Building School Nurses’ Capacity to Undertake School Dental Screening: A Pilot Project in Santa Rosa, California

ABSTRACT

Background

California school nurses have cited a lack of training as an obstacle to conducting dental screenings. The objectives of this pilot project were to develop educational materials, train school nurses to perform basic dental screening examinations, and evaluate the acceptability and perceived effectiveness of the training program.

Methods

A two-part training program (synchronous webinar followed by practical session) to train school nurses from Santa Rosa City Schools, California, for conducting basic screening surveys was developed during the COVID-19 pandemic. This was a mixed methods study.

Results

At baseline, half of the nurses did not feel confident in performing dental screening (10-point Likert scale scores ranged from 2 to 4). After the training, the nurses reported enjoying the training program as well as an improvement in their knowledge and increase in confidence to 1) screen children’s mouths, 2) identify decayed teeth that need treatment, 3) triage oral health care needs appropriately, and 4) refer children to a dentist (average Likert scale scores of 7–8).

Conclusions

The training program was acceptable to school nurses and increased their perceived capacity to perform school dental screening. This study shows that by training and educating school nurses, it is possible to build their capacity up to the point where they are empowered to confidently perform basic dental screenings.

Practical Implications

School-based dental programs should consider partnering with school nurses to screen for children with dental needs. This study adds to the literature on inter-sectoral collaborations and team-based partnerships to improve oral health.

KEYWORDS:

• School dental screening
• school nurses
• training
• oral health
• dental referrals
• dental caries
• intersectoral collaboration

Acknowledgments

The authors are grateful to all the school nurses from Santa Rosa City Schools who participated in this study (Jennifer Rodriguez, Alison O’Herlihy, Nicholo Atup, Heather Ginnever, Sangmo Witzman, Amanda Arend, and Cheryl Closser) as well as to Terese Voge (Sonoma County Department of Health Services) for her advice and support for this project.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Other than funding from the Sonoma County Department of Health Services to procure the personal protective equipment and dental mouth mirrors for conducting the practical teaching session, no other sources of financial support were received for the conduct for this study.

Notes on contributors

Gabriel Tse Feng Chong

Gabriel Tse Feng Chong, BDS, MPH (Hons), MFOdont (Dist), DipFHID, EMBA, FAMS (DPH), MRACDS (DPH), FFFLM, is a Consultant in Dental Public Health and Forensic Dentistry. He is currently serving as an active-duty Dental Officer in the Singapore Armed Forces (SAF) as the Head of General Staff of the SAF HQ Medical Corps. This project was undertaken during his studies at the University of California San Francisco, which was sponsored by the SAF.

Andrea Pickett

Andrea Pickett, MPH is a Health Information Specialist with the Sonoma County Department of Health Services, Public Health Division. She is the Project Coordinator for the Sonoma County Oral Health Program.

Elizabeth Munns

Elizabeth Munns, RN, BSN, PHN, MS is the Head School Nurse at Santa Rosa City Schools. She is registered with the California Board of Registered Nursing.

Kristin Hoeft

Kristin Hoeft, PhD, MPH, is Associate Professor in the Division of Oral Epidemiology and Dental Public Health at the University of California, San Francisco School of Dentistry.