Date of Graduation


Document Type

UAF Access Only - Thesis

Degree Name

Bachelor of Science in Nursing

Degree Level





Patton, Susan

Committee Member/Reader

Vowell Johnson, Kelly

Committee Member/Second Reader

Hentzen, Jane


Background: Dental caries, the disease process that causes tooth decay, is one of the most common chronic childhood diseases. With more than 25% of children in the US between 2-5 years of age and more than 50% ages 12 to 15 affected by dental caries, the prevalence is unacceptably high and disproportionately affects minorities and low-income populations (Centers for Disease Control and Prevention [CDC], 2017). The purpose of this study was to evaluate the relationship between parent reported children’s oral health status, an oral health assessment conducted at a school-based dental program, and a tooth decay risk score. Methodology: Data was obtained from a program where trained senior nursing students examine children for oral hygiene and apply fluoride varnish. The program is currently being implemented in pre-schools in Northwest Arkansas where a high percentage of children qualify for free and reduced school meals. Data collected from the program includes a parent-completed permission form with yes or no questions regarding the child’s dental health. The second data set is completed by the student nurses and determines a tooth decay risk score. During the study period (Spring, 2018), a total of 456 three and four-year-old children were assessed for oral health and 436 children had fluoride varnish applied to their teeth by the student nurses. Ninety children, 21%, were referred to a dentist for further evaluation and treatment.Results: Ninety-two percent of the parents reported brushing their child’s teeth at least once a day using toothpaste with fluoride; 60% reported that their child drinks fluoridated water; 77% reported that their child drinks juice or sweetened drinks between meals or eats sugary snacks; and 8% reported that their child sleeps with a bottle filled with milk to drinks other than water. There was a statistically significant difference in the presence of tooth decay between children whose teeth were brushed at least once a day using toothpaste with fluoride and those whose were not. A second statistically significant difference was between children whose parents reported that they slept with a bottle filled with milk or drinks other than water and those who did not. Conclusion: Results of this study indicate that screening of children’s teeth and mouth that enables early detections and referral to the dental team for detailed examination and treatment can be effectively carried out by trained school nurses and nursing students. New laws allow nurses to apply fluoride varnish, increases children’s’ access to preventative dental care. Results also indicate that oral health education programs are needed. Educational programs should include information about the cariogenic effects of sugar and the importance of fluoride, as well as emphasizing parenting skills and strategies to promote children’s eating habits for oral health.


dental caries, fluoride, parents, tooth decay, pediatric, oral hygiene