Programa de Salud Bucodental en escolares de la Comunidad del Bajo Boulogne / Oral Health Program in children from Bajo Boulogne Community

Las afecciones bucodentales constituyen un problema de salud pública por su alta prevalencia y su fuerte impacto individual y colectivo en términos de dolor, malestar y discapacidad social y funcional. El Centro de Medicina Familiar y Comunitaria San Pantaleón, ubicado en la provincia de Buenos Aires, brinda asistencia sanitaria gratuita a la comunidad. Un relevamiento documentó que el 97% de los concurrentes presentaba caries y no se lavaban los dientes por falta de cepillo y pasta dental. Se decidió llevar adelante un programa de promoción de la salud bucodental. El objetivo fue evaluar su implementación; que incluyó: a) rastreo de caries y problemas odontológicos; b) coordinación interinstitucional; c) entrega de cepillos y pasta dental; d) intervención educativa; e) extensión comunitaria. Participaron en forma irregular 120 niñas, niños y adolescentes entre 5 y 18 años del Centro de Apoyo Escolar Fundación Bajo Boulogne. Se realizaron dos encuentros educativos y entrega de cepillos y pasta dental. En la revisión odontológica inicial sobre 60 participantes se detectaron caries en 43 (71,6%), que fueron derivados para tratamiento odontológico, pero concurrieron solo 26 (60,4%). El conocimiento sobre salud bucodental mostró cambios entre los más pequeños luego de las intervenciones educativas. Se logró implementar el programa, cumplimentando las actividades propuestas. Pero surgieron barreras que dificultaron la cobertura. En cuanto a la eficacia de la intervención educativa, no se logró mostrar cambios en el conocimiento. Se consiguió la detección oportuna, la incorporación de hábitos como el cepillado dentro de la institución educativa, la articulación para mejorar el acceso a la atención y la vinculación entre los diferentes actores comunitarios. (AU)

Oral disorders are a public health problem due to their high prevalence and their strong individual and collective impact in terms of pain, discomfort, and social and functional disability. The San Pantaleón Family and Community Medicine Center, located in the province of Buenos Aires, provides free healthcare to the community. A survey documented that 97% of those present had cavities and did not brush their teeth due to a lack of brush and toothpaste. It was decided to carry out an oral health promotion program. The objective was to evaluate its implementation; which included: a) tracking of caries and dental problems; b) inter-institutional coordination; c) delivery of brushes and toothpaste; d) educational intervention; e) community extension. 120 girls and boys and adolescents between 5 and 18 years of age from the Bajo Boulogne Foundation School Support Center irregularly participated. Two educational meetings were held, handing out brushes and toothpaste. In the initial dental review of 60 participants, caries was detected in 43 (71.6%), who were referred for dental treatment, with only 26 (60.4%) concurring. Oral health knowledge showed changes among the youngest after educational interventions. It was possible to implement the program, completing the proposed activities. Barriers arose that made coverage difficult. Regarding the effectiveness of the educational intervention, it was not possible to show changes in knowledge. Timely detection was achieved, the incorporation of habits such as brushing within the educational institution, articulation to improve access to care and the link between the different community actors. (AU)

Care Provided by Students in Community-Based Dental Education: Helping Meet Oral Health Needs in Underserved Communities.

Since 2000, reports have documented the challenges faced by many Americans in receiving oral health care and the consequences of inadequate care such as high levels of dental caries among many U.S. children. To help address this problem, many dental schools now include community-based dental education (CBDE) in their curricula, placing students in extramural clinics where they provide care in underserved communities. CBDE is intended to both broaden the education of future oral health professionals and expand care for patients in community clinics. The aim of this study was to develop a three-year profile of the patients seen and the care provided by students at extramural clinics associated with one U.S. dental school. Three student cohorts participated in the rotations: final-year students in the Doctor of Dental Surgery, Bachelor of Science in Dental Hygiene, and Master of Dental Therapy programs. The study was a retrospective analysis of data retrieved from the school's database for three consecutive academic years. The data included patients' demographics and special health care needs status (based on information collected by students from their patients) and procedures students performed while on rotations. For the three-year period, the results showed a total of 43,128 patients were treated by 418 student providers. Approximately 25% of all encounters were with pediatric patients. Students completed 5,908 child prophylaxis, 5,386 topical fluoride varnish, and 7,678 sealant procedures on pediatric patients. Annually, 7% of the total patients treated had special health care needs. The results show that these students in CBDE rotations provided a substantial amount of oral health care at extramural sites and gained additional experience in caring for a diverse population of patients and performing a wide range of procedures.

Undergraduate education in special needs dentistry in Malaysian and Australian dental schools.

Meeting the oral health care needs of the growing population of people with special health care needs (SHCN) starts with dental students' acquisition of sound knowledge and development of clinical competence at the predoctoral level. The aim of this study was to review the level of undergraduate education in Special Needs Dentistry (SND) in Malaysian and Australian dental schools. The deans of all six Malaysian public dental schools and eight of nine Australian dental schools participated in a postal survey on current undergraduate didactic and clinical training in SND at their institutions. The results showed the number of dental schools in Malaysia with teaching in SND as a specific discipline was relatively low compared to that of Australia. However, a high percentage of Malaysian and Australian dental schools reported incorporating teaching of SND into pediatric dentistry (83.3 percent vs. 75 percent), oral medicine/oral pathology (66.7 percent vs. 75 percent), and oral surgery (66.7 percent vs. 25 percent). Most respondents said their school delivered SND clinical training in dental school clinics, hospital-based settings, and residential aged care facilities. Respondents in both countries viewed lack of faculty expertise as the greatest barrier to providing SND education. The study provides valuable information that can direct SND curriculum development in the two countries.

Odontología, Universidad y Sociedad / Dentistry, University and Society

Las reformas en salud en Latinoamérica han fomentado la privatización de los tratamientos en salud, estando asíel acceso a los servicios acorde al poder adquisitivo del individuo. Actualmente, las patologías bucales representan un problema prioritario en salud pública. Comunidades desfavorecidas económicamente tienden a acumular niveles de salud bucal deteriorados. Para reducir las desigualdades en salud bucal, las estrategias y recursos deben considerar las diferencias entre comunidades, promoviendo la odontología preventiva primaria desde una perspectiva comunitaria; teniendo en cuenta aspectos biológicos, contexto social, cultural, económico, ambiental y acceso a los sistemas de atención en salud. Para ello la educación y el cambio de conducta tienen un papel preponderante. La Universidad como componente de la sociedad, tiene como misión participar en la cultura y aportar soluciones a los problemas sociales, articulando la formación en salud bucal comunitaria con la docencia, investigación y extensión, de manera a formar profesionales orientados en la atención de necesidades de la población. La metodología de la investigación científica debe facilitar y contribuir en la generación de nuevos conocimientos que aporten soluciones concretas al mejoramiento en salud bucal comunitaria. Es preciso emprender nuevos esfuerzos en la formación odontológica a nivel nacional. En tal sentido, se presenta una revisión de los aspectos fundamentales que conciernen a la desigualdad en salud, a la educación como punto de partida para la prevención, a la motivación humana y al cambio de conducta del individuo, incluyendo al rol de la Universidad en la propuesta de soluciones a problemas sociales. Palabras clave: Odontología Comunitaria -Educación en Salud Dental - Odontología Preventiva

Health reforms in Latin America have encouraged the privatization of treatments, thus, access to services are dependent of the individual's purchasing power. Oral pathologies currently represent a public health priority. Economically disadvantaged communities tend to present high levels of impaired oral health. In order to reduce inequalities in oral health, both strategies and resources should consider the differences between communities, promoting primary preventive dentistry from a community perspective, while taking into account biological, social, cultural, economic, and environmental aspects, as well as the access to health care systems. In this regard, education and behavioral changes have a major role. The University, as a component of society, has the mission to participate in culture and provide solutions to social problems, articulating community oral health education with teaching, research and extension, in order to form professionals focused on caring for the needs of the population. Scientific research methodology should facilitate and contribute to the generation of new knowledge that provides concrete solutions for the improvement of community oral health. New efforts on dental training nationwide need to be applied. In this regard, fundamental aspects of health inequality, education as a starting point for prevention, human motivation and individual behavioral change, including the role of the University role in the solution of social problems. Keywords: Community Dentistry -Health Education, Dental - Preventive Dentistry

An innovative HIV training program for dental students.

Dentists need to be able to give people with HIV/AIDS compassionate and comprehensive care. Previous studies have shown that many dental students have negative attitudes towards treating such individuals. This article addresses the effectiveness of a program that trains dental students in the issues of treating this population. All predoctoral students at the Loma Linda University School of Dentistry are required to receive this training. Students complete a pre-session survey during their third year and a post-session survey as they complete the training during their fourth year. The survey was administered from 2003 to 2009 during which 386 students completed responses to the post-session survey. Five questions in the survey address self-evaluation of knowledge, attitudes, and confidence in the efficacy of universal precautions and post-exposure prophylaxis following bloodborne exposures. This study reports on five two-year testing cycles and shows significant shifts in all five areas surveyed. The most significant gains were in the two areas that are not addressed in much detail in other courses in the dental school curriculum. These are familiarity with post-exposure prophylaxis (PEP) and confidence in the efficacy of PEP. These data support the usefulness of such a program in preparing future dentists to deliver appropriate care to persons living with HIV/AIDS.

Measuring clinical productivity in community-based dental education programs.

Community-based dental education programs (CBDEPs) are an important part of the curriculum in many dental schools. This article describes the redesign of the CBDEP at the University of Kentucky College of Dentistry. As part of the formative evaluation of this CBDEP, information on clinical productivity was collected in order to educate intramural faculty members about the scope and extent of services provided in extramural sites; develop an understanding of the productivity expected; complement the intramural education by placing dental students in particular settings where they could enhance certain clinical disciplines; and serve as a decision making tool in the selection of sites that provide the richest clinical experiences. A total of 158 students participated in the CBDEP during the three years of our study (2006-08). Productivity per site was calculated based on total, mean, and median number of services provided, billing (utilizing Kentucky's Medicaid fees for 2006), and Relative Value Units (RVUs). A total of 26,202 services, $972,109 in billing, and 43,053 RVUs was generated by the students, with an average of 175 services, $6,481, and 287 RVUs per student. Four categories (restorative, oral surgery, preventive, and diagnostic) accounted for 88 percent of total RVUs for all sites and all years. Productivity measured with RVU was the highest at private practices. Students spent most of their time providing restorative and oral surgery services. Measuring clinical productivity can be an effective tool to establish benchmarks, improve the site selection process, and educate those skeptical about the benefits of extramural education. Such an evaluation will enable faculty and program administrators involved in CBDEP to make continuous improvements.

Developing an assessment in dental public health for clinical undergraduates attending a primary dental care outreach programme.

BACKGROUND: This paper describes the development and implementation of a Dental Public Health (DPH) assessment within the Primary Dental Care Outreach (PDCO) course at Newcastle University. The assessment was piloted alongside the delivery of the Bachelor of Dental Surgery (BDS) curriculum in accordance with established learning outcomes. AIM: To design and implement a pilot summative assessment, incorporating patients' social histories obtained by undergraduate students attending primary dental care outreach clinics. METHOD: Undergraduates were tasked with obtaining a detailed social history from a patient seen during their two-year outreach attachment. Each student submitted a written account of their patient's social history and placed this in context by researching a number of demographic and social variables centred upon their patient's home residence. The final component involved writing a concise case feature for a nominated newspaper based upon the case history, where students were encouraged to identify one or more public health messages using language appropriate to a lay readership. RESULTS: Seventy one clinical undergraduates (98.6% of the year-group) subsequently submitted all components of the assessment. Eighty six per cent of the year-group was deemed to have passed the assessment with 9.9% achieving a 'Merit' grade and 76% a 'Satisfactory' grade. Following the assessment, students and clinical teachers were asked for their feedback through a focus group for staff, and a brief feedback form for students. CONCLUSION: Undergraduates subsequently reported greater awareness of the significance and importance of obtaining a detailed social history and its relevance when devising appropriate and realistic treatment plans.

Comparison of clinical productivity of senior dental students in a dental school teaching clinic versus community externship rotations.

The aim of this study was to report on the clinical and monetary productivity of fourth-year dental students at community-based clinical sites and school-based clinics at the Harvard School of Dental Medicine (HSDM). This study included forty-seven students from the graduating classes of 2006, 2007, and 2008. These fourth-year students were required to spend twelve weeks at one of several participating community health centers throughout Massachusetts and New Hampshire. Students also treated their patient pool in the teaching practice at HSDM in the fourth year. The most common sixty American Dental Association procedure codes were compared, and variables were created by grouping them by specialty or type of service. HSDM dental students completed 8,365 procedures at an externship site during their community experience. An average of 178 procedures was completed per student, and mean revenue of $17,486 was produced. In comparison, the same students completed 3,640 procedures during an equal amount of time spent (normalized for this study) at the school teaching practice clinic, where each student completed an average of seventy-seven procedures and generated $16,802 in revenue. The results of this study show that fourth-year dental students at the community health centers, working under the supervision of adjunct faculty, completed more than double the number of procedures they did in the HSDM teaching practice clinic. However, the revenue generated was very similar at the two sites. In addition, the types of procedures performed by students at externship sites were simpler than the complex and specialized procedures performed at the HSDM clinic, which include fixed and removable prosthetics, periodontal surgery, and implantology.

Impact of the University of Colorado's Advanced Clinical Training and Service (ACTS) Program on dental students' clinical experience and cognitive skills, 1994-2006.

The University of Colorado Denver School of Dental Medicine has operated a community-based dental education program for all of its students since 1985. A database of student productivity has been maintained in a standardized format, capable of multiyear compilation, since 1994. This study utilizes twelve years of these data to profile the type and amount of clinical treatment that can be provided by a typical fourth-year dental student during a 100-day community-based training experience. Between 1994 and 2006, the school's 423 graduates provided a mean of 922 treatment procedures per student at a mean of 498 patient visits per student. During a typical four-week clinical affiliation, each student provided a mean of approximately twenty-seven restorations on permanent teeth, sixteen restorations on primary teeth, and twenty-four oral surgery procedures (extractions). Students also gained considerable experience in periodontics, fixed and removable prosthodontics, and endodontics. Self-assessed competency ratings tended to increase after completing the program, as did willingness to treat underserved populations after graduation. About 16 percent of graduates reported planning to practice in the public sector after completing dental school. A community-based experience such as this appears to offer an opportunity to substantially augment dental students' clinical training experiences.

Continuing dental education in radiation protection: monitoring the outcomes.

OBJECTIVES: To evaluate an evolving radiation protection dental postgraduate course run in Wales between 2003 and 2007. METHODS: We compared three standardized course series. Course content was enhanced in 2006 to target areas of weakness. In 2007, a single best answer multiple choice questionnaire instrument superseded a true/false format. Practitioners' performance was studied pre- and immediately post-training. 900 participants completed identical pre- and post-course validated multiple choice questionnaires. 809 (90%) paired morning-afternoon records, including those of 52 dental care professionals (DCPs), were analysed. RESULTS: Mean (standard error) pre- and post-course percentage scores for the three courses were 33.8 (0.9), 35.4 (1.4), 34.6 (1.0) and 63.6 (0.9), 59.0 (1.4), 69.5 (0.9). Pre-training, only 2.4%, 3.1% and 4.9% of participants achieved the pass mark compared to 57.7%, 48.4% and 65.9% post-training, indicating a rather greater pass rate and gain in the most recent series than earlier ones. In recent series, older more experienced candidates scored slightly higher; however, their gain from pre- to post-training was slightly less. CONCLUSIONS: Baseline levels of radiation protection knowledge remained very low but attending an approved course improved this considerably. Targeting areas of weaknesses produced higher scores. Current radiation protection courses may not be optimal for DCPs.

Utilizing dental colleges for the eradication of oral cancer in India.

Dental education in India has grown in such a way that it ranks first in the world in having the highest number of dental schools. There are 240 dental schools all over the country. Paradoxically, even with this large number of dentists and dental institutions, India contributes to the highest number of incident cases of oral cancer. In India, oral cancer burden approximates to 20-30% of all cancers. The plausible reason for this high incidence of oral cancer could be expounded on the fact that there exists a high usage of tobacco within the country. The evidence for the high prevalence of using chewable tobacco products, especially in the youth, was recently reported in the Global Youth Tobacco Survey. This increasing usage of chewing tobacco and related products will further accrue to the mortality and morbidity figures in the near future. To effectuate a breakthrough in the existing situation, the work force of dental schools could be capitalized on. The aim of this article is to present the burden of oral cancer in the country and identify trends in the prevalence of tobacco usage, which if continues could alert an epidemic of oral cancer in the near future; and how dental schools in the country can be utilized for preventing this upcoming epidemic.

Atividades extramuros na ótica deegressos do curso de graduação emodontologia / Extramural activities in the view of graduate students of Dentistry Graduation Course

A participação de acadêmicos da área da saúdeem atividades extramuros possibilita o conhecimentoe atuação nas dimensões estruturais dos serviços públicosde saúde e faz parte da proposta das diretrizescurriculares dos cursos de graduação em odontologiae das recomendações da lei 8080 que regulamenta oServiço Único de Saúde. O objetivo deste trabalho foiavaliar o Serviço Extramuro Odontológico (SEMO) e suasatividades correspondentes, sob a ótica dos egressosda FOA-UNESP. Foi realizado um estudo descritivotransversal, de abordagem quali-quantitativa. Foi enviadopor correio um questionário abordando diversosaspectos relacionados ao SEMO, para 76 ex-alunosformados em 2003. Os dados obtidos foram submetidosà análise quantitativa pelo software Epi Info. Parainterpretação das questões abertas, utilizou-se o modeloAnálise de Conteúdo. Retornaram respondidos47 por cento do total enviado, sendo que 100 por cento destes afirmaramque a participação no SEMO foi satisfatória. Váriosfatores foram relacionados à contribuição doSEMO na formação profissional, como conhecimentoda realidade e contexto social (21,2 por cento) capacidadede adaptação de recursos disponíveis (18,2 por cento) e contatocom a realidade (15,2 por cento). Por meio da técnica deassociação de palavras, foram identificadas categoriascomo “Importância do SEMO” (100 por cento), “realidadesocial” (53,1 por cento), e “ensino” (40,6 por cento). Dentre algumasdificuldades encontradas, foram listadas as deficiênciasna infra-estrutura (63,6 por cento). Os objetivos propostospelo SEMO foram plenamente e razoavelmente...

The development of a primary dental care outreach course.

The aim of this work was to develop the first north-east based primary dental care outreach (PDCO) course for clinical dental undergraduate students at Newcastle University. The process of course design will be described and involved review of the existing Bachelor of Dental Surgery (BDS) degree course in relation to previously published learning outcomes. Areas were identified where the existing BDS course did not meet fully these outcomes. This was followed by setting the PDCO course aims and objectives, intended learning outcomes, curriculum and structure. The educational strategy and methods of teaching and learning were subsequently developed together with a strategy for overall quality control of the teaching and learning experience. The newly developed curriculum was aligned with appropriate student assessment methods, including summative, formative and ipsative elements.

Evaluation of an academic service-learning course on special needs patients for dental hygiene students: a qualitative study.

The purpose of this study was to evaluate the outcomes of a service-learning course on special needs patients for dental hygiene students by considering student reflections, community site coordinators' feedback, and faculty reflections in a qualitative analysis. Twenty-three female dental hygiene students beginning their fourth semester in the program provided preventive oral health services at eight community sites serving six diverse groups of people having special health care needs. Students reflected on the experience via commentaries written in self-reflection journals. The investigators applied the constant comparative method to analyze and unitize the data, ultimately reaching consensus on three category topics: awareness, higher order thinking, and professionalism. End of course project assessments provided additional data that was used to triangulate with data from the reflective journals. Telephone interviews with the site coordinators and personal interviews with the course faculty provided data from multiple perspectives. The outcomes of this study suggest that service-learning pedagogy can facilitate a deeper understanding of the subject matter and provide an opportunity for students to use critical thinking strategies in addition to becoming aware of complex social and professional issues related to the oral health care of individuals with special needs.

Representação social de acadêmicos de odontologia sobre a área de Odontologia Social / Social representation of dental students about the field of social dentistry

A concepção tradicional do currículo odontológico, dividido em disciplinas, não foi capaz de aproximaro profissional formado da realidade do sistemanacional de saúde. No início da formação, osacadêmicos dos cursos de Odontologia são capazesde construir uma imagem da área de estudo de algumasdisciplinas; porém, quanto à OdontologiaSocial, há desconhecimento da área de atuação. Foiobjetivo do presente trabalho conhecer a percepçãopreviamente formada sobre a Odontologia Social,de alunos do 3º ano do Curso de Odontologia daFaculdade de Odontologia de Araçatuba da UniversidadeEstadual Paulista (FOA-UNESP), que aindanão haviam cursado a referida disciplina. A cada ano,no primeiro dia de aula da disciplina, todos os alunosrespondiam à pergunta aberta: “Odontologia Socialé...”. Ao final de 3 (três) anos, foram apurados 195questionários. Inicialmente, fez-se uma leitura naíntegra de todas as respostas de uma forma rápida;em seguida, novas leituras foram realizadas de formacriteriosa, considerando-se as partes significativas.Posteriormente, foram identificados as palavras-chavese os trechos pré-codificados para cada uma dascategorias. Foram pós-categorizados 05 temas: desconhecimentoda área, integração do profissionalcom a sociedade, atuação meramente preventiva,odontologia voltada para a população carente e políticaspúblicas. Concluiu-se que os acadêmicos desconhecemo objetivo da área e ainda possuem umavisão restrita da Odontologia Social como sendo voltadapara ações de cunho assistencial em populaçõescarentes, com ênfase na prevenção das doenças. Essesdados demonstram a necessidade de uma adequaçãodo currículo da instituição para atender asDiretrizes Curriculares Nacionais para os cursos degraduação em Odontologia

Saúde bucal na web: uma avaliação dos sites brasileiros / Oral health on web: An evaluation of Brazilian sites

Este estudo propõe uma análise descritiva dos sitesbrasileiros oficiais e comerciais que abordam temas educativossobre saúde bucal. Método: Foram selecionados 50 web sitesa partir de uma busca sistematizada na Internet, utilizandopalavras-chaves pré-determinadas. Foi criado um instrumentode avaliação dividido em cinco categorias: apresentação dosite, conteúdo, credibilidade, design e interatividade.Resultados: A cárie dentária foi o conteúdo de maiorfreqüência observada nos sites (82 porcento). Dos 50 sites avaliados,22 apresentavam ilustrações relacionadas à saúde bucal emsuas páginas. Quanto a navegabilidade, imagens e arquiteturadas páginas, 44 porcento 64 porcento dos sites, o conteúdo oscilou entre bom emuito bom. De um modo geral, os sites apresentaram umaqualidade satisfatória quanto à credibilidade, emboramostrassem deficiências na precisão das fontes. Osmecanismos de interação com o usuário foram insuficientes.Conclusão: Apesar da necessidade de adaptação paraaperfeiçoamento de sua qualidade, os web sites brasileiros sãopromissores como importantes instrumentos de educação emsaúde bucal, podendo contribuir na promoção de saúde dopaciente e conseqüentemente na sua qualidade de vida

Percepções maternas sobre a saúde bucal de bebês: da informação à ação / Maternal perceptions about the bucal health of babies: from the information to the action

O objetivo deste trabalho foi analisar as diferentes realidades vivenciadas por um grupo de mães, do período gestacional aos primeiros meses de vida do bebê, e compreender como elas valorizam e dão sentido a saúde bucal de seus filhos. A abordagem metodológica compreendeu a participação de 20 mulheres, que tiveram o acompanhamento pré-natal e parto realizados no Hospital Cel. Pedro Germano, em Natal - RN, e consistiu na aplicação de duas entrevistas semi-abertas, realizadas em momentos distintos: a primeira durante a gravidez, antes da palestra odontológica educativa, e a segunda após o nascimento de seus filhos, durante a visita domiciliar. os dados coletados foram submetidos à técnica qualitativa de análise de conteúdo das entrevistas, com o intuito de analisar a percepção das gestantes sobre a saúde bucal e os cuidados que estas pretendiam ter com seus filhos e, após o nascimento destes, avaliar as ações realizadas, os hábitos presentes e a percepção delas acerca dos métodos educativos empregadas. De acordo com os achados, conclui-se que muitas mães se perdem no percurso entre a intenção e a ação, percebendo-se, assim, a necessidade do acompanhamento da mãe, do bebê e do núcleo familiar também no período pós-parto.

Reexamining educational philosophy: the issue of professional responsibility, "Cleveland First".

This paper proposes a shift of emphasis in the dental curriculum from measures to protect and improve the oral health of individuals to measures to protect and improve the oral health of the community or society. This shift represents a fundamental change in educational philosophy of the dental school. To illustrate this shift in emphasis, this paper describes a demonstration project to test the feasibility of this approach involving all seventy first-year students in the Case Western Reserve University School of Dentistry in a four-week experience placing dental sealants in erupting molars of second and sixth graders in fifty schools of the Cleveland City School System. In future years, the program is expected to reach all second and sixth graders in the Cleveland School System. The experience is a required integral component of the curriculum, involving every student in the class, and is designed to make a demonstrable difference in oral health in the City of Cleveland. The experience is reinforced with course material on professional responsibility. The school is developing additional intensive experiences for second-, third-, and fourth-year classes involving smoking prevention for adolescents, oral health maintenance for nursing home residents, and dental care delivery in the inner city. The initial year of the program has had effects on students' responses to other elements of the first-year curriculum that go beyond the experience of placing sealants in children's teeth. The focused efforts of dental students every year are expected to have a measurable effect on the disparities in oral health found in the City of Cleveland as well as a measurable effect on dental students' and dentists' attitudes concerning professional responsibility.