Dental Care on the Move


By Amanda N. Wegner

Taking care of your teeth and gums isn’t just important for a healthy mouth and welcoming smile; more and more research suggests that the health of one’s mouth mirrors their overall health. For instance, research indicates that keeping your mouth, teeth and gums healthy can help decrease your chance of serious medical issues down the road, including heart attack, stroke and diabetes.

Though these may seem like far-off issues, especially for school-aged children, the work of keeping your mouth healthy starts early. Two easy yet effective ways to help children maintain their oral health is with the use of sealants and the application of fluoride. And while these are a reliable and effective line of defense in the fight for oral health, these preventative treatments are out of reach for many families who don’t have access to dental care or have limited dental insurance. But not in Walworth County, which participates in the Seal-A-Smile program.

A collaborative effort between Children’s Health Alliance of Wisconsin, Wisconsin Department of Health Services and Delta Dental of Wisconsin, the Seal-A-Smile program provides oral health education, screening, sealant placement and fluoride varnish application free of charge to elementary school students. For almost 10 years, the Walworth County Public Health Department has partnered with Registered Dental Hygienists to bring these services to county schools.

“This program is so important for our students and families,” says Chiper Tennessen, principal of Star Center Elementary School in Lake Geneva. “Many would not have access to these kinds of dental care services without Seal-A-Smile.”

Adds Laurie Knepper, a health aide at the school: “The program has definitely helped our students. I see fewer coming in now with mouth or teeth pain, which can affect how they eat, sleep and perform in school. It really is a great program.”


Tooth decay is one of the most common health problems in children. Kids are drinking more sugary beverages, and the sugar and acid in these drinks can break down tooth enamel and form cavities. Because it is difficult for toothbrushes to reach the back teeth, plaque and food can hide in the teeth’s grooves, causing decay.

Thankfully, tooth decay is preventable thanks to sealants, which help keep plaque and food out of the teeth’s grooves, and fluoride, which helps prevent early decay. Sealants and fluoride offer a one-two punch by keeping teeth healthy and strong while preventing the need for unnecessary fillings and other dental procedures. In fact, according to Oral Health America, approximately 75 percent of teeth sealed remain cavity free. By comparison, less than one-third of teeth that are not sealed remain free of cavities.

In Walworth County, the Seal-A-Smile program serves children in 4- and 5-year-old kindergarten, second grade and fifth grade, with retention appointments for students in third and sixth grade, explains Chase Wolff, RDH, a registered dental hygienist and the county’s coordinator for the program.

Because most students don’t yet have their permanent molars, children in pre-kindergarten and kindergarten who participate in the program receive a screening and fluoride treatment.

Through the course of the program, children receive two fluoride treatments, which is especially important for students in Walworth County. “Very few of the municipal water systems have community fluoridated water,” says Erica Bergstrom, Walworth County public health officer. “These fluoride supplements are really able to help protect teeth.”

For those few kindergartners who may have their molars, says Wolff, sealants are applied, but certainly by the secondgrade visit, students receive sealants on their first molars. In fifth grade, students whose second molars have come in receive another sealant treatment on their new molars.

Education is another important piece of the program. “We do chairside education with each child,” says Wolff. “We use a disclosing solution and give brushing instructions. Each student goes home with a toothbrush, toothpaste, information on why baby teeth are important, sugary drinks and preventing decay, and general information on sealants and the benefits of them.”

“For many, the Seal-a-Smile program is their first dental experience,” says Wendy Zimmerman, MSN, BSN, RN, CSN, Elkhorn Area School District nurse/supervisor. “They climb into the portable dental chair and are amazed they can see the plaque after the dye is applied. They learn the toothpaste isn’t magical, but the toothbrush is. They watch in the mirror as the plaque disappears when they make tiny circles with their free toothbrush. Many of the students will dress up for the day of the visit and almost all say “thank you” to the registered dental hygienist.”

Teeth cleaning is not provided as part of the Seal- A-Smile program, and children who are found to need further dental care are referred to area dental clinics.


The need for an oral care program in the county was identified nearly 10 years ago by Zimmerman as she was working on a capstone project for her master’s degree. Through annual health screenings, she found many children had dental issues and began seeking ways to address this local health concern. Then she found the state’s Seal-A-Smile program.

“Initially, the program involved a significant amount of time reaching out to parents to explain the program,” says Zimmerman. “Parents needed reassurance a registered dental hygienist would be performing the educational program and they wanted to make sure there were no hidden fees. Today, we have parents calling the school to make sure their children are able to participate and thanking us for having the program in the school.”

From a pilot program serving 107 students in two Elkhorn schools during the 2009-2010 school year, Walworth County’s Seal-A-Smile program has grown substantially, now serving 27 schools and nearly 3,000 participants. It is available to schools with 35 percent or higher participation in the free and reduced meal program, with all students in qualifying schools eligible to participate.

Not only did Zimmerman identify inschool dental care services as a critical need for the county, but improved dental health has long been— and continues to be — a priority of the Walworth County Public Health Department as well.

“Dental health continues to be a huge priority in our community,” says Bergstrom. “Every five years, Public Health conducts a community health assessment, and it continues to show the county is underserved per population. We have about 2,000 residents for every dentist and many people, of all ages, are going without basic dental care.”

“The Seal-a-Smile program is important for Walworth County because it is a dental education program that improves the health and well-being of the whole family,” says Zimmerman. “Many families have sought out a dentist to call their ‘own’ after their child returned home and shared what they learned from the registered dental hygienist. They are teaching their parents, grandparents and younger siblings that healthy teeth mean healthier bodies and that a dental chair isn’t scary.”

“Healthy teeth improve one’s appearance, speech, breath, and total body health,” Zimmerman adds. “Let’s be honest: If you have dental decay, bad breath, and are frequently ill it is harder to obtain and keep a job. The Seal-a-Smile program, along with routine dental visits, promotes healthier and more employable people and that is good for everyone.”

For more information about Seal-A-Smile, contact the Walworth County Public Health Department at 262-741-3140.

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