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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Preventive Dental Visit: Child.

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Strategy. School-Based Screenings and Follow-Up. (13.2)

Approach. Utilize school-based dental screenings to improve children’s oral health status and the use of dental services

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Overview. School-based dental screening is a popular public health intervention.[1] School-based dental screening refers to visual inspection of children’s mouths in a school setting followed by making parents aware of their child’s oral health status and treatment needs and making referrals to dentists, when necessary. The low-certainty evidence is insufficient to allow for conclusions about whether school-based dental screening improves dental visits.[2,3,4] There is a continued need for high-quality studies that assess the impact of programs that primarily focus on school-based dental screening to inform evidence-based public health decisions.[5] However, substantial research has been conducted on the effectiveness of school-based dental programs that, in addition to screening students for oral health needs, provide preventive care, such as applying dental sealants and applying fluoride varnish.

Evidence. Mixed Evidence. Strategies with this rating have been tested more than once with results that sometimes trend positive and sometimes show little effect. These strategies still have potential to work; however, further research is needed to understand the components of the strategies that have the most potential in producing consistent positive results. (Clarifying Note: The WWFH database calls this "insufficient evidence").

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source. (Read more about understanding evidence ratings).

Source. Peer-Reviewed Literature

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.
  • Timeliness of Care. This strategy promotes delivery of healthcare services in a timely manner to optimize benefits and prevent complications.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Outreach (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")

PROCESS MEASURES:

  • Number of schools offering dental screening programs. (Measures availability of dental screening access points)
  • Number of students receiving oral health education and promotion messages in conjunction with screenings. (Measures integration of preventative education with existing oral health services)

Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")

PROCESS MEASURES:

  • Percent of school-based screening programs using standardized, evidence-based screening protocols. (Measures school-based oral health program fidelity to recognized oral health best practices)
  • Percent of parents who receive clear, actionable communication about their child's screening results. (Measures level of family engagement in dental screening results and interpretations)

Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")

PROCESS MEASURES:

  • Number of schools that adopt policies for procedures to institutionalize dental screenings. (Measures sustainability and institutionalization of school oral health screening program)
  • Number of partnerships between schools, dental providers, and community organizations to support screening follow-up. (Measures level of care coordination for oral health across community organizations)

OUTCOME MEASURES:

  • Number of students who establish a dental home and receive regular care after screening and referral. (Measures breath of long-term linkages to oral health care)
  • Number of Medicaid-eligible students successfully enrolled in dental coverage as a result of screening and referral. (Measures connections between Medicaid-eligible students and families and potential benefits)

Quadrant 4:
Measuring Quality of Effect ("How are they better off?")

PROCESS MEASURES:

  • Percent of school screening programs tailored to schools with high enrollment of students from communities that have additional needs in the oral health system. (Measures level of tailoring of oral health programs)
  • Percent of families with limited English proficiency for other communication barriers receiving screening results in usable formats. (Measures level of communication strategies)

OUTCOME MEASURES:

  • Percent reduction in school absenteeism due to dental pain for infections in schools with screening programs. (Measures school oral health program impact on school attendance and learning)
  • Percent decrease in gaps in oral health status and untreated decay between students in high- vs. low-risk schools with screening programs. (Measures school oral health program impact on health access)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

1 Sanjeevan V, Janakiram C, Joseph J. 2019. Effectiveness of school-based dental screening in increasing dental care utilization: A systematic review and meta-analysis. Indian Journal of Dental Research 30(1):117–124.

2 Arora A, Khattri S, Ismail NM, Nagraj SK, Eachempati P. 2019. School dental screening programmes for oral health. Cochrane Database of Systematic Reviews (8).

3 Holmes RD. 2018. Insufficient evidence for the role of school dental screening in improving oral health. Evidence-Based Dentistry 19(1):3–4.

4 Joury E, Bernabe E, Sabbah W, Nakhleh K, Gurusamy K. 2017. Systematic review and meta-analysis of randomised controlled trials on the effectiveness of school-based dental screening versus no screening on improving oral health in children. Journal of Dentistry 58:1–10.

5 Graham A, Tajmehr N, Deery C. 2020. School dental screening programmes for oral health: Cochrane systematic review. Evidence-Based Dentistry 21(3):87.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.