It only takes five minutes. Melinda Nadeau, a registered nurse at Harriet Beecher Stowe Elementary School in Brunswick, Maine, has her pre-K through fifth-grade students brush their teeth and lie down on the bed. Using a head lamp with magnifying glasses, Melinda examines a student’s teeth and easily sees the area of concern — a tooth is showing signs of possible decay that is at risk of infection and pain. Expertly, she dries the tooth and then applies silver diamine fluoride (SDF), a topical medication to stop the progression of and prevent further cavities in the affected area.

Immediately, the bacteria that cause decay begins to die. If decay was truly present, then the affected spot will blacken over the next 24 hours. Not having to worry about this cavity or experience pain from an infected tooth allows the student to better focus in and outside of school. Melinda is one of the first school nurses in Maine to apply SDF to students in school.

“I feel like I’ve done some good. The kids don’t have to suffer, and, instead, they can be in the classroom and learn,” she said. “When your body has an infection, it’s harder to learn and focus. It affects everything. This will change that, and these kids will be able to better focus after SDF treatment and prevent pain.”

Typically, school nurses don’t apply SDF, but thanks to a CareQuest Institute for Oral Health® grant that MCD Global Health received, school nurses can now receive training to apply the SDF treatment to students who need oral health care.

MCD was one of 10 organizations nationwide, and the only one in Maine, to receive the $125,000 grant that focuses on school-based and school-linked initiatives to improve oral health outcomes.

For Melinda (image at right), who has been a nurse for 30 years, a school nurse for 18, and has worked in Brunswick schools for four years, this pilot training program is a “game changer.”

“There are a lot of school nurses in the state that are willing to apply SDF, and I’m hoping through this pilot program that there is a good outcome, and we can move forward with having it in our schools,” she said. “If it wasn’t for the Maine Center for Disease Control and Prevention School Oral Health Program (SOHP), we wouldn’t have any of this.”

Integrating oral health into children’s primary care as early as possible is vital to ensuring a healthier life into adulthood. In Maine, about half of all children are not receiving any preventive dental care, and even fewer can access care in a traditional dental home.

MCD’s SOHP team has recruited and trained seven school nurses in oral health assessment, SDF application, and follow-up care. The results of this pilot will help determine the feasibility of this model as part of the SOHP and how this strategy can be adopted on a broader scale in more schools.

This story originally appeared in MCD's 2024 Annual Report.