Expanding Access to Oral Health Care Services in School-based Health Centers through Innovative NP/Dental Student Service-Learning Experiences

Dental caries is the most common chronic disease in children.  Currently, 42% of children from 2 to 11 years of age have dental caries and half of children 12 to 15 years of age (CDC, 2011).  Yet, there is limited access to quality oral health care services, particularly in underserved inner-city communities.  The largest concentration of dental caries occurs in children from low-income families with limited access to pediatric dental services.  More than 14 million children living in low income families did not see a dentist in 2011 (DHHS, 2011), and 42% of uninsured children had not been to the dentist within the past year in 2011 (Bloom, Cohen, Freeman, 2012)

There is currently a national workforce shortage of pediatric dentists to fill the demand for pediatric oral health services and comply with the recommendation by the American Academy of Pediatric Dentistry (AAPD) that all children establish a dental home.  Studies show that pediatric primary care providers lack knowledge and confidence in integrating oral health assessment and prevention into primary care visits (Golvineaux et al., 2012, Talib, 2011).   Providing enhanced workforce capacity through improved educational training programs for nurse practitioners including interprofessional clinical learning experiences will begin to address the gap in access to quality oral health services for children.  

This presentation will discuss an innovative academic-community practice model utilizing pediatric and family nurse practitioner students and dental students to expand access to preventive oral health services, including oral health assessment and fluoride varnish application. Collaboration includes nursing faculty offering a motivational interviewing skills workshop for dental students and dental faculty providing education in advanced oral health assessment skills including application of fluoride varnish for nurse practitioner students.  Trained dental and NP students work together with faculty and community providers in school settings to conduct oral health assessments and provide fluoride varnish applications.  A mass oral health screening for children in two inner city middle schools increased sustainability for the school-based health centers through provision of billable services while providing referral to the centers for other unmet child health needs and valuable service-learning experience for nurse practitioner and dental students.