Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 173 - CONTROL OF COMMUNICABLE DISEASE
Chapter 7 - SCHOOL HEALTH SCREENING, PHYSICAL EXAMINATION AND VISUAL EVALUATION
Attachment 173-7-2E - DENTAL SCREENING COMPETENCIES

COMPETENCY

KEY POINTS

1. Plan for a smooth flowing screening activity: Notify families of dental screening day. Plan logistics of student flow.

Coordinate scheduling of dental screening with building administrators and teachers. If efficiently organized for traffic flow, each inspection will take one minute or less.

If available, for infection control purposes, team each screener with a person to record results of inspection for each student.

Try to avoid screening immediately after a meal or snack. If necessary offer sugar free gum to help remove food particles before screening.

2. Assemble necessary supplies and equipment:

* Good light source (flashlight or goose- necked lamp)

* Gloves

* Single-use disposable tongue blades (optional),

* Trash can with liner,

* Alcohol-based sanitizer.

* Student roster, pen, and writing surface alternative method for recording results.

A good light source is essential: An LED light source is preferred!

Tongue blades are used to move tongue or cheek as needed to see teeth; discard after each student, and used at the discretion of the screener.

3. Glove, or prepare for "no-touch" screening.

Gloves are not required unless contact is to be made with student's skin, lips, teeth, or saliva. Most dental inspections will not necessitate physical contact.

Change gloves as needed between students or after coming into contact with anything that has touched skin, lips, teeth, or saliva.

Masks are optional at the discretion of the screener.

Hand sanitizer or hand washing between students is strongly recommended if contact occurs, and/or between glove changes.

Prepare for proper disposal of all contaminated materials.

4. The examiner positions him or herself in a comfortable face-to-face position with the child.

The child bares teeth for inspection of outer surfaces.

Have the child open mouth as wide as possible for inspection of chewing and inner surfaces of teeth. Child lifts and moves tongue so screener can see inner, outer, and top surfaces of all teeth, or screener may use tongue blade to gently maneuver tongue.

Utilizing light source, observe teeth for irregularities:

* areas where teeth are eroded or not the usual shape,

* unusually-colored teeth: severe discoloration

Look for gross, obvious problems in this brief visual inspection.

See color plate examples of significant findings for comparison.

5. Record results.

Assign student to one of the following categories:

0 = no obvious irregularities of the teeth

1 = observable irregularities with the teeth in one or two areas. Parents are notified of need for further dental care.

2 = observable irregularities with the teeth in three or more areas. Parents notified of need for further dental care.

Indicate location of areas of concern by quadrant (upper right, lower right, upper left, lower left) - oriented to the student's right and left sides.

Incidental observations about the gums or oral mucosa are noted and reported to the school nurse or communicated to parents at the screeners' discretion.

Note date, and name of qualified screener.

6. Carry out rescreen and notification procedures per local school practice/policy.

Parents are notified of the need for further evaluation for "1" and "2" results.

Urgent notifications should be made to parents if/when there are severe changes to any teeth, any complaints of mouth or tooth pain, and/or any areas of apparent swelling or drainage, indicating possible active infection or injury.