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EDMUND G. BROWN JR.
Governor

State of Californiaā€”Health and Human Services Agency
California Department of Public Health


20-01
April 30, 2020


TO:
California Local Oral Health Programs

SUBJECT:
Guidance to Local Oral Health Programs on School-Based Activities During the COVID-19 Crisis



This communication is to provide guidance to Local Oral Health Programs (LOHPs) regarding school-based activities during the COVID-19 crisis. The Office of Oral Health (OOH) acknowledges school closures and suspension of non-emergency dental care due to COVID-19 has caused unforeseen delays in work related to school-based programs. This guidance is provisional due to the uncertainty of how long the pandemic, and ensuing delays, will last. It is also uncertain how the pandemic will affect the way dental services are provided in the future. Note: OOH anticipates LOHPs will be able to use unspent State Fiscal Year (SFY) 2019/2020 funds to roll over into SFY 2020/2021 in order to complete activities.

For the next Progress Report, please include a list of delayed activities and/or reassignments experienced by LOHP staff. Explain the delays as they relate to COVID-19 such as school closures, redirected assignments, etc. Please describe activities that were being conducted during this time such as the activities suggested in the preceding paragraphs. Provide an estimate when regular activities resumed or will resume.

Our goal is to maintain strong and supportive relationships with all of our schools, so we can retain their participation. Though schools are currently arranging for distance learning, once in place, we encourage you to check in with your school sites. Explain the changes in the immediate term and let them know you would like to maintain their participation for the next two years.

The OOH recommends the following activities acceptable to work on until schools reopen:

  • Coordinate with schools to identify children who may need toothbrush kits and other dental information.
    • Work with schools to provide toothbrushing kits that could be distributed with back-to-school packets, meal pick-up, homework pick-up, or mailed to homes.
    • Include brushing chart/calendar or other tracking methods to ensure kids are brushing with fluoridated toothpaste two (2) times daily.
    • Resource: Mouth Healthy
  • Communicate regularly with schools that you have an established relationship.
    • Offer to participate in Distance Learning by presenting information to students on oral health, toothbrushing, nutrition, etc.
    • Plan with schools once teachers/administrators are back to prepare for upcoming school year activities/events and to make arrangements for on-site school visits to provide oral health education, setting up for Kindergarten Oral Health Assessment (KOHA), if protocols allow, distributing toothbrush/toothpaste kits, etc.
    • Provide regular contact regarding oral health messaging. Be a resource for teachers, students, parents, administrators, etc. Be creative with approaches to stay in contact.
    • Reach out to schools who previously were not receptive to outreach efforts as they may be looking for resources to support students post COVID-19.
  • The kits would include toothbrushes, floss, fluoride toothpaste, and messages such as the importance of maintaining oral health, oral hygiene instruction, and toothbrushing activities; for instance, playing a song to brush along or toothbrushing apps.

  • Include COVID-19 information to describe dental emergencies, what to do, and resources for care like Smile, CA and safety-net clinics in your area.
  • For children under age 5, include Brush Book Bed materials.
  • Work with schools and their distance learning to include oral health curriculum. 

KOHA - OOH is currently working with the California Department of Education (CDE) to issue a joint letter to notify County Offices of Education and Superintendents of school districts regarding KOHA forms have been updated per Senate Bill 379, which also allows schools to provide onsite screening using passive consent. Once finalized the letter and updated forms will be posted on the CDE website. Progress has been delayed due to school closures and setting up distance learning programs. Hopefully, the KOHA documents will be ready by June 1, 2020. An announcement will be sent to LOHPs when the forms have been approved. Note: KOHA activities may be delayed beyond the current school year. Additionally, guidance may change from CDC, CDE, and Association of State & Territorial Dental Directors regarding the protocol for conducting KOHAs. OOH will provide additional guidance as needed.

  • Presently, the OOH does not recommend buying supplies, in particular Personal Protective Equipment (PPE), because there is still a shortage of PPE for health care providers who are addressing the urgent COVID-19 cases and an anticipated surge is expected in the next few weeks. Also, the price of PPEs has gone up considerably and may be cost prohibitive.

  • Develop your LOHP webpage if it has not already been developed. Post guidance on dental related COVID-19 information for the public on the following:
    • Identify and provide resources for your county regarding the importance of maintaining oral health during the pandemic crisis;
    • Provide a list dental providers and safety net clinics that are open for new patients to receive emergency dental care;
    • Provide information describing dental emergencies during the COVID-19 pandemic;
    • Provide information on how to obtain Medi-Cal dental coverage;
    • Provide information about obtaining COVID-19 testing;
    • Provide guidance for postponement of non-urgent dental care during COVID-19 pandemic state order;
    • Provide information/alerts on LOHP webpage once dental practices start to re-open or new guidance on any changes as a result of COVID-19.

  •  Additional resources
  • In addition, ensure dental providers are receiving all the appropriate COVID-19 guidance and resources from the California Dental Association (CDA), California Department of Public Health (CDPH), and Centers for Disease Control and Prevention (CDC). Notify OOH when dental practices in your county start to re-open or if Local Health Officer sends out new guidelines for healthcare professionals which include dentists/dental health professionals re: COVID-19.
  • Post educational information on fluoride and community water fluoridation, if applicable.

Further Information:

For questions regarding this guidance, please email DentalDirector@cdph.ca.gov or your grant manager.

Sincerely,
Jayanth Kumar signature

Jayanth Kumar, DDS, MPH
State Dental Director
Office of Oral Health

CDPH, Office of Oral Health

 MS 7218 l  P.O. Box 99737  l  Sacramento, CA 95899-7377

(916) 440-7197  l  (916) 636-6678 FAX

Internet Address: www.cdph.ca.gov

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