As schools shut down, and preventive and non-emergency dental care came to a halt due to COVID-19, unanticipated consequences occurred: children’s oral health declined.

Nikki Frisch

With schools turning virtual or limiting visitors, the Wisconsin Seal-A-Smile (SAS) program has been unable to provide care in the same way and capacity it has in the past. Come October 2020, Nikki Frisch, dental hygienist and owner of Seals on Wheels Oral Health Program, took extra precautions to successfully and safely provide preventive dental care in schools to help the students that need it.

“Because of the pandemic, we weren’t able to see kids from March until October in 2020,” Frisch said. “Just with those few months of not being able to provide care in schools, I’ve seen a lot more decay this year. I know this program is important in reducing childhood caries. Being part of Seal-A-Smile has helped us get back in to schools safely to talk about oral hygiene with kids, safely provide preventative dental services and help families find a provider for follow up treatment needs.”

The services provided through SAS are needed now more than ever. After not being in schools from March to October, Frisch has only been able to see about 30% of students at schools she is at but has seen a 319% increase in early dental needs such as broken or missing fillings and suspected decay. Additionally, urgent dental needs such as kids that are experiencing pain, infection or swelling have increased 147%.

The students with urgent dental needs experience more than just the physical symptoms, explains Sharon Friederick, the school nurse for Iowa-Grant and Highland School Districts.

“If our students are experiencing oral health issues, they can’t eat properly and then there are worries about nutrition,” Friederick said. “If their teeth are hurting, they aren’t going to learn properly or even get enough sleep, so they will have trouble focusing in school. Dental care is almost like the core of everything, it’s just as important as medical care.”

Providing dental services through SAS is needed to ensure the overall wellbeing of children, which is why it was crucial for Frisch to provide her services in schools across the state during COVID-19. Frisch and her team are following all CDC guidelines and those put in place by Wisconsin SAS, such as taking temperatures, reducing aerosols, wearing n95 masks and face shields and asking screening questions, while providing care in schools.

“Having this service in our school is necessary for our kids, and it’s safe to do with all of the extra precautions in place,” explains Friederick. “Nikki and her staff were able to provide the necessary dental care specific to each student while following all guidelines. Many dental clinics are still catching up with seeing their patients because of the required closures over the past year, and having our students see Nikki has been their only dental care during this pandemic.”

Frisch sees students age pre-k through high school in Columbia, Dane, Dodge, Grant, Iowa, Richland and Sauk counties. Before COVID-19, Seals On Wheels provided more than 2,400 children with sealants in the 2018-19 school year. Before schools closed in the 2019-20 school year, 1,684 students received dental sealants. And since April of this year, 428 students have received sealants. Wisconsin Seal-A-Smile hopes to be back to fully operational in all 1,100 schools in the 2021-22 school year.

COVID-19 caused an increase in oral health problems for children for a few reasons, Frisch explains. Across the country most dental offices were only providing emergency care to patients and school-based programs like SAS were completely shut down. With being at home all the time, it’s likely that kids fell out of a normal hygiene routine, increased their snacking and did not receive preventative dental care. Because of this, the care that Frisch and others provide through SAS is essential.

“The kids are only out of the classroom an average of 15 minutes and during this time we can screen for any decay, pain, or suspicious areas. We also provide other preventative services like dental cleanings, sealants, and fluoride. We then send a letter home or call parents to let them know of their child’s needs. If a family is in need of a dental home we do help with referrals. ,” Frisch said.

“During COVID-19 we’ve seen a lot of troubling numbers. I look forward to providing services for more students this fall. Some students will have gone without dental services for 1.5 years by that point. With Seal-A-Smile we will be able to screen for urgent decay and provide referrals, and this has the capability of improving students’ concentration and learning in class which is so important.”

Wisconsin Seal-A-Smile is a collaborative effort between Children’s Health Alliance of Wisconsin, Delta Dental of Wisconsin and the Wisconsin Department of Health Services. The program’s mission is to improve the oral health of Wisconsin children by providing school-based dental sealants. SAS grantees include dentists, dental hygienists, schools, hospitals, local health departments, community health centers, non-profit agencies and free clinics.