Gaining and Maintaining Community Support
Gaining and maintaining community support is key to the success of a school-based dental sealant program. This step involves considering all individuals and organizations that could provide support for the program. Such individuals and organizations may include
- The local oral health community
- Dental association representatives
- School board
- School administrators and staff
- School health committees
- Head Start programs
- Parent-teacher associations
- Child advocacy organizations
- Social service agencies
- Health departments and safety-net clinics
- Boards of health
- County commissioners
- City council members
- State legislators
- Business leaders
- Potential funders (such as private foundations and philanthropic organizations)
- Third-party payors
- Faith-based organizations
To gain and maintain community support, the planning committee should establish a larger advisory group with representatives from the types of groups and organizations listed above. Establishing an advisory group will help ensure that the community's needs and interests are adequately addressed.
An effective advisory group provides support without becoming involved in the day-to-day activities of planning and implementing the program. Advisory group members should be champions for the program. They can help gain the support of their representative organizations and can help educate the community about the importance of dental sealants, which may generate political support and funding.
An invitation to potential advisory group members should include information about the oral health status of the target population, the rationale for the program, and expectations about members’ time commitment and responsibilities. Potential members may need to be asked more than once to join the advisory group.
Once the school-based dental sealant program is established, the advisory group should continue to meet with the planning committee on an ad hoc basis to help strengthen and maintain relationships.
The local oral health community encompasses community health centers, safety net clinics, and private practices. Approaches used to gain support from the local oral health community vary widely among programs. This source of support is critical to the success of school-based dental sealant programs.
School-based dental sealant program administrators have encountered questions, and even opposition, from local dentists for a variety of reasons, including concerns about
- Assessments being conducted without bitewing X-rays
- Dental sealants placed over incipient caries
- Dental hygienists applying dental sealants
- Quality of care provided in a portable program
- Effective infection control
- Methods used to target participants
- Disruption to established dentist-client relations
- Insufficient follow-up for students with tooth decay or other oral health problems
The approach used to gain support from the local oral health community depends upon the relationship between school-based dental sealant program administrators and the local oral health community. For some programs, gaining support is simple; for others, it is more complex and challenging.
To help elicit the support of the local oral health community, it is often beneficial to invite a supportive representative from the local dental society to serve on the advisory group. When deciding who will approach the dental society representative, it is important to keep in mind individual relationships and local considerations. Often, the representative will be more receptive if the invitation is extended by a colleague. If a dentist is not already part of the advisory group, consider recruiting a dentist working in private practice, a local or state health department, a community health center, a safety net dental clinic, or a dental school. This individual can then help elicit the support of the local oral health community.
No matter what approach is used to gain support from the local oral health community, it is important to take the time to address the community's questions and concerns. School-based dental sealant program administrators will need to explain the program carefully, reassure the local oral health community that it is unlikely to affect private practices, and clarify the role that the oral health community can play in reducing the incidence of tooth decay in children and adolescents who would not normally receive regular oral health care.
To assist those working to establish school-based dental sealant programs, responses to questions that local oral health community members ask frequently have been developed, along with supporting references (see Frequently Asked Questions).
Although some school-based dental sealant programs that begin operation without support from the local oral health community are successful, opposition to the program can arise at the planning and implementation stages. When this occurs, considerable time and effort is needed to ensure the establishment of an effective program.
Support from school officials is essential to establishing a school-based dental sealant program. The first steps in ensuring support are to conduct an environmental scan of how the school district is organized, to identify the key decision makers, and to understand the process that is used to approve new programs. Gaining support from school officials can be a lengthy process, and it should begin at least several months before the program's anticipated starting date.
School Boards and Superintendents
In most school districts, the school board or superintendent makes decisions about whether to allow a new program into the district. In small districts, the school board tends to make these decisions, while in large districts the decisions are most likely made by the superintendent. In either case, the appropriate governing body’s approval is necessary to establish a school-based dental sealant program. In most cases, approval is given for the entire school system. In other cases, the school board or superintendent may approve the program but may leave the final decision about whether to implement it up to each school principal.
Before proposing the concept of a school-based dental sealant program to the school board or superintendent, it is important to understand the process of proposing a new program for consideration. The program administrator needs to learn what criteria the governing body uses to make its decision, determine how the dental sealant program can improve students' ability to learn, and enlist key stakeholders to emphasize the importance of the program. The administrator should also complete all the paperwork needed to present the proposal to the governing body.
After the school-based dental sealant program is approved, every effort should be made to gain the support of school administrators and staff in each targeted school. The program administrator should determine the extent to which the school board or superintendent is likely to help gain acceptance for the program in each individual school. The school board or superintendent can have a tremendous effect on principals' attitudes toward the program. Likewise, principals can have a similar effect on teachers, and teachers can influence students' decisions about whether to take home and return consent forms.
It is also important to make sure that each school principal that has been targeted for a dental sealant program is receptive to the program. As mentioned earlier, principals can have a positive effect on teachers' and students' attitudes toward the program. Principals can also help identify an appropriate space within the school in which to operate the program and can address teachers' or parents' questions and concerns.
School Program Directors
In large school districts, directors of student services, children with special health care needs programs, or health programs may be helpful in introducing the school-based dental sealant program to principals and school staff. Teachers, school nurses, or parents who are active in the school can also play an important role in gaining acceptance within a school.
School nurses are important advocates for school-based dental sealant programs because they have established trust with school principals and administrators. The support of school nurses is vital for enhancing student participation rates, because school nurses are in the schools on a regular basis and, therefore, can reinforce the importance of returning consent forms.
Parent Teacher Associations
For those schools or school systems with active parent teacher associations (PTAs), PTAs can be strong program advocates and may be helpful in convincing superintendents or principals to agree to host a school-based dental sealant program.
Other Sources of School or Community Support
In schools or school districts without active PTAs, it is important to find another program champion within the school or community. This could be one individual parent, teacher, or social worker.
School administrators and staff may not be aware of dental sealants, may not understand the importance of sealants, or may confuse sealants with fluoride. School-based dental sealant program planning committee members should be prepared to meet with school administrators and staff to educate them about the benefits of sealants, succinctly explain the program, and convince them that the program is worthwhile.
It may be useful to suggest that school administrators and staff speak with colleagues who have experience with successful school-based dental sealant programs. It is also important to emphasize that school-based dental sealant programs provide a learning experience for participants. School-based dental sealant program administrators should provide school administrators and staff with an information packet containing resources, such as a copy of the program consent form and a selection of fact sheets.
Fact sheets to place in the information packet may include Seal Out Tooth Decay, Dental Sealants, and Preventing Tooth Decay and Saving Teeth with Dental Sealants.
Gaining the Support of City Councils, Boards of Health, County Commissioners, and Philanthropic Organizations
The support of city councils, boards of health, and county commissioners can be especially important to the success of a school-based dental sealant program. Members of these groups are influential, highly visible, and well respected, and they can be particularly helpful if support from the oral health community or school administrators and staff is weak. City councils, boards of health, and county commissioners are also potential funders of school-based dental sealant programs.
Philanthropic organizations such as United Way, Kiwanis, the Lions Clubs, and other service organizations can be approached for funding school-based dental sealant programs. Receiving even a small amount of financial support from a philanthropic organization may create community support for the program.