Vermont’s Tooth Tutor Dental Access Program
A Description from the
Vermont Department of Health
A brief synopsis of Vermont’s model – the Tooth Tutor Dental Access Program. The program was developed in response to school nurses who wanted to spend funds for dental health but wanted school-wide screenings, classroom dental health education and toothbrushes for everybody. We helped them to see that ultimately getting every child into a dental home could answer all these needs – by targeting children, eventually the target group would only include new students to the school.

The Tooth Tutor Dental Access Program was developed to give schools a realistic and effective approach to improving dental health through education, prevention, and by assisting children without a regular dentist to find a dental home. School districts that consider dental health and access to care to be a priority can use EPSDT reinvestment money to hire a dental hygienist or other health professional to carry out the Tooth Tutor Dental Access Program. The essential parts and summaries follow.

  1. Grades 1-6 are encouraged to participate in the Fluoride Mouthrinse Program if the students in the school are not drinking fluoridated water. Studies show that new decay can be reduced by up to 30% by rinsing weekly with a 0.2% sodium fluoride mouthrinse solution. The Vermont Department of Health provides training and all supplies free of charge.
  2. Establish rapport with the local community dentists explaining the Tooth Tutor Program. The Target group may need assistance in locating a dental home. The dental hygienist introduces him/herself to area dentists and their offices to help in the facilitation of receiving an appointment. As a result of the visual exam the dental hygienist is able to provide information on the student’s dental status being either a preventive, restorative or emergency appointment.
  3. A paper screening on all of the children will determine which do not have a dental home. Information for the paper screening is ideally obtained from the student’s school health history. The target group children are those who do not have a dentist, or have not been in the last year or have provided no information. A Dental Fact Sheet, Something to Smile About, is sent home providing parents with information about regular check-ups, fluoride and sealants.
  4. The visual screening is ONLY for children without a dental home. They will require continuous follow-up, which will involve contacting and receiving permission from the parents/guardians. There are samples of referral forms, letters and the Dental Fact Sheet, Something to Smile About, in the Tooth Tutor Manual to guide the hygienist through this process. The Vermont Department of Health provides all visual-screening supplies. Even the children without permission for a visual screening are still part of the target group until they have a dental home.
  5. The Tooth Tutor classroom dental health education is for grades K-6. The Vermont Department of Health provides the Tooth Tutor Curriculum and all the supplies. The supplies include a canvas tooth tote, 3 videos, a large tooth model and demo toothbrush, a storybook for the kindergarten level, toothbrushes for first grade, floss for third grade, a mouthguard sample for fifth grade and lesson plans for all levels including transparencies, experiments and parent information.

The intent of the Tooth Tutor Dental Access Program is to place most of its resources toward children who do not have a dentist. The goal of this program is to promote a dental intervention program that will increase the number of children receiving oral preventive services and routine care in a dental office. All of the children will benefit through the Fluoride Mouthrinse Program and Tooth Tutor curriculum.

Vermont has 58 schools participating, which is approximately 20% of its elementary schools. In school year 2000/01 75% of the students had a dental home in September – this grew to 89% in June. Preventive care only cases were 56% of the Target group, 34% needed restorative care and 9% needed emergency care.

Summary provided by:
Rebecca J. MacDonald, RDH
Dental Health Education Coordinator
Dental Health Services
Vermont Department of Health
P.O. Box 70 108 Cherry Street
Burlington, VT 05401
Tel: 802-863-7341 M-F
Fax: 802-651-1634