SPOT Toolkit
- SPOT Toolkit

Innovative Trainings
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Part 1
School Professionals Resource Center
Welcome School Nurses
This section of our oral health toolkit is designed specifically for you, providing a wealth of resources to help improve children’s oral health. Here, you’ll find materials to incorporate oral health into your daily activities with students, printable resources to display throughout the school, and content for weekly newsletters or emails sent home to parents and caregivers.
Why Focus on Oral Health?
Oral health is a critical component of overall health, especially for children. In Pennsylvania, the data highlights the importance of proactive oral health measures:
- Approximately 20% of third-grade children in Pennsylvania have untreated dental decay.
- Nearly 50% of children aged 6-9 have experienced dental caries.
- Children with poor oral health are three times more likely to miss school due to dental pain. Here is a link to the most recent basic screening survey conducted in PA in 2021-2022. Please include this BSS one pager summary to continue to advocate for overall health for students in your school.
By utilizing the resources in this toolkit, you can help reduce these statistics and promote healthier smiles among your students.
Finding Dental Care For Students
Ensuring children have access to dental care is vital for their overall health and well-being. As a school nurse, school administrator, or teacher, you play a key role in connecting families to the resources they need. Below is a guide to help parents and caregivers navigate dental care options for their children.
- Are you in a school district with a Mandated Dental Program (MDP) or a Dental Hygiene Services Program (DHSP)?
Regardless of which program your school district participates in, there should be a Dentist of Record that you can consult with for referrals. If you have a DHSP, discuss with the Certified School Dental Hygienist the oral health needs of your students.
The first step in assisting families to find dental care is working with your dentist of record. All school districts are required to identify a “dentist of record”; districts with a Mandated Dental Program can utilize a Public Health Dental Hygiene Practitioner to complete the screenings and sign the forms. Refer to this form for more information on a PHDHP. These providers may already have a list created that you can provide to families.
- Utilize the Pediatricians
This includes the pediatrician of record within the school district and potentially referring families to their own family pediatrician. Pediatricians can have networks of dental professionals they can recommend. This is an opportunity to encourage families to discuss dental care during visits with their pediatricians for helpful referrals and advice. - Create a Local Provider Network
If the above is not available to you or the students, consider building a list of local dental providers. Creating a localized dental care referral guide. - Leverage Health Events
Health awareness events are excellent opportunities to:- Invite local dental professionals to speak to students and/or families
- Build relationships with providers who can address the dental needs of your school community
Use these websites to help begin to build your provider lists
American Academy of Pediatric Dentists offers a valuable tool to help locate a pediatric dentist within your community. Please encourage caregivers contact child’s insurance to guide them to offices in-network or participating providers. Schools can also use this tool to locate local dentists in the school district to network for dental health events and working together to help with any oral health needs.
Dental and Dental Hygiene Programs in Pennsylvania provide dental services at a low or reduced cost to anyone. There are 13 Dental Hygiene Programs and 4 Dental Programs.
Federally Qualified Health Centers (FQHCs) are primary care facilities in rural and urban areas. There are more than 120 FQHC sites in PA that provide dental care. All insurances are accepted. Fees are based on what the patient can pay and are often based on income level and family size. To locate an FQHC, visit my.pachc.org/Find-a-Health-Center.
Managed Care Organizations (MCOs) can connect their members with dental providers in their regions. For the member services phone numbers for each managed care organization, visit dhs.pa.gov/providers/Providers/Pages/Statewide-Managed-Care-Map.aspx. For provider lists by health plan, visit enrollnow.net.
Rural Health Clinics are focused on providing primary care services in non-urbanized areas. Availability of dental services will vary by location. For more information, visit www.porh.psu.edu
Making a list of local Medicaid-accepting pediatric dentists. You can use resources like https://www.insurekidsnow.gov/find-a-dentist to locate Medicaid providers and dental clinics.
Pennsylvania Coalition for Oral Health offers these options as well as many others to help aid in finding dental care. The Finding Dental Care resource is available in English and Spanish.
Managed Care Organizations (MCOs)
Managed Care Organizations (MCOs) can connect their members with dental providers in their regions. For the member services phone numbers for each managed care organization, visit dhs.pa.gov/providers/Providers/Pages/Statewide-Managed-Care-Map.aspx. For provider lists by health plan, visit enrollnow.net.
Rural Health Clinics are focused on providing primary care services in non-urbanized areas. Availability of dental services will vary by location. For more information, visit www.porh.psu.edu
Making a list of local Medicaid-accepting pediatric dentists. You can use resources like https://www.insurekidsnow.gov/find-a-dentist to locate Medicaid providers and dental clinics.
Pennsylvania Coalition for Oral Health offers these options as well as many others to help aid in finding dental care. The Finding Dental Care resource is available in English and Spanish.
Resources Available
Printable Posters and Flyers: Display these around the school to remind students about the importance of brushing and flossing.

Choose Oral Health
Download
Colgate - steps to good oral health
Download
A Guide to Packing a Healthy Lunch
Download
Why Children need fluoride?
Download
Water With Fluoride Builds A Foundation for Healthy Teeth
Download
Healthy Sips
Download
Sugar in drinks YouTube (Attach as QR code on poster)
Visit Site
All About Fluoride
Download
Fluoride Fast Facts
DownloadOral Health Education (Print or electronic – poster options available for select)
- Why Children Need Fluoride? (ilikemyteeth.org)
- Tooth tips for tweens and teens (AAP)
- How Fluoride Works
How to Fit Oral Health Into Your Schools
Keeping students and caregivers engaged in overall health is crucial. By taking these steps, you can empower students to prioritize overall health and provide them the opportunity to learn and understand health at a young age.
Here are some examples of what you can do throughout the school year.
- Start the conversations during health check-ups in the nurses office. You can learn a lot from these questions beyond their oral health.
- Have you seen a dentist in the last year?
- What have you been snacking on?
- Are you drinking water?
- Are you brushing your teeth every day?
- School digital outreach strategies such as social media, apps, portals, text messages, and newsletters: Insert any of the resources found in the toolkit to your school’s newsletter templates or social media posts. Send reminders to visit a dentist for routine check-ups.
- School wide activities and student engagement.
- Below are some events you can incorporate at your school to foster student engagement and raise awareness. These events don’t need to focus solely on oral health, they can also highlight the connection between oral health and overall well-being. Create activities/newsletters/digital outreach based around these events. For instance, during Oral Cancer Awareness Month, activities could include anti-tobacco or nicotine campaigns, HPV education, and discussions about the oral health impacts of these factors. And National Nutrition Month, schools can emphasize the connection between nutrition and oral health.
- February National Children’s Dental Health Month
- March is National Nutrition Month – highlight how proper nutrition is related not only to overall health but preventing cavities
- March 6th National Dentist’s Day – great opportunity to reach out to local providers to share school oral health needs and thank them for any support they can provide
- March 20th World Oral Health Day
- April Oral Cancer Awareness Month
- 2nd week in April is Dental hygienist Appreciation week – another opportunity to bring oral health providers into your school and share oral health needs that they be able to support the school with.
- National Smile Month (Mid May-Mid June)
- June 23rd is National Hydration Day – highlight the importance of drinking water vs sugary beverages. Great chance to show the importance related to overall health, including cavity prevention.
- August 6th National Fresh Breath Day
- November 1st National Brush Day
Remember you can make these days any day of the year. These are just ideas to incorporate into your school year to promote and bring awareness oral health. Refer back to resources to use around the school for these events.
Get the library involved
Here are some dental related books to display throughout the year.













and Amy Wummer

and Allison Valentine

and Jason Fruchter
Free Toothbrush and Toothpaste
Free Toothbrush and Toothpaste: Please share this link with your teachers for an amazing program Colgate runs each fall and spring for free toothbrushes, toothpaste, activities, and other resources.
Encourage healthy snacks, drinking water, supplying students with toothbrushes
Early Head Start Kit
*All Early Head Start materials will be available only digitally (effective Jan ’24) – please access them below
*All items are bilingual
Head Start Kit
Kindergarten/1st Grade Kit
For Teachers
- Teacher’s Guide
- Accompanying storybook
- Classroom wall poster (page 1, page 2)
For Students
- Colgate toothbrush & toothpaste
- Take home brushing chart
QR Codes
Easily direct parents to additional resources by including QR codes in your communications.
Newsletter Content
Ready-to-use articles and tips for your weekly newsletters or emails to parents.
Educational Content for School Nurses
Informative resources for your to learn more about oral health and opportunities for continuing education. Please utilize all sections of this toolkit, including the parent section for educational materials.
Together, we can support PA Oral Health Plan and Healthy People 2030 Oral Health Objectives whiling making a significant impact on the oral health of children in our community. Thank you for your dedication and commitment to their well-being!
Part 2
Parent/Caregiver Resource Center

Welcome Parents!
Your children’s school is dedicated to ensuring not only their academic success but also their overall health and well-being. The Pennsylvania Chapter of the American Academy of Pediatrics (PA AAP) has developed this section specifically for you to address any oral health questions you may have.
Why Oral Health Matters
Oral health is a crucial part of your child’s overall health. Did you know that:
- Approximately 20% of children aged 5-11 years have at least one untreated decayed tooth.
- Dental caries (cavities) is the most common chronic disease among children aged 6 to 19 years.
- Children with poor oral health are three times more likely to miss school due to dental pain.
By staying informed and proactive about your child’s oral health, you can help prevent these issues and ensure they maintain a healthy smile.
If you have any questions or need further assistance, please explore the resources provided here. We’re here to support you and your child’s journey to better oral health!
Prevention works
Oral health prevention is effective because it helps avoid the onset of dental diseases and conditions, which can lead to significant health issues and economic costs. A significant portion of dental decay can be prevented with proper oral hygiene and preventive measures. Prevention involves a combination of professional care and self-care practices aimed at maintaining good oral hygiene and health.
Finding Dental Care
If you have insurance, please contact your insurance to guide you to offices in-network. You can also utilize these resources to help you locate a clinic if you do not have dental insurance and/or need assistance.
Finding Dental Care (Available in English and Spanish)
Fluoride
Use these websites to help begin to find a dental home:
American Academy of Pediatric Dentists offers a valuable tool to help locate a pediatric dentist within your community. Contact your child’s insurance to find offices in-network or participating providers.
Dental and Dental Hygiene Programs in Pennsylvania provide dental services at a low or reduced cost to anyone. There are 13 Dental Hygiene Programs and 4 Dental Programs.
Federally Qualified Health Centers (FQHCs) are primary care facilities in rural and urban areas. There are more than 120 FQHC sites in PA that provide dental care. All insurances are accepted. Fees are based on what the patient can pay and are often based on income level and family size. To locate an FQHC, visit my.pachc.org/Find-a-Health-Center.
Managed Care Organizations (MCOs) can connect their members with dental providers in their regions. For the member services phone numbers for each managed care organization, visit dhs.pa.gov/providers/Providers/Pages/Statewide-Managed-Care-Map.aspx. For provider lists by health plan, visit enrollnow.net.
Rural Health Clinics are focused on providing primary care services in non-urbanized areas. Availability of dental services will vary by location. For more information, visit www.porh.psu.edu
Making a list of local Medicaid-accepting pediatric dentists. You can use resources like https://www.insurekidsnow.gov/find-a-dentist to locate Medicaid providers and dental clinics.
Pennsylvania Coalition for Oral Health offers these options as well as many others to help aid in finding dental care. The Finding Dental Care resource is available in English and Spanish.
***Insert Finding dental care as image as well (Spanish and English) and image of Creating a localized dental care referral guide
Community Water Fluoridation
Curious to see if your local water is fluoridated: My water’s fluoride through the CDC can inform you about your water supply or Community Water Fluoridation Status in Pennsylvania through University of Pitt.
Topical Fluoride Varnish
What is Fluoride Varnish?
Fluoride varnish is a protective coating that is applied to teeth to help prevent cavities. Fluoride varnish is made with fluoride, a naturally occuring mineral that can be found in many foods and water and strengthen tooth enamel (outer coating on teeth).
Why is Fluoride Varnish recommended?
Cavities can cause pain and infections, which can lead to problems eating, speaking, playing, and learning. Fluoride varnish makes teeth stronger, stops cavities from getting worse and helps prevent new cavities from forming.
Is Fluoride Varnish safe?
Yes, fluoride varnish is safe to apply at any age. Only a small amount is used, and hardly any fluoride is swallowed. It is quickly applied and hardens.
How is Fluoride Varnish applied?
Fluoride varnish is painted on teeth with a brush. The process is quick and easy and does not cause pain. The varnish sticks to the teeth and may leave a thin, temporary coating. This is normal and will go away when teeth are brushed.
How long does Fluoride Varnish last?
Fluoride varnish protects teeth for several months. It works best when reapplied every three to six months.
Can my child eat or drink after application?
Eating and drinking after application is ok. If possible to avoid hot, hard or sticky foods for 4-6 hours.
Part 3
Implementing a Topical Fluoride Varnish (TFV) Program
Pennsylvania Chapter, American Academy of Pediatrics has added this section of the toolkit to help support implementing a fluoride varnish program for your school. These programs are aimed at improving the oral health of our students. This evidence-based program offers numerous benefits that can significantly impact the well-being and academic success of our children.
Why Implement a Fluoride Varnish Program?
- Prevention of Tooth Decay: Fluoride varnish is a proven method to prevent dental caries (tooth decay). By applying a small amount of fluoride varnish to the teeth, we can strengthen the enamel and make it more resistant to acid attacks from bacteria, thereby reducing the incidence of cavities.
- Promoting Health Equity: This program is especially beneficial for children from low-income families who may have limited access to dental care. By providing preventive dental care at school, we can help bridge the gap and ensure all students have the opportunity to maintain good oral health.
- Cost-Effective Solution: Preventive care is far more cost-effective than treating dental problems after they occur. By reducing the need for more extensive dental treatments, we can save families and the healthcare system significant costs.
- Enhancing Overall Health: Good oral health is closely linked to overall health. Preventing dental issues can reduce the risk of other health problems, such as infections and chronic diseases, contributing to the overall well-being of our students.
- Supporting Academic Success: Healthy children are better learners. By preventing dental problems, we can help ensure that students miss fewer school days due to dental pain or treatment and can focus better on their studies.
- Community Engagement: Implementing this program in our schools fosters community engagement and raises awareness about the importance of oral health. It provides an opportunity for parents, teachers, and healthcare providers to work together towards a common goal.
Resources
Here are resources to help support initiating a TFV program.

Guidelines for the School Dental Health Program for Pennsylvania's School Age Children and Adolescents
Download
What is fluoride?
DownloadOral Health: School Fluoride Varnish Delivery Programs – Systematic Review
Visit Site
Oral Health in Your School
The School-Based Oral Health Initiative, developed by the Pennsylvania Chapter of the American Academy of Pediatrics (PA AAP), is a comprehensive training program that equips school nurses with the knowledge and skills to integrate preventive oral health services into their daily practice. This course covers essential topics including dental caries prevention, fluoride varnish application, and…
Start CourseWalk through on how to document SHARRS
SHAARS Documentation
School nurses should be reporting their fluoride information from the current school year during the SHARRS Reporting window.
*For example, 2024-2025 school year reporting window runs from May 2025 – September 2025.
There are two areas of the SHARRS report that are applicable to fluoride programs:
- Itemized Expenditures:
- Mandated Dental Services Program
- Daily reporting sheet
Suggest Models
How to fit into school year

Quick Guide
View the Quick Guide
Quick Guide
- Introduction to Topical Fluoride Varnish
Overview: What is fluoride varnish and its benefits?
Evidence-Based Practices: Research supporting its use in preventing dental caries.
- Application Guidelines
Step-by-Step Instructions: Detailed guide on how to apply fluoride varnish.
Safety Measures: Proper handling, storage, and disposal of materials.
Video Demonstrations: Visual aids to complement written instructions.
- Consents
Superintendent/Principal Approval: Letter explaining program and benefits of fluoride varnish
Physician of record and Dentist of record approval: Letter explaining program and confirming necessary documentation is completed (signing off on running order for fluoride)
Parent Consent Form Template: A sample form that includes necessary information (child’s name, date of birth, parent/guardian contact information, etc.).
Instructions for Parents: Clear explanation of what fluoride varnish is, its benefits, and any potential side effects.
Distribution Plan: How to distribute and collect consent forms from parents.
- Incorporating into Daily Tasks
Integration with School Routine: How to incorporate fluoride varnish application into the school day without disrupting classes.
- Record Keeping
Documentation Templates: Forms for recording each application (date, time, nurse’s name, etc.).
SHARRS: How to use SHARRS to maintain records.
- Training and Resources
Training and workshops: Opportunities for school nurses to receive hands-on training and support.
Reference Materials: Handouts, guides, and quick-reference resources.
Support Network: Contact information for dental professionals, oral health organizations, dental/dental hygiene programs, and support resources.
- Evaluation and Feedback
Monitoring and Assessment: Methods to evaluate the effectiveness of the fluoride varnish program.
Feedback Mechanism: How to gather feedback from parents, students, and staff to improve the program.
Part 4
Organizations and valuable websites
Resources

Oral Health Professional Resources
DownloadReferences
- CareQuest Institute for Oral Health
- U.S. Centers for Disease Control and Prevention Oral Health
- Colgate
- Smiles for Life
- Association of State & Territorial Dental Directors
- American Journal of Orthodontics & Dentofacial Orthopedics
- Oral Health Progress and Equity Network
- From the First Tooth
- Journal of The American Dental Association
- Pennsylvania School Health Guidelines
- American Dental Association – Fluoride Facts
- Bright Futures: Oral Health—Pocket Guide, 3rd edition
- Pennsylvania Coalition for Oral Health Resources
Valuable Website to Visit
- Pennsylvania School Health Guidelines
- CareQuest Institute for Oral Health
- Pennsylvania Chapter, American Academy of Pediatrics: Oral health and resources
- Healthy Teeth, Healthy Children
- Pennsylvania Coalition for Oral Health
- Pennsylvania Office of Rural Health
- Pennsylvania Office of Community Health Centers
- National Maternal and Child Oral Health Resource Center
- Bright Futures: Oral Health—Pocket Guide, 3rd edition
- Smiles for Life
- From the First Tooth
- American Dental Association
- School-Based Health Alliance
- National School Nurse Association – Oral Health Connections
- Pennsylvania Association of School Nurses and Pracitioners
- CDC Healthy Schools
- Oral Health Learning Cafe
- Missouri Department of Health and Senior Services Office of Dental Health: Oral Health Guide for Caregivers of School-Aged Children – Dental First Aid