BH.01.APR0319.C06 - Oral Health Programs: Healthy Smiles Ontario, January- December 2018, Oral Health School Screening, 2017/2018 School Year

To: Board of Health
Meeting Date: April 3, 2019
Report No.: BH.01.APR0319.C06
Prepared By: Rosalyn LaRochelle, Acting Manager, Child and Youth Services
Approved By: Andrea Roberts, Director, Healthy Living
Submitted By: Dr. Nicola J. Mercer, MD, MBA, MPH, FRCPC Medical Officer of Health & CEO
Subject: Program/Service Information Report: Oral Health Programs: Healthy Smiles Ontario, January- December 2018, Oral Health School Screening, 2017/2018 School Year

Key Points

  • The Oral Health programs achieved their accountability indicator targets. 100% of JK, SK, and Grade 2 students in local schools were screened for oral health problems.
  • Wellington-Dufferin-Guelph Public Health (WDGPH) offers fluoride varnish treatment to children in 12 high-risk elementary schools. This program was expanded to reach patients at the Guelph Community Health Centre (GCHC).
  • In November 2018, a weekly restorative dental clinic was opened at WDGPH’s Guelph office (Chancellor’s Way). Dr. Mohammed has been contracted to provide dental services to Healthy Smiles Ontario (HSO) clients.
  • The percentage of screened children identified with urgent dental needs has decreased from 4.3% (2010/2011) to 1.82% (2017/2018).

Strategic Directions & Goals

Service Centred Approach - We are committed to providing excellent service to anyone interacting with public health.

  • We will improve access to public health programs and services while enhancing the client experience.
  • We will increase community awareness of public health programs and services.
  • We will engage communities with more opportunities for collaboration.

Organizational Capacity - We will improve our capacity to effectively deliver public health programs and services.

  • We will work to improve health services for priority populations.
  • We will implement processes for continuous quality improvement (CQI).
  • We will enhance our understanding of the local needs and priorities of the communities we serve and develop programs and services in response to those needs.

Operational Plan Objectives

Oral Health Assessment and Surveillance:

  • To screen 100% of eligible children in schools.
  • To submit HSO and screening reports to MOHLTC, as required.
  • To provide case manager/service coordination and follow-up for children who have been identified with urgent needs during school screening.
  • To educate students, teachers and principals about the importance of oral health.
  • To educate school personnel about the HSO program.
  • To educate students and their families about the availability of HSO services.

Non-Mandatory Oral Health Programs:

  • To provide fluoride varnish in 12 high-risk elementary schools.
  • To decrease the percentage of children identified during school screenings with urgent dental needs.
  • To introduce early oral health interventions to children during well-baby visits with primary care.

HSO Program Objectives:

  • To assist low-income families with applications to the HSO Program.
  • To provide case management, system navigation and service coordination to low-income families seeking dental services.
  • To provide proficient and expert dental care for children under the HSO Program.
  • To improve access to oral health care for low-income children with dental needs.

Summary of OPHS Requirements

OPHS Standard: School Health


  • To achieve optimal health of school-aged children and youth through partnership and collaboration with school boards and schools. Children and youth from low-income families have improved access to oral health care.


  • Disease Prevention
  • Disease Prevention/Health Protection
  • Assessment and Surveillance


  • Conduct surveillance, oral screening and report data and information in accordance with the Oral Health Protocol, 2018 (or as current) and the Population Health Assessment and Surveillance Protocol, 2018 (or as current).
  • Provide the HSO program in accordance with the Oral Health Protocol, 2018 (or as current).
  • Offer support to school boards and schools to assist with the implementation of health-related curricula and health needs in schools, based on need and considering, but not limited to, oral health.

Accountability Indicators:

Oral Health Assessment and Surveillance Accountability Indicators, 2017-2018 School Year

Deliverables Achievement
% of schools screened 100%
% of JK, SK and Grade 2 students screened 100%
% of JK, SK and Grade 2 students who were absent and excluded/refused 10.72%

Performance variance or discrepancy identified:

  • No


The Oral Health Team achieves timely and effective detection and identification of children and youth at-risk of poor oral health outcomes. In 2019, the Team’s work was re-organized into:

  • the Oral Health Assessment and Surveillance Program;
  • the Non-Mandatory Oral Health Programs; and
  • the HSO Program.

Oral Health Assessment and Surveillance Program

The Oral Health Assessment and Surveillance Program includes school screenings that identify children with urgent and non-urgent dental needs. Oral Health Team staff then facilitate referral to care so that children receive necessary dental care. In the classroom, Oral Health Team staff also provide education to students about healthy eating and proper tooth-brushing.

This program screens Junior Kindergarten, Senior Kindergarten, Grade 2, and Grade 7 students in schools across Wellington-Dufferin-Guelph (WDG). This includes:

  • 89 publicly-funded elementary schools;
  • 14 publicly-funded high schools;
  • 16 private schools (7 in Guelph, 3 in Orangeville, 6 in Wellington); and
  • 22 parochial schools.

Oral Health Assessment and Surveillance Program Indicators, 2017-2018 School Year

Deliverables Achievement

% of JK, SK and Grade 2 students screened


% of children identified with urgent needs


% of children identified with non-urgent needs


Non-Mandatory Oral Health Programs (Fluoride Varnish)

The Non-Mandatory Oral Health Programs include all programs supporting oral health that are not explicitly mandated by the Ontario Public Health Standards (OPHS). It includes the application of fluoride varnish to Grade 2 students in 12 high-risk elementary schools within WDG. Children in other grades may also have fluoride varnish applied if their parent completes a consent form.

From June 2017 to June 2018, WDGPH partnered with the GCHC to offer fluoride varnish treatments to children 0-6 years old during well baby visits. WDGPH dental staff provided training and fluoride varnish supplies to staff at GCHC, who then offered and provided fluoride varnish to eligible patients. Although this service was offered at both the Shelldale and the downtown sites of the GCHC, statistics were only collected from the Shelldale site. At the Shelldale site, 37 patients received the fluoride varnish treatment, with two patients returning for a second application. Ninety-nine percent (99%) of varnish applications took no more than 1-2 minutes. GCHC had agreed to continue this initiative, along with purchasing the fluoride varnish supplies, following June 2018.

Mandatory Oral Health Program Indicators, 2017-2018 School Year

Deliverables Achievement

% of schools screened


% of JK, SK and Grade 2 students screened


**% of JK, SK and Grade 2 students who were absent and excluded/refused



Children and youth from low-income families can access preventive oral health care through HSO clinics at each WDGPH office location, as well as 9 portable clinics held in rural areas to reach priority populations that face transportation barriers. WDGPH also offers a Dental Intake Line that received over 1,640 calls in 2018 from parents, youth, dental providers and community partners. To further the program’s reach, the Oral Health team participated in 71 outreach activities in 2018.

In November 2018, the Oral Health Team opened a Restorative Dental Clinic for HSO clients at the Chancellor’s Way office. A contracted dentist, Dr. Baseer Mohammed, attends the clinic on Wednesdays to provide dental treatment. 74 clients were seen from November 9, 2018 to December 31, 2018. A fulsome evaluation of this clinic will take place in 2019, with a follow-up report to the Board of Health.

Overall, the oral health of children and youth in WDG has improved as evidenced by our decreasing percentage of screened children identified with urgent dental needs to a high of 4.3% in the 2010/2011 school year to 1.82% in the 2017/2018 school year.

Health Smiles Ontario Program Indicators, 2018

Deliverables Achievement

Total # of children seen in preventive clinics


# of children screened in HSO preventive clinics


# of children identified through HSO preventive clinics with urgent needs

622 / 26.3%

# of dental cleanings performed in preventive clinics


Related Reports

BH.01.APR0418.C05 - Oral Health Program (Healthy Smiles Ontario January – December, 2017 and Oral Health School Screening 2016/2017 School Year) – Program/Service Information Report.