NUEVO – Since 2007, parents of every student in California’s public schools have been required by state law to confirm that their student has received an oral health assessment before the end of their first year of school. There are indications that less than one-third of school children eligible for the Kindergarten Oral Health Assessment successfully check in with a dental professional.

“Students may not be receiving their oral health screenings for a variety of reasons,” said Riverside County Administrator of Health Services, Dr. Leticia Esau. “Parents can submit a waiver form to opt-out, while some families do not have access to a professional dental health provider, or may not see it as a priority.”

A new pilot program to bring oral health assessments into schools has been launched in Riverside County through a partnership with the Riverside County Office of Education, Riverside University Health System-Public Health, the Riverside First 5 Commission, and the California Northstate University College of Dental Medicine, and Dental.com.

“It is common knowledge that students can better focus on their learning when they have glasses to improve their vision, and they are able to engage with their studies when they are not hungry. In the same way, we know that oral health challenges can be one more barrier to student success,” said Riverside County Superintendent of Schools, Dr. Edwin Gomez. “We are excited to be on the forefront of integrating technology and partnerships that lead to more equitable access to oral health for students, and we are actively seeking to make this available to all 430,000 students in 23 school districts in Riverside County.”

“In California, more than 50% of kindergarten children have already experienced dental decay. It's important to remember that tooth decay is preventable. Early detection and regular prevention of dental disease are crucial for avoiding severe dental complications that often require invasive and costly treatments. As educators, health officials, parents, and students, we all have the power to make a difference by becoming oral health champions. Through this collaboration, we took proactive steps to put children on a path toward better health and academic success by providing oral hygiene education and conducting kindergarten oral health screening to identify potential issues early on,” said Riverside University Health Systems Public Health Oral Health Program Coordinator, Sandra Velasco.

How It Works

For the demonstration held in May after receiving parent permission, the following three steps took place:

1. An initial look into the student’s mouth by a registered dental hygienist.
2. A school staff member who has gone through the training, separately takes pictures using the Smart Scan app on a smartphone and submits the images to Dental.com
3. At Dental.com, a dentist remotely reviews all of the gathered information for an individual student, and provides a comprehensive report for parents along with a referral to a local provider

Following the process, Riverside University Health System’s County Oral Health Program can share additional local resources with parents, check for insurance, arrange transportation to appointments, and address any additional health or social service barriers.

The initial goal of this demonstration was to show that the school staff member, equipped with the Dental.com technology and backed up by a remote dentist, could produce the same quality assessment that could be obtained by an in-person dental hygienist. This goal was successfully achieved.

A next goal of this effort is to work with the California Department of Public Health and other agencies and advocates to expand coverage and availability of this innovative system through private insurance, Medi-Cal, or other means of support.

Pilot Program at Nuview Union School District

On Tuesday, May 14, 2024, students at Nuview Elementary School and Valley View Elementary School in the Nuview Union School District participated in a successful pilot assessment of the program. After receiving an oral health lesson earlier in the month from RUHS-PH Oral Health Program that included stories about tooth care, counting their own teeth, and healthy eating, the students were prepared to take the next steps in improving their own dental health.

More than 60 students at both schools received the oral screening administered by Nuview Union School District’s Director of Student Services and Special Education, Dr. Anny Iacono, and RCOE Administrator of Health Services, Dr. Leticia Esau.

Using nothing more than a smartphone to take photos of the inside of students’ mouths, many of the students were receiving the first oral health screening of their lives while attending school that day. Several students presented with dental caries, holes in teeth, significant decay, and other conditions necessitating dental services. One student reported being in pain but stated that he had become accustomed to it.

“It was wonderful to observe the school staff interacting with the children, collecting needed information, taking photographs, and making all this available to the remote dentist for review. It was clear that this system has tremendous potential to be used in many schools across California,” said Dr. Paul Glassman, Associate Dean for Research and Community Engagement at the California Northstate University College of Dental Medicine (CNU), and Principal Investigator for this demonstration. “It is important that innovation, technology, and community involvement are addressing this long-standing problem.”

“Our students were very enthusiastic about the screening, thanks to the exciting classroom presentations to prepare them for the screening day. Oral health is critical to our students' well-being and directly impacts learning. If they are in pain or need extended dental procedures due to lack of adequate dental care, they will miss important class time and not be able to focus as well. We want our students to be healthy and able to access their education. A dental screening provided in school can help us accomplish those goals,” said Nuview Union School District Director of Student Services and Special Education, Dr. Anny Iacono.

“We are happy that Dental.com is able to support this innovative and important work with technology that is dedicated to improving oral health,” said Richard Lee, CEO of Virtual Dental Care, whose brand Dental.com is utilizing artificial intelligence to power the pilot program.

Research on Oral Health in Students

Recent research reports reveal the importance of oral health for students:

• Studies show that children with poor oral health status were nearly three times more likely than were their counterparts to miss school as a result of dental pain. (Impact of Poor Oral Health on Children's School Attendance and Performance)
• Absences caused by pain are often associated with poorer school performance but absences for routine care are not. (Impact of Poor Oral Health on Children's School Attendance and Performance)
• Findings suggest that improving the oral health status of children may be a vehicle to enhancing their educational experience. (Impact of Poor Oral Health on Children's School Attendance and Performance)
• Cavities are preventable and ensuring that students have the preventive oral health services they need in school is important in helping them stay healthy and ready to learn. (CDC Healthy Schools - Oral Health)

About the Riverside County Office of Education (RCOE)

RCOE is a service agency supporting the county’s 23 school districts and 500+ schools that serve nearly 430,000 students—more than the student population of 17 states. RCOE services include administrative support to districts and charter schools, programs for preschool, special education, pregnant minor, correctional, migrant, and vocational students. In addition, the organization provides professional training, support, and resources for more than 18,000 teachers, administrators, and staff, throughout the 7,000 square miles of Riverside County. Learn more at www.rcoe.us.

About Riverside University Health System – Public Health

RUHS-PH offers a wide range of services and programs, with a staff of more than 700 doctors, nurses, health educators, nutritionists, communicable disease and community program specialists, managers, and fiscal and support staff. Our mission is simple: to promote and protect the health of all county residents and visitors in service of the well-being of the community. It's all part of our vision for healthy people and a healthy community.

About California Northstate University College of Dental Medicine

California Northstate University College of Dental Medicine is a relatively new dental school located in the Sacramento California. Included in its mission is the goal of improving the oral health of society through education and community services programs. Learn more about California Northstate University College of Dental Medicine's mission.

About Dental.com

Dental.Com is a product of Virtual Dental Care (VDC). VDC’s mission is to create technology to help facilitate dental care delivery to underserved populations. Learn more at Dental.Com.