5.1 Effective Program Operations

Targeting Populations

Targeting Children in Specific Grades

School-based dental sealant programs often target children in specific grades (e.g., grades 2 and 6) to provide dental sealants for vulnerable, newly erupted permanent molars. However, programs may target other grades. Staff at several dental sealant programs have noticed children’s molars erupting earlier and/or that children are experiencing dental caries on their molars by the time they are seen in third grade. Thus, many programs have started screening children in earlier grades and applying sealants when necessary. Many programs also visit children in seventh and eighth grades for follow-up and to seal more newly erupted second molars.11 Follow-up with these children again the following year when they are in the next higher grade serves two purposes: (1) screening for dental sealant retention and providing 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 dental sealant team arrives at a school, as well as on staff calibration, 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 dental 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 to lower per-child costs for providing sealants.

Click here for a list of steps that programs can take to increase efficiency.

  • Collect consent forms at least 1–2 weeks in advance of the date on which dental 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. Begin seeing students as soon as possible once school begins, and continue until dismissal.
  • Work full days rather than partial days. Working partial days reduces efficiency because the time needed for travel and for equipment set-up and breakdown is the same as for a full day, but the number of children who receive sealants is lower.
  • Have a small group of children waiting to be screened to determine whether they need sealants.
  • 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 (3rd ed.) for information on how to efficiently set up the work area and manage patient flow for screenings and sealant placement).
  • Use of cotton roll holders may 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. If feasible, the isolyte is an effective tool in keeping the mouth dry, providing light, and dividing quadrants of the mouth for sealant placement.
  • 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, programs may wish to schedule short-term retention checks at a school nearby or to screen children in multiple schools in one day. School schedules (e.g., lunch times) may dictate the feasibility of this approach.