5.1 Effective Program Operations
Targeting Populations
Targeting Children in Specific Grades
School-based dental sealant programs in some eligible schools target children in specific grades (typically grades 2 and 6) to provide sealants for vulnerable, newly erupted permanent molars. With ODH approval, programs may target other grades (e.g., grade 7, with grade 8 follow-up, to seal more newly erupted second molars).
Follow-up in grades 3 and 7 serves two purposes: (1) screening for sealant retention and sealant repair or replacement, if needed, and (2) sealing previously unerupted molars.
Efficient Program Operations
The efficiency of a program depends on the extent to which planning takes place before the sealant team arrives at a school, as well as on staff mindset, which must be oriented toward working as efficiently as possible. Making a program more efficient results in more children (e.g., 20 vs. 10) receiving sealants each day, which in turn leads to completing a school in fewer days and serving more schools during a school year. Efficient operations also translate into lower per-child costs for providing sealants.
Click here for a list of steps that programs can take to increase efficiency.
- Collect consent forms 1–2 weeks in advance of the date on which sealants will be placed to allow time for health histories to be screened and charts to be prepared.
- Check with school personnel (e.g., principal, nurse, teacher, secretary) to make sure there are no scheduled field trips, tests, special guests, parties, or other events that could interfere with sealant screening or placement.
- Set up the operatory and support area before the start of the school day. Start seeing students as soon as possible once school begins, and continue until dismissal. Working partial days reduces efficiency because the time needed for travel and for equipment set-up and break-down is the same as for a full day, but the number of children who receive sealants is lower.
- Have a line of children ready to be screened to determine their need for sealants (30–45 children per hour).
- Always have one child in the chair receiving sealants and one child waiting for his or her turn (see Step 8 of Seal America: The Prevention Invention (2nd ed.), for information on how to efficiently set up the work area and manage patient flow for screenings and sealant placement).
- Give the child who is waiting for sealants a dry toothbrush, and ask the child to brush his or her back teeth. Place the brush in a sealed plastic bag for the child to keep. After applying sealants, send the child back to class with the name of another child who should come to receive sealants.
- Use auto-polymerized sealant material. Under ideal conditions, a half-mouth of sealants (two to four sealants) can be applied from one mix of sealant material, with all the sealants curing in about 1 minute. Cooler temperatures slow the curing time, and warmer temperatures accelerate it. Light-cured sealant material requires curing each tooth individually, which takes more time and may result in fewer children receiving sealants over the course of a school day. For more information on auto-polymerized sealant materials, refer to “Sealant Materials.”
- Use cotton roll holders to make it easier to maintain a dry environment. Cotton roll holders are particularly important when sealing a half mouth at a time. Most teams who do not use cotton roll holders seal a quadrant at a time, which is more time consuming.
- In programs covering large geographic areas, coordinate scheduling of schools that are near each other, if practical. For example, when scheduling the dentist for screenings, you might schedule short-term retention checks at a school nearby, or screen children in multiple schools in one day. School schedules (e.g., lunch times) may dictate the feasibility of this approach.
|
BACK
