Problem Addressed: Oral Health

Healthy People 2010 Objective: 21

Web Address: None

SNAPSHOT

Seal a Smile, part of the Price County Health Department, is an oral health program providing services to all second and seventh grade students in public, private, and home schools, as well as the uninsured and underinsured in Price County, Wisconsin. Seal a Smile also serves the Medicaid/Badger Care population (the State Children’s Health Insurance Program [SCHIP]); Women, Infant, and Children (WIC) program; Family Planning, Prenatal Care Coordination program; and early Head Start.

THE MODEL

Blueprint: Seal a Smile delivers services through the schools, Price County Health Department, and Head Start. Seal a Smile provides several programs including:

community and school-based dental sealant program,
countywide fluoride supplement program,
non-fluoridated schools host a school-based fluoride rinse program,
lift-the-lip screenings for early childhood caries, and
case management and referral for children with oral health needs.

Price County, population 15,822, is a rural county and is a designated health professional shortage area and dental health professional shortage area; it is being reviewed as a mental health provider shortage area. There is no public transportation in the county, and the federal free and reduced lunch participation within the schools was 58 percent for the 2000-2001 school year.

Seal a Smile is staffed by one paid staff member, donated time by three staff members of Price County Health Department’s Dental Health Program, and volunteer staff consisting of six dentists, nine registered dental hygienists, and five dental assistants. The WIC program, Prenatal Care Coordination program, and Family Planning and Medical Assistances are all part of the Health Department and provide referrals and support staff to the Seal a Smile Program.

Making a Difference: For the 2001-2002 school year, 255 students (68 percent of the student population) received dental screening services; 183 students (73 percent of students screened) received sealants, with a total of 800 sealants applied. Placing the sealants represents a $20,000 cost savings to parents. The dental sealant program retention rates for second and seventh graders was 98 percent. These numbers reflect a significant increase in program utilization and services provided each year since the program’s inception.

Beginnings: Seal a Smile began in September 1999 and was fully implemented in October 2000 in response to the need for children’s dental care. The problem of dental access was identified by the Health Department through needs assessments and lack of providers who would accept Price County dental referrals. Partnerships providing initial funding and valuable financial support for the program include the State of Wisconsin, Department of Health and Family Services, Family Health Center through the Marshfield Clinic, Northern Area Health and Education Center (NAHEC), Children’s Miracle Network, the AnnMarie Foundation, Weathershield Lite Foundation, the Price County service organizations, Price County Health Department, and the March of Dimes. Healthy Smiles for Wisconsin, a coalition focusing on improving the oral health of all children in Wisconsin, and the Center for Disease Control provided technical support for the project.

Challenges and Solutions: The greatest challenge for the program is finding continued funding. The overall goal of the Price County Health Department is to continue the Seal a Smile Program as long as funding is available. The potential to charge for some services through the State of Wisconsin Medical Assistance Program will help to sustain the program. The Board of Supervisors in Price County is looking to reduce the tax levy, thereby expanding the program to include a permanent oral health coordinator position in the county.

A second challenge is in finding a dentist who will accept children identified as acute care clients, including low-income children. Additionally, a dentist is needed to conduct the state-law-required prescription examinations on the children in the schools, giving dental hygienists permission to place the sealants. There is overwhelming evidence that the Seal a Smile program would become a permanent program if it was possible to overcome the challenge of finding a dentist to take clients through the program’s case management services.

Future plans for the program include beginning a Fluoride Varnish Program through the WIC and Health Check programs and an Elder Care Dental Health Program. Public presentations, writing to Wisconsin legislators, testifying before the Governmental Dental Access Committee, writing for all available grants, and publishing articles in the State Dental Journal and the two State Dental Hygiene Associations serve to bring the program to the attention of potential funders and supporters.

PROGRAM CONTACT INFORMATION

Nancy Rublee or Tracy Ellis

Price County Seal a Smile

104 S. Eyder Avenue

Phillips, WI 54555

Phone: (715) 339-3054

Fax: (715) 339-3057