School-Based Dental Programs Reduce Cavities by 50%

Child at the dentist.

Peter Cade / Getty Images

Key Takeaways

  • A study links school-based cavity prevention programs to a 50% decrease in childhood cavities. 
  • Many logistical barriers keep children from visiting a dentist and receiving preventative oral care.
  • Poor oral health can lead to many health conditions including diabetes, oral cancer, and heart disease.

A study led by the NYU College of Dentistry found that bringing school-based cavity prevention programs directly to school settings reduced cavities in both baby and permanent teeth by 50% after six visits, signifying that dental care in schools can make a significant impact on children’s oral health.

The study, which implemented the free dental clinic at 33 public, high-risk elementary schools in Massachusetts using dental hygienists, serviced nearly 7,000 children. This eliminated two major barriers to dental care: cost and transportation. 

“Screenings are mandated in many states, but they haven’t been shown to improve health,” lead study author Richard Niederman, DMD, professor and chair of the department of epidemiology and health promotion at NYU College of Dentistry, tells Verywell. “With our program, we are able to actually treat them right there in a matter of minutes.”

What This Means For You

Experts recommend going to the dentist twice a year to maintain good oral health and prevent illness and disease. But a lack of insurance, transportation, and more can all be barriers to accessing dental care. If you're encountering issues scheduling a dental appointment for yourself or your children, try reaching out to your local school, doctor, or public health agency to learn about any potential dental programs in place.

Barriers to Access

Poor oral health is prevalent in the United States. The Centers for Disease Control and Prevention (CDC) estimates that 52% of children have had a cavity in their baby teeth by the time they are 8 years old, and children in lower-income families are twice as likely to have cavities as their higher-income-family classmates.

Lack of oral hygiene not only negatively affects students' health but also impacts their school attendance, with over 34 million learning hours lost to emergency dental care each year. Although many parents understand the importance of good oral health, there are barriers that keep them from taking their children to see a dentist. According to the Rural Health Information Hub, the most prominent barriers to oral care include:

  • Too few providers for the population (dental deserts) 
  • Too few providers who accept Medicaid or the Children's Health Insurance Program 
  • Limited or no dental insurance benefits
  • Lack of transportation
  • Lack of child care
  • Limited or no water fluoridation
  • Insufficient knowledge of oral health
  • Geographic isolation
  • Poverty
  • Cultural differences
  • Stigma

The COVID-19 pandemic has only added to the list of challenges thanks to office and school closures. And even once dentists' offices were open, fears that aerosols and dental equipment could help spread the deadly virus remained. To meet this particular challenge head-on, Niederman’s research team moved their clinic and used new tools to help deliver care to the children that needed it most.

“We are able to treat cavities with glass ionomer gel, which doesn’t require any shots or drilling,” Niederman said. “We can apply this gel in a matter of minutes, and six months later, we do a follow-up with no problems.”

School-Based Dental Prevention Programs 

School-based dental prevention programs are at the forefront of oral health equity models designed to break down barriers in accessing preventative dental care in at-risk communities. 

The Ecological Model to Advance Oral Health Equity highlights many positive outcomes that school-based dental clinics can provide including:

  • Improve healthcare access
  • Improve general health and well-being
  • Improve skills-based health education 
  • Increase positive healthy behaviors 
  • Provide important health education to students and parents

According to the Centers for Medicare and Medicaid Services, in 2015, about 2,000 school-based health centers (SBHC) were operating nationwide and 16% of these centers had oral health providers on-site. SBHC can offer oral health services onsite, like screenings, fluoride treatments, and oral health education.

Even though cavities are preventable, they remain the most common chronic condition among school-age children. 

Importance of Oral Health

Oral health isn’t just about white teeth and pleasant breath. Our mouth acts as a gatekeeper to keep germs out, but with the absence of preventative care, the mouth can act as a key entry-point for illness and disease, possibly leading to negative outcomes in our overall health. 

Research has found associations between poor oral health and other illnesses, such as cardiovascular diseases and diabetes. It is not yet clear whether poor oral health actually causes these diseases.

“If I wore a dozen of different hats, I would mandate school-based cavity prevention programs nationwide," Niederman says.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Starr JR, Ruff RR, Palmisano J, Goodson JM, Bukhari OM, Niederman R. Longitudinal caries prevalence in a comprehensive, multicomponent, school-based prevention program. J Am Dent Assoc. 2021;152(3):224-233.e11. doi: 10.1016/j.adaj.2020.12.005

  2. Centers for Disease Control and Prevention. Oral health fast facts.

  3. Rural Health Information Hub. Barriers to oral care in rural communities.

  4. Gargano L, Mason M, Northridge M. Advancing oral health equity through school-based oral health programs: An ecological model and review. 2019;7:359. doi: 10.3389/fpubh.2019.00359

  5. Centers for Medicare and Medicaid Services Oral Health Initiative. Engaging schools to support better health for low-income children.

  6. Gargano L, Mason M, Northridge M. Advancing oral health equity through school-based oral health programs: An ecological model and review. Front Public Health. 7:359. doi:10.3389/fpubh.2019.00359

  7. American Dental Association. Oral-systemic health.

By Amy Isler, RN, MSN, CSN
Amy Isler, RN, MSN, CSN, is a registered nurse with over six years of patient experience. She is a credentialed school nurse in California.