Home Pediatric Dentistry Early Smiles Sacramento Boosts School-Aged Student Consent Rate

Early Smiles Sacramento Boosts School-Aged Student Consent Rate

by adminjay

Early Smiles Sacramento (“Early Smiles”), a unique school-based program of the Center for Oral Health that serves the most vulnerable children in Sacramento County, announced it has launched targeted initiatives, including an oral health program tool kit, to increase its current consent rate for school-aged students—those in elementary, middle, and high school.

Center for Oral Health Team with Students (Photo: Business Wire)

Consents allow Early Smiles to provide oral health assessments and fluoride varnish to students, among other services, helping prevent the overuse of emergency rooms for preventable oral health issues. By focusing on prevention, Early Smiles saves up to 33% ($3.2 million) in potential dental costs for restorative care.”1

In its recent six-year evaluation of Early Smiles, one of the challenges the Center for Oral Health identified facing the program was lower consent rates for school-aged students.1 During the program year 2023, Early Smiles reported a consent rate of 25% for school-aged students compared to a 54% consent rate for preschoolers and Head Start students. Lower consent rates mean less students with oral health assessments and fluoride varnish applications and can translate into more missed school days due to dental pain.

“Tooth decay is the most common chronic disease among children aged six to 11 years old,” said Kevin Scott, CEO for the Center for Oral Health. “Many children simply don’t have the resources to be able to address tooth decay.”

“In California alone, the numbers can be astounding,” said assemblymember, Kevin McCarty. “Children miss approximately 874,000 school days annually due to dental pain, costing our California schools between $29 million and $32 million annual in average daily attendance funding.2

Prior to administering oral health assessments and applying fluoride varnish to students, the Early Smiles team first engages students with educational sessions. The Center for Oral Health has identified that the lower consent rates among school-aged students may be linked to the virtual format of their oral health education program, which was implemented in response to the COVID pandemic. Currently, the Early Smiles team continues to offer virtual education for school-aged students, but they have transitioned back to in-person sessions for preschoolers, where consent rates are higher. While the virtual format served the purpose of preventing COVID transmission, it appears that students show a preference for in-person interactions. This preference is associated with increased motivation, better focus, and improved retention of information compared to virtual education formats.

“Early Smiles has been a tremendous success, with over 104,000 total oral health assessments for students having been performed since its inception in 2016 and nearly 91,000 students receiving oral health education during the 2023 program year alone1,” said Kevin Scott, CEO, Center for Oral Health. “Despite these wins, we want to do better and currently are targeting an increased consent rate for school-aged students from 25% to 40% by Summer 2025.”

Already addressing the lower consent rates and focusing on the 40% consent rate goal for school-aged students, Early Smiles has introduced an oral health program tool kit with extremely positive initial reactions.

“When creating the oral health program tool kit, we knew the obstacles we needed to overcome and tried to make this tool kit as robust, engaging, and motivational as possible,” said Tiffany Turner, COO, Center for Oral Health. “The tool kit includes in-person educational materials, games, posters, flyers, and even wristbands—all focused on oral health education.”

“We want to educate more students about the importance of good oral health,” said Amaya Weiss, student support coordinator at Sacramento City Unified School District. “We have noticed that school-aged students just are not as engaged and more often do not have consents for us to proceed with oral health assessments and fluoride varnish applications. One of the many admirable qualities about Early Smiles is its agility and willingness to overcome challenges—and to tackle obstacles quickly. Recently, they introduced an oral health tool kit to address the lower consents, which has been well-received. Already, I am seeing more students engaged and motivated—and importantly, an increase in consents.”

“At my school, we get to play games about our teeth,” said one of the students in the Early Smiles Sacramento program. “For me, it’s a win-win because I learn how I can keep my teeth healthy, and I have fun with my friends. And it makes my mom really happy.”

“In addition to the oral health program tool kit, we also are planning other initiatives to reach our Summer 2025 goal,” said Rachel Shafer, program director, Center for Oral Health. “These include participating in more parent education meetings and reinstating in-person oral health education for school-aged students’ group. We also plan to pilot electronic consents. At the end of the day, we love saving smiles and will continue to be as proactive as possible to ensure Early Smiles does this.”

“I am a champion for school-based programs designed to educate and provide assistance to vulnerable children with dental needs, including access to education and assistance,” said Cathy Levering, executive director and CEO, Sacramento District Dental Society and Foundation. “I appreciate the work Early Smiles does to teach children the importance of oral health and that tooth decay can be prevented with a good dental health regimen.”

“Making a difference in the oral health of children underscores our vision of improving the oral health of our communities through a whole-person approach,” said Marti Lolli, president and CEO of LIBERTY Dental Plan. “We are thrilled to partner with Early Smiles Sacramento to help make oral health education a reality for tens of thousands of children who may not otherwise have the opportunity to learn preventive care, receive a dental screening, and have fun in the process. We thank Early Smiles for their dedication to this invaluable mission.”


  1. ESS Evaluation 2023(centerfororalhealth.org)
  2. Kumar, J. and Thurmond, T. (2023) Kindergarten Oral Health Assessment Requirement Update, Kindergarten Oral Health Assessment Requirement – Letters (California Dept of Education). Available at: https://www.cde.ca.gov/nr/el/le/yr23ltr0419.asp#:~:text=Tooth%20decay%20is%20the%20most,in%20average%20daily%20attendance%20funding. (Accessed: 10 Aug 2023).

About Early Smiles Sacramento

Early Smiles is a program managed by the Center for Oral Health. It is funded and supported by LIBERTY Dental Plan, Access Dental Plan, HealthNet of California, and First 5 Sacramento. The program is dedicated to educating students and families about oral health and education, dental screening to identify dental urgency of the child, fluoride varnish treatment, and connecting families to dental care. Early Smiles provides services to 16 school districts and more than 27,000 children throughout the year and educates an average of 45,000 students annually.

To learn more, watch this informational video, visit centerfororalhealth.org/early-smiles-sacramento/ or call 916-245-1674.

Center for Oral Health

The Center for Oral Health is a California non-profit founded in 1985 and remains dedicated to improving oral health, especially of vulnerable populations, through innovation, research, education, and advocacy.

About LIBERTY Dental Plan Corporation

LIBERTY is a dental benefits administrator founded by dentists and health industry professionals in 2002. LIBERTY currently administers dental benefits in all 50 states, including on behalf of 6.5 million Medicaid, Medicare Advantage, commercial, and exchange members. A high-touch approach to member and provider engagement, along with innovations to improve the quality and cost-effectiveness of dental care delivery, has propelled the company’s growth. Welsh, Carson, Anderson & Stowe, is a majority investor in LIBERTY.

Elevance Health, a customer since 2010, is a minority investor. LIBERTY operates and lives by its motto: Making Members Shine, One Smile at a Time.™ Learn more at LIBERTY Dental Plan.

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