The Saving Smiles Program is a preventive program aimed at reducing the amount of tooth decay in the children of Lafayette County, Missouri. Saving Smiles implements an evidence-based treatment approach (application of fluoride varnish) and provides this service at the child's school.

Lafayette County Health Department (LCHD) partners with the Missouri Oral Health Preventive Services Program (PSP) which is managed by the Missouri Oral Health Program within the Office of Primary Care and Rural Health. LCHD receives support from school administration, local dentists, and community volunteers who make this program possible. Lafayette County also has two Federally Qualified Health Centers with dental clinics for students who have Medicaid or no insurance.

In the fall of each school year, LCHD coordinates on-site oral health screenings by local licensed dental professionals in each participating school district. Community volunteers assist the dentists with the recording of the oral screening and providing the fluoride varnish for participating students. Students also receive oral health education from LCHD staff using "Bugsy," a large and colorful stuffed character with big teeth, his own toothbrush, and an exam mirror. Bugsy is used both to demonstrate the proper way to care for the children's teeth as well as what to expect at the exam and varnishing.

Following the oral screening exam by the dental professional, a dental referral form is filled out and sent home with the child. The screening form indicates: 1) no obvious need for dental treatment at this time, but should see a dentist for regular check-ups; 2) need for dental treatment soon - please make an appointment with a dentist; 3) need for urgent dental treatment due to a toothache or infection - please schedule an appointment with a dentist as soon as possible.

In the spring, LCHD staff returns with community volunteers to complete a second application of preventive fluoride varnish. There is no oral screening done by the dentist at the spring visit. PSP provides the oral health screening supplies (disposable mouth mirrors, fluoride varnish, and toothbrush and toothpaste) in the fall. LCHD coordinates scheduling the site visit with the schools, dentists, and community volunteers as well as sending all the permission forms home to parents.

The last step of Saving Smiles is case management. This past school year, LCHD began following up with the students who had urgent or immediate marked on their screening forms. LCHD followed up with the parent to be sure the parent received the screening form and to assist with a referral to a dentist if necessary. Through the follow-up phone calls, LCHD hopes to gain information about the barriers to oral health care. They are interested in if children are not being seen by a dentist due to lack of dental insurance, lack of transportation, lack of education/knowledge of the importance of oral health care, or other factors.

The goal of Saving Smiles is to improve the oral health and in turn overall health of children in Lafayette County, especially for the poor and underserved.

Most students from the 11 participating schools in Lafayette County received a screening, fluoride varnish, and oral health education, and most of the children referred for dental care were seen by a dentist.

11 schools in Lafayette County participated in the Saving Smiles program with 76% of these students (preschool through 4th grade) receiving a screening, fluoride varnish, and oral health education. 62% of children referred for dental care were seen by a dentist. One of the dental providers commented, "I would like to express both the community and my appreciation for the program. It has filled an important need in our area."