R-2404-21031

MCD Global Health (MCD) is a public health nonprofit and member of the National Network of Public Health Institutes (NNPHI) that works to improve health for all through cost-effective, high-quality, and universally accessible public health solutions. The organization engages in global health improvement work, but its headquarters and project proposal are based in Maine.

The Maine CDC School Oral Health Program (SOHP) administered by MCD, sends dental hygienists to elementary schools to provide screenings and preventive care; however, there are not enough dental hygienists for every school. Maine is a rural state experiencing workforce shortages across the health sector. Dental providers that accept Medicaid are sparse and often scheduled out for months. In response to these shortages, the Children’s Oral Health Network of Maine held local discussion groups with parents, nurses, and advocacy partners resulting in cross-sector commitment to piloting a medical-dental integration project.

The proposed project outlines a collaboration between medical, dental, and school partners to deploy school nurses to provide screenings and preventive services to elementary age children. MCD will recruit seven school nurses to participate in a pilot where they will receive hands on training in oral health assessment and silver diamine fluoride (SDF) application. Following the training, the school nurses will receive ongoing mentoring and technical assistance to increase their comfort level with oral health care, including the utilization of telecommunication and intraoral cameras for remote support. Through this work, MCD seeks to reduce the likelihood that children in Maine, especially those in rural areas of the state without a dental home, will need invasive treatment in the future.

MCD serves as the operational home of the School Oral Health Program (SOHP), which serves all children in Maine public schools. MCD will oversee the project, facilitate relationship building between school, medical, and dental partners, and support the process of developing a school-based model that will help to ensure access without local provider dependencies. MCD will conclude the project with a report summarizing successes, barriers, lessons learned, and recommendations. MCD will leverage the report to spur change and will refine its recommendations to include protocols for training, continuous support, and non-invasive prevention in school settings.

The proposed request includes funding for project personnel, training resources and time for the nursing cohort, a stipend to the state association of school nurses, and evaluation support. The development of the training and tools for ongoing support and implementation by the pilot cohort of nurses will allow for future adoption and adaptation based on population and context. The request represents less than 1% of the organization’s overall budget.