We created the Partnerships for Better Health focus area to support innovative projects and new partnerships. The goal for these projects is to find creative ways to use existing resources to improve health across Montana.
This month, we are highlighting Sprout Oral Health and their School Nurse Fluoride Varnish Program. To address oral health disparities, Sprout Oral Health developed and implemented a sustainable School Nurse Fluoride Varnish Program in low-income elementary and Head Start schools. This project is significant because there are currently no other practice models like it found in the United States. Dr. Jane Gillette, a Bozeman-based dentist and founder of Sprout Oral Health, created the program with the help of a $50,000 grant from the Montana Healthcare Foundation.
Finding a child-friendly dentist who also accepts Medicaid can be challenging in rural Montana. Many communities do not have a dentist nearby, and for many families, the time and resources it takes to find a dentist, make an appointment, and then take the time to drive to that appointment is a significant struggle. Poor oral health can lead to pain, infection, missed school hours, tooth loss, and poor self-esteem. Luckily “fluoride varnish” is an easily applied treatment that can reduce tooth decay by 43%. The Association of State and Territorial Dental Directors recognizes fluoride varnish as a best practice when delivered in a community-based setting such as schools.
“School and public health nurses are the boots-on-the-ground champions for rural and frontier health. They already possess the passion and skills needed to deliver dental disease-preventing therapies. With a little support, we can create a low-cost, sustainable, and replicable model for improving the oral health of Montana’s children.”
– Dr. Jane Gillette
The School Nurse Fluoride Varnish Program created partnerships with 18 elementary schools in underserved and frontier communities throughout Montana. Because low-income children often have less access to dental care and higher rates of poor oral health, the program targeted schools with a federal free and reduced lunch rate of 70% or higher, a surrogate measurement for low-income status.
Through these new school partnerships, the program recruited and trained 36 school and public health nurses. The nurses received training through a customized and standardized curriculum, which educated them to apply fluoride varnish under the standing orders of a physician, nurse practitioner, or dentist. Having nurses provide this service helps to ensure that the program is sustainable after the grant is over because these services are reimbursable by Medicaid and private insurance.
After they received their training, the nurses identified and administered, at no cost to families, fluoride varnish to over 200 high-risk children. Children enrolled in the School Nurse Varnish Program were also provided case management services to resolve barriers to care, establish a “dental home” (or regular dentist), and address unmet oral health needs.
To help with the program’s ongoing sustainability and replication, Sprout Oral Health created a manual and reimbursement toolkit, which will be published in May 2020.
This innovative project demonstrates that school and public health nurses can learn to safely deliver fluoride varnish in the school and Head Start setting. Sprout Oral Health has integrated the School Nurse Fluoride Varnish Program into the package of community-based dental programs they maintain and implement across rural and frontier Montana. For more information about Sprout Oral Health and the work they are doing to improve oral health for Montana’s kids, visit SproutOralHealth.org