Understanding School Nurses as an Oral Health Workforce

Oral health is a critical but often overlooked component of children’s overall health and academic success. Untreated dental caries is the most common chronic disease in childhood and is associated with pain, missed school days, and diminished quality of life. Nationally, 30% of children aged 6-12 miss school days due to dental problems, resulting in over 9 million lost school days annually. In California, approximately 444,000 children were absent for at least one school day due to a dental problem in 2018, resulting in a loss of over $30 million for California schools.

School nurses are an important point of contact for children’s health and well-being, including for oral health. Although there have been attempts to bring oral health to schools, there are no oral health modules for school nurse credential programs, nor a toolkit/training with continuing education (CE) for already practicing school nurses. Preliminary pilot survey data from the California School Nurses Organization (N=226; 16% participation rate) found that 80% of responding school nurses felt oral health problems were common among their student populations, 51% reported receiving no or insufficient training in oral health, and 88% reported an interest in improving their oral health knowledge and skills. Initial conversations with the four school nurse credentialing programs in California found high interest in more training in oral health, especially something that was easily packaged for use in their program.

Given the magnitude of this initial pilot data in one of the largest states, there is a need to assess the current state of oral health knowledge and practice among school nurses nationally and to identify which topics and formats would be most helpful to increase oral health knowledge and skills in school nurses as a supplement to the oral health workforce.
This study will generate foundational data to inform the need for oral health training/credentialing modules and guide policy strategies to strengthen integration of oral health into the services provided by the school nurse workforce.