidance for Healthcare Professionals about COVID-19.

How to Host a School Sealant Program

School-based programs are conducted completely within the school setting using portable dental equipment. School-linked programs are implemented through schools, but services are implemented in a mobile unit or clinic setting. 

To learn how to implement a school sealant program, follow the below steps accordingly.

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.  

Be sure to connect with:  

  • Local dental providers and hygienists
  • Nearby academic institutions: dental schools, dental hygiene programs, and dental assistant programs 
  • School board members, school administrators and staff, teachers, school health advisory committees, and school nurses
  • Parent teacher associations (PTAs) 
  • Community service clubs, especially those that are serve youth  
  • Faith-based organizations  
  • Healthy community coalitions
  • Community health centers 
  • Business leaders
  • Local dental associations 
  • Local school of public health 
  • Local health education or health promotion programs within university

Choose an elementary or middle school in your community in which at least 50% of students qualify for federal or Louisiana free/reduced meal programs. Schools that are also located in dental healthcare provider shortage areas 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! 

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 

You will also need patient supplies to conduct the program.  

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, parents or guardians.

Staff

  • Ensure all dental staff participating in your school sealant program have the required permits and licenses. Visit the Louisiana State Board of Dentistry for more information.
    • Louisiana requires a prior exam by a dentist, and further requires a dentist to be present when a sealant is applied in a school sealant program. 
  • Designate one primary point of contact at your organization to coordinate with the school’s primary point of contact.  

 

Schools

  • Determine if the program will be school-based or school-linked. 
  • If the program will be school-based, discuss space at the school for the program. The space should have exceptional lighting, proper ventilation, and an adequate number of electrical outlets. Portable dental equipment can be noisy, so be sure to consider this when determining a location within the school.   
  • Discuss the oral health educational component of Louisiana Seals Smiles. There should be a student educational component and a parent educational component.
    • For Parents: This should include a verbal or written explanation on the importance of dental sealants. This could be delivered during via a presentation at a PTA meeting, during parent teacher conferences, or in a school newsletter.   
    • For Students: At a minimum, this includes a brushing and flossing demonstration. Click here for a free download of an oral health worksheet.

 

Parents or Guardians

Parent or guardian support is essential for a successful program. Utilize the materials below to communicate with parents or guardians about Louisiana Seals Smiles! 

  • Parent Flyer can be used to notify parents or guardians about Louisiana Seals Smiles. 
  • Student Consent Form should be used to obtain consent for participation from parents/guardians.  
  • Additional Information can be used to provide more in-depth information on the importance of dental sealants. 

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 Child Screening Summary should be completed. The Child Screening Summary 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 Child Screening Summary 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.  

Louisiana Dental Health Professional Shortage Areas

Louisiana is a predominately rural state with 86% of residents living in a Dental Health Professional Shortage Area. According to Medicaid data, children of low-income families’ experience greater barriers to receiving dental services. This includes lower rates of dental insurance, issues with provider office location and a limited number of practices accepting Medicaid insurance.

Funding School Sealant Programs

To operate effectively and ensure sustainability, all Louisiana Seals Smiles programs need adequate funding. Considering direct reimbursement through Medicaid, CHIP or by sliding fee payments, is an option to secure a means for ongoing services.

Possible funding sources may include: 

  • Federal funding agencies such as the Centers for Disease Control and Prevention 
  • Maternal & Child Health (MCH) Block Grant (Title V)
  • Preventive Health & Health Services (PHHS) Block Grant
  • DentaQuest
  • State General Funding
  • Other Public or Private Funding

Our Impact

Louisiana Seals Smiles provides dental services to children in our state who otherwise may not have access to dental care.  Since 2012, more than 4,700 students across the state have received dental sealants!

YearChildren ScreenedChildren who Received Sealants
2018-2019804413
2017-20184942
2016-201700
2015-20166344
2014-20152,0751,042
2013-20143,5782,121
2012-20132,1711,120
Totals8,7044,782

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