Dental Services

Policy

This policy supports local decision making on facilitating access to dental services and promoting oral health.

Summary

• Schools may facilitate access to mobile dental services (public and/or private) during school hours, on the school site.
• Smile Squad is the Victorian Government’s only school dental program, providing free dental care to all Victorian government students. Information for schools on the Smile Squad program can be found in the Guidance tab.
• If schools wish to facilitate access to a private dental provider, they are required to:
  • identify and engage an appropriate dental service based on the recommended considerations as outlined in this policy and
  • enter into a School Council Health Service Agreement with the dental service provider.

Schools play an important role in promoting and supporting good oral health and can do so by creating a healthy school culture and physical environment, supported by engaging teaching and learning programs.

Details

Facilitating access to dental services is a local decision made independently by each school.

If schools wish to facilitate access to dental services on the school site, they can engage Smile Squad or a private dental provider.

Smile Squad

Smile Squad is the Victorian Government’s only school dental program. It is being rolled out across the state over 2021 to 2023. A fleet of Smile Squad vans will visit government primary, secondary, P–12 and specialist schools across Victoria to provide free oral health examinations and necessary follow up treatment to all students. This includes teeth cleaning, fluoride applications, fillings and any other non-cosmetic, follow-up treatments.

Refer to the Smile Squad guidelines in the Guidance tab for information on:

• services provided to schools
• the process for implementing the Smile Squad school dental program
• requirements relating to:
  • consent (including mature minor consent) for students to access the program
  • recording attendance of students attending Smile Squad
  • privacy and information sharing considerations.

The Victorian Government has ensured that all Smile Squad providers meet the necessary legal and safety requirements. This means that, unlike the requirements for private dental providers, when Smile Squad visits, schools:

• do not have to enter into a formal licence agreement with the provider
• do not have to check documentation regarding licences, registrations and insurances.

All Smile Squad staff have undertaken Working with Children Checks and meet all COVID-19 guidelines required by the Department of Health and the Department of Education and Training.

For more information, visit Smile Squad or contact the department's Child and Youth Health Branch via email health.advice@education.vic.gov.au

Mobile dental services (private dental providers)

Some schools may wish to facilitate access to private dental services (that is mobile dental vans). These services are generally provided on the school grounds and are privately run and operated (not through the Victorian Government’s free public dental program).

Engaging a private dental provider

If schools wish to engage with a private dental service provider, they must identify and engage an appropriate dental service based on the documentation outlined in the steps below and enter into a School council health services licence agreement – dentist (DOCX) (staff login required) with the dental service provider.

Step 1 – Identify and engage an appropriate dental service provider

Schools must record evidence of the following documentation (ideally at least 5 days prior to the service attending the school):

• Registration – schools must confirm a visiting dental practitioner is a registered practitioner with the Dental Board of Australia. Schools must ask to see a registration certificate from the Australian Health Practitioner Regulation Agency or they can obtain this information directly from the Dental Board of Australia.
• Insurance – view evidence that the provider has public liability and professional indemnity insurance and check that it is current.
• Working with Children Check (WWCC) – schools are bound by laws that require a WWCC for adults undertaking child-related work in a school, and must adhere to department policies regarding suitability checks for employees, visitors and volunteers, including those from a dental service. Refer to the department's policy on Working with Children and other Suitability Checks for School Volunteers and Visitors.
• Radiation protection – schools must obtain a copy of the provider's Victorian Radiation Use Licence for any providers taking x-rays.
• Child Dental Benefits Schedule – private dental service providers may promote their services as 'free' to patients by relying on this funding source. Limits to the benefits apply and schools should consider how service providers will inform families of additional costs they may need to pay.

Schools will also need to ensure the following arrangements have been considered prior to the dental service arriving at the school:

• Supervision – schools need to ensure there is appropriate supervision of children who visit the dental service. Refer to the department's Duty of Care Policy.
• Consent – for any student accessing dental services on school grounds, the school must seek consent from parents/carers prior to them receiving treatment.
• Accreditation – while it is not mandatory for private dental providers to be accredited with the National Safety and Quality Health Standards, schools can consider accreditation as an indicator of a quality provider. Schools should seek a copy of the provider’s accreditation certificate.

Step 2 – Enter into a School Council Health Services Licence Agreement with the dental service provider

Where a school is enabling an external provider to attend school premises to deliver health services, the department’s Legal Division recommends the use of a license agreement. The School council health services licence agreement – dentist authorises the non-exclusive use of an area of the school by an external provider of health services and is available on the Resources tab.

If required, schools may contact the Legal Division to review the completed draft licence agreement before providing it to the external provider, by emailing legal.services@education.vic.gov.au

Promoting good oral health

Oral health is essential to overall health and wellbeing. Oral diseases can cause pain and discomfort and can negatively affect general health and quality of life.

Schools can promote and support good oral health through programs like Vic Kids Eat Well and the Healthy Schools Achievement Program. The Achievement Program takes a structured, whole-school approach to embed health and wellbeing into the school culture. The Achievement Program works with Dental Health Services Victoria to support schools to promote good oral health for the whole school community.

Below are some simple strategies schools could implement to promote good oral health.

Leadership and commitment

Schools may consider using a whole-school approach to health and wellbeing, with consistent practices in place to support and promote good oral health.

Healthy physical environment

• Have tap water available at all times
• Promote healthy food and drink choices
• Increase availability of ‘everyday’ food and drinks and limit 'occasional' and 'select carefully' food and drinks
• Ensure students wear mouth guards while participating in contact sport, to protect against dental injuries

Healthy culture

Encourage staff and families to role model healthy eating and oral health practices.

Teaching and learning

Incorporate learning activities into the curriculum focused on healthy eating and oral health practices.

Support staff and educators

Provide staff with the tools and resources and practical strategies on a regular basis to support oral health at school and home.

Community partnerships

• Consider families, students and staff as key partners in developing and supporting oral health initiatives
• Provide staff and families with tools and resources and practical strategies on a regular basis to support oral health and school and at home
• Consult students about healthy eating and oral health initiatives via relevant representative structures (for example, junior school council)
• Encourage staff to work with local health professionals, services and other organisations to increase their capacity to deliver and promote healthy eating and oral health initiatives
• Establish links with oral health services, oral health professionals and organisations to promote access to dental health checks and treatment

Promote public dental services

Dental Health Services Victoria aims to improve the oral health of all Victorians, including school aged children, through providing access to public dental care. In particular, children from at-risk or vulnerable cohorts may have priority access to public dental care and/or may be exempt from paying fees.

Schools may wish to promote the more than 50 community dental clinics located throughout metropolitan Melbourne and rural Victoria, where many children are eligible to receive free public dental care.

Refer to:

• List of community dental clinics
• Are you eligible?

Related policies

• Canteens, Healthy Eating and Other Food Services
• Duty of care
• Working with Children and other Suitability Checks for School Volunteers and Visitors

Smile Squad guidelines

These guidelines provide assistance to principals and other school staff who are implementing the Smile Squad school dental program in their school.

The guidelines contain the following chapters:

• About Smile Squad
• Steps for implementing Smile Squad in your school
• Consent and other requirements

About Smile Squad

Overview and management of Smile Squad

The Smile Squad school dental program is the Victorian Government’s school dental program providing free dental care to Victorian government school students. All students attending government schools are eligible for Smile Squad – they do not need a healthcare card, Medicare or access to the Child Dental Benefits Scheme.

All Smile Squad services are free. There are no out of pocket costs for students or families for examination and any necessary follow up treatment.

The program is led by the Department of Health, coordinated by Dental Health Services Victoria (DHSV) and supported by the Department of Education and Training. The Department of Education and Training has entered into an agreement with the Department of Health for Smile Squad on behalf of schools. This eliminates the need for schools to enter into a licence agreement with Smile Squad providers, which schools are required to do when engaging private dental providers.

The objectives of the Smile Squad program are to:

• improve access to oral health care and education for children, resulting in better health outcomes into adulthood
• minimise future demand and cost to Victoria’s health system by preventing the need for higher-cost, more complex interventions (including avoidable hospital admissions) in the future
• ease cost of living pressures on families and save them the inconvenience of having to visit the dentist.

The program is delivered by dental agencies within each school’s local community. Smile Squad is being rolled out in stages and will reach all Victorian government schools by the end of 2023. Further information about the roll out can be found on the Smile Squad website – refer to Roll-out areas.

Services provided to schools

Smile Squad provides free oral health examinations and follow up treatment, with no out of pocket costs for families.

Annual oral health examinations

Each school will be visited by Smile Squad who will provide a free oral health check-up to each student.

Services provided include an examination, x-rays when required, oral health and dietary advice, coaching and prevention interventions including the application of fluoride varnish.

In some circumstances, schools may receive a separate visit for the application of fluoride varnish 6 months after the oral health examinations.

Examinations and fluoride applications will usually be delivered in a room on the school site using mobile dental equipment – for example, portable chair and portable examination tools.

Follow up treatment

Free follow up treatment will be provided to all students who need it.

Services provided include teeth cleaning, fissure sealants, root canals, restorations (fillings), extractions and all other treatment required. Cosmetic procedures or orthodontics will not be provided.

Follow up treatment will take place in a van on the school site, with a fully functioning single-chair dental clinic set up.

More complex treatments (including root canal treatment, complex restorations and complex or surgical extractions) may need to occur at the local community dental agency.

All Smile Squad examinations and treatments are free. Smile Squad may utilise the Child Dental Benefits Schedule for some services, however, remaining costs will be covered by Smile Squad, so there are no out of pocket costs for students and families.

Oral health promotion

Smile Squad will provide dental packs to schools to distribute to students prior to the Smile Squad visit. The dental pack includes a toothbrush, tooth paste and oral health education material to promote dental health to students.

Preventative components such as the provision of dental packs, education on diet and teeth brushing, and the application of fluoride varnish will complement and build on existing prevention and oral health initiatives in preschools, maternal and child health settings and in primary care.

The Smile Squad workforce

Smile Squad staff are equipped with the necessary qualifications to provide a wide range of dental care in a variety of settings, including schools. All Smile Squad clinicians are registered with the Australian Health Practitioners Registration Association.

The Smile Squad workforce is comprised of the following.

Dental therapists and oral health therapists

Dental therapists and oral health therapists are trained to provide oral health examinations and many of the follow up treatments included in Smile Squad. They provide the following services for children and young people:

• oral health assessments
• diagnosis, treatment and management of dental conditions
• preventative services.

Oral health therapists have an additional qualification in dental hygiene and can carry out tasks such as complex scaling and teeth cleaning.

Dentists

Dentists specialise in the treatment of conditions affecting the mouth, teeth, jaw and gums. They provide assessment, diagnosis, treatment, management, and preventive services. Dentists will provide more complex treatments such as root canals or complex extractions.

In some circumstances, tertiary students completing a Bachelor of Oral Health, Bachelor of Dental Science or Doctor of Dental Surgery may provide services under the full supervision of oral health therapists or dentists.

Dental assistants

Dental assistants support oral health therapists, dental therapists and dentists during examinations and treatment. Dental assistants prepare for and clean up after procedures and provide assistance during procedures, such as passing instruments and operating suction equipment. Dental assistants are also responsible for scheduling appointments, updating patient records and other administration tasks.

Smile Squad workforce management and suitability checks

DHSV supports the management of the Smile Squad workforce by:

• providing a comprehensive on-boarding program that includes the provision of practical resources, advice and ongoing support
• ensuring the service is delivered in accordance with department requirements
• supporting a child safe environment in accordance with the Child Safe Standards.

The Department of Education and Training has worked closely with the Department of Health and DHSV to verify qualifications, registrations and accreditations of the Smile Squad workforce. DHSV has undertaken work to ensure that all dental professionals working for Smile Squad are appropriately qualified and have the requisite knowledge, skill and expertise to perform their roles and are suitable to work with children. DHSV has also ensured all Smile Squad service providers hold appropriate public liability and professional indemnity insurance and a current radiation use licence.

This means that schools do not have to check documentation regarding licenses, registrations and insurances, including Working with Children Checks (WWCC), when Smile Squad visits.

All Smile Squad staff are expected to:

• perform services in a skilful, efficient and courteous manner
• comply with all relevant school’s wellbeing and safety policies and school procedures, particularly in relation to the Child Safe Standards
• hold a valid WWCC prior to entering school premises
• not share any confidential information, unless compelled to do so by law
• only examine and treat students where consent has been obtained as per the Smile Squad consent and other requirements chapter in these guidelines
• be appropriately qualified and have the requisite knowledge, skill and expertise to provide Smile Squad services
• comply with all COVID-19 obligations required by the Department of Health and the Department of Education and Training, including vaccination requirements.

If a principal has concerns regarding a Smile Squad staff member, they should contact Smile Squad: smilesquad@health.vic.gov.au

Steps for implementing Smile Squad in your school

Overview of the Smile Squad process

Step 1: initial engagement

Schools will receive a letter of invitation to participate in the Smile Squad program. Smile Squad (through community dental agencies) will contact each school to discuss program requirements and schedule dates for the Smile Squad visit.

Step 2: school site assessment

Smile Squad will visit the school site to determine where the dental services will be delivered. Schools will need to provide a room for the oral health examinations, as well as electricity, water and a flat surface for a treatment van.

Step 3: promote Smile Squad to the school community

Smile Squad will provide physical and digital promotional material for schools to promote the program to staff, students and parents along with dental health packs for students.

Step 4: implement consent and supervision processes

Schools will hand out consent packs provided by Smile Squad and collect returned consent forms to provide their Smile Squad contact.

Step 5: Smile Squad visit

Smile Squad will visit the schools annually to provide a free oral health examination to students. Smile Squad will schedule follow up treatments.

Step 6: follow up treatment

Smile Squad will provide follow up treatment once consent is received. This occurs within the Smile Squad treatment van which is set up on school grounds or in the agency’s fixed clinic.

Step 7: reschedule your next annual Smile Squad visit

Schools will schedule annual visits at a mutually suitable time.

Step 1: initial engagement

The below information summarises the process for the initial engagement of Smile Squad.

Role of Smile Squad

• Invite schools to participate in the program (Department of Health will email via smilesquad@health.vic.gov.au). Smile Squad is being rolled out in stages and will reach all Victorian government schools by the end of 2023. Further information about the roll out can be found on the Smile Squad website – refer to Roll-out areas. Schools will be contacted when their local government area is scheduled for roll out
• Contact schools (through a local community dental agency) who have been invited to explain the program and discuss the requirements of the school.

Note: Any correspondence schools receive will contain a Smile Squad 'smiling tooth' logo shown below.

Role of the school

Nominate a key school contact for Smile Squad to liaise and work with Smile Squad to assist with planning and delivery of the program. This may be your school’s wellbeing lead, assistant principal, leading teacher or other appropriate staff member.

Role of the school contact

• Act as the main point of contact for Smile Squad when planning and delivering the program
• Work with the Smile Squad staff to schedule dates for Smile Squad visits, including the site assessment, oral health examination visit and follow up treatment visit
• Schedule the following annual visit for the following year to ensure students receive annual dental services
• Support Smile Squad with the school site assessment to identify an appropriate room in the school and location of the treatment van on the school site
• Ensure Smile Squad has the necessary information about the school student cohort to ensure the appropriate services are provided
• Distribute consent packs to all students and liaise with parents, carers or mature minors to obtain completed consent forms
• Provide the completed consent forms to the community dental agency
• Provide Smile Squad with relevant school-level policies and procedures, such as relevant health and wellbeing policies, child safety policies, emergency procedures and any other relevant information that may assist Smile Squad to deliver the program safely

Role of the Smile Squad staff

• Act as the main point of contact for the school when planning and delivering the program
• Work with the school contact to schedule dates for the Smile Squad visit
• Schedule and conduct a school site assessment to ensure the school has an appropriate location for conducting the dental service
• Work collaboratively with principals, school health and wellbeing teams, school administrators and teachers to support promotion and delivery of the service and enhance student participation
• Collect consent forms from the school and register students into a confidential patient management system

Licence agreements

Schools will not need to enter into a licence agreement or any other agreement with Smile Squad or local community health agencies who are providing services through the Smile Squad program.

To minimise administrative burden for schools who are participating in the Smile Squad program, the Department of Education and Training has worked closely with the Department of Health and Dental Health Services Victoria (DHSV) to enter into agreements on behalf of schools, thereby eliminating the need for schools to enter into a formal licence agreement with the providers.

Step 2: school site assessment

Smile Squad staff will conduct a site assessment with the school contact and any other relevant school staff prior to the service commencing to ensure the school can adequately host Smile Squad on the school grounds.

Site assessment process

• Smile Squad staff will meet the principal and the school contact to discuss the requirements for delivery of the program
• Smile Squad staff will assess the space and site requirements for:
  • oral health examinations – requires a room in the school (ideally with a sink and electricity). Alternatives will be discussed if a room isn’t available
  • follow up treatment – requires a space on the school grounds for the treatment van, close to the school building with a flat surface, electricity, water, waste management (for water only)
• Smile Squad staff will identify any minor remedial works that may need to occur to allow for program delivery (for example, installation of a power point)
• Smile Squad staff will determine whether they require connection to the school’s guest WiFi service (Smile Squad does have their own network however experiences poor connectivity in some areas)

If minor remedial works are required

Smile Squad will fund minor remedial works (for example, addition of a power point), in consultation with the school, if they are required to make a school ready to deliver the program.

To assist with the process, schools should consider and discuss with Smile Squad any school-level processes for engaging with contractors to complete minor remedial works. The school must obtain and submit a quote to DHSV for approval prior to any work commencing.

Schools will not have to pay any costs for minor remedial works provided prior approval has been received and all the quoted work is required to support Smile Squad.

Public Private Partnership schools

If minor remedial works are required at a Public Private Partnership (PPP) school, schools will need to advise Smile Squad of any additional processes that may need to occur and liaise with the PPP funds manager to ensure that approvals for works to occur are gained prior to the program commencing.

Step 3: promote Smile Squad to the school community

Schools and school staff (including principals, school staff, health and wellbeing staff, administration staff) can support the delivery of Smile Squad by promoting the program to the school community.

Smile Squad have developed a communications toolkit that can be found on the Dental Health Services Victoria website. The toolkit is designed to support schools promote the program through various school communication channels when schools commence participation in the program. The toolkit includes:

• a selection of key messages
• school newsletter content
• text for the school website
• social media posts
• photos and graphics
• the Smile Squad logo
• digital copies of Smile Squad brochures to provide to families.

Smile Squad will also send dental packs to schools for distribution to students prior to the Smile Squad visit. The packs will promote the development of good oral health skills and include a toothbrush, toothpaste, and educational material about the benefits of eating well, drinking well and cleaning well.

Step 4: implement consent and supervision processes

Please refer to the Consent and other requirements chapter of these guidelines for detail regarding:

• consent requirements (including mature minor consent) for students to access the Smile Squad school dental program
• recording attendance of students attending Smile Squad
• privacy and information sharing considerations.

Role of school contact

• Work closely with the Smile Squad staff during the consent process
• Send communications to parents and carers that the Smile Squad service will be visiting the school via school student management systems
• Distribute consent packs to all students ideally 6 weeks prior to Smile Squad’s visit to the school
• Liaise with parents, carers or mature minors to obtain completed consent forms (FAQs for schools and parents/carers can be found on the Resources tab)
• Collect returned, signed consent forms from students, ensuring they remain enclosed and sealed in their envelope (schools should not open envelopes)
• Provide the completed consent forms to the community dental agency using the method as directed by the Smile Squad agency
• Obtain a list of students who have received or provided consent to be seen, from Smile Squad, and provide this information to the appropriate staff (for example, classroom teachers, casual relief teachers, specialist teachers and other school staff)

Role of Smile Squad staff

• Provide consent packs to schools, for schools to distribute to students prior to Smile Squad’s visit to the school
• Collect consent forms from the school and register students into a confidential patient management system
• Provide a list of students who have received or provided consent to be seen to the school contact

For more information, or if parents have questions or concerns, please contact: smilesquad@health.vic.gov.au or call 1300 503 977.

Duty of care and supervision of students travelling to the Smile Squad service

Principals, teachers and other school staff continue to owe a duty of care to students whilst they are receiving care from Smile Squad clinicians at school. This means school staff must take active and reasonable steps to minimise the risks of reasonably foreseeable harm to students where there are risks that are within staff control or knowledge.

In particular, supervision may be required for students when they are travelling to and from Smile Squad on school grounds and should be assessed on a case-by-case basis. The level of supervision required will depend on a number of factors, including:

• where in the school the Smile Squad is delivering services
• the age and maturity of the students receiving services
• individual student needs, including health, disability or behavioural needs. For example, if a student has a disability or special health or behavioural need, additional support by a school staff member may be considered a ‘reasonable step’ to protect that student and others from reasonably foreseeable risks of harm.

For further, general information on duty of care in schools, refer to the department’s Duty of Care Policy.

Step 5: Smile Squad visit

Smile Squad will visit schools to provide dental services to students during school hours. Dental services provided include examinations, x-rays when required, oral health and dietary advice and coaching and preventative interventions, including the application of fluoride varnish.

The oral health examinations will:

• usually be delivered in a room on the school site using mobile dental equipment (for example, portable dental chair, portable examination tools)
• usually be delivered by a team of 2 oral health or dental therapists and 2 dental assistants
• take approximately 15 minutes for each student.

Each child will be provided with a post care report and care plan to provide the parent, carer or mature minor with information about the student’s oral health and any further treatment that may be required.

If no further treatment is required, students will be seen when the examination van returns to the school the following year.

In some circumstances, schools may receive a separate visit for the application of fluoride varnish 6 months after the oral health examinations. Smile Squad will advise individual schools whether this will occur during the annual visit.

Examinations and fluoride applications will usually be delivered in a room on the school site using mobile dental equipment – for example, portable chair and portable examination tools. Visits for the application of fluoride varnish require less time on the school site than visits for oral health examinations.

Risk management

Schools are responsible for identifying and managing risks that might affect their students, staff or operations. Schools should be aware of the risks associated with the implementation of Smile Squad services on the school grounds and ensure risks are managed in line with broader school risk management processes.

For more information, refer to the department’s Risk Management – Schools Policy.

Managing emergencies and incidents

Every Victorian government school must have a current emergency management plan (EMP) that addresses site specific hazards and threats which have the potential to result in emergencies and critical incidents.

Schools should take steps to ensure Smile Squad are informed of and understand relevant emergency procedures and any other relevant information that may assist Smile Squad to deliver the program safely.

For more information, refer to the department’s Emergency and Critical Incident Management Planning Policy.

Step 6: facilitate follow up treatment

Please refer to the Smile Squad consent and other requirements chapter of these guidelines for detail regarding the follow up consent process.

Smile Squad will attend the school on the scheduled date to provide follow-up treatment to students who need it. In most cases, visits for follow up treatment will occur soon after a visit for oral health examinations. Follow up treatment may include services such as teeth cleaning, fissure sealants, root canals, restorations (fillings), extractions and any other treatment required.

Follow-up treatment

Follow-up treatment will be delivered in a Smile Squad treatment van containing a fully functioning single chair dental clinic set up that will be located on the school site. The treatment van will be staffed by oral health therapists, dental therapists, oral health educators, dental assistants and/or dentists. More complex treatments (including root canal treatment, complex restorations or complex extractions) may need to occur at the local community dental agency.

Post care following treatment

Smile Squad will discuss the specific type of follow up treatment and after-care requirements with parents/carers/students when seeking consent, including the risks and benefits.

To support schools to manage any first aid requirements for students following examination or treatment, Smile Squad will provide some basic after-care information to school staff in an ‘after-care requirements’ form.

The purpose of the ‘after-care requirements’ form is to provide schools with enough information to ensure school staff can support students with their healthcare needs following any treatment procedures. The student will take the form back to class and provide it to their teacher. Instructions on the form will include basic instructions around managing any bleeding (from an extraction) or if students have a numb cheek or lip.

Smile Squad clinicians will also notify the school if students are affected by medication used during treatments or may require further analgesia.

If a student feels unwell after dental treatment or if any other medical issues arise, school staff should follow the department’s First Aid for Students and Staff Policy and school’s local first aid policy, and inform Smile Squad and the student’s parents or carers where appropriate.

Medication

In the case that a student may require further analgesia following treatment, Smile Squad will discuss this with the parent, carer or mature minor when gaining verbal consent for treatment. If required, parents/carers will need to provide analgesics to the school and complete a medication authority form in accordance with the department’s Medication Policy.

Step 7: schedule your next annual Smile Squad visit

To ensure scheduling of Smile Squad works well for the program’s and the school’s calendar, schools are encouraged to schedule their next annual visit during their current visit.

Smile Squad will advise schools whether a visit for the application of fluoride varnish is required in 6 months’ time and encourage schools to schedule it in at the time of visit.

Contacts

For more information visit the Smile Squad website.

For general queries or concerns about Smile Squad, please contact: smilesquad@health.vic.gov.au

For general queries or concerns about school requirements or responsibilities when implementing Smile Squad, please contact the Health, Prevention and Advice Team, Wellbeing Health and Engagement Division, Department of Education and Training: health.advice@education.vic.gov.au

Consent and other requirements

Purpose

The purpose of this guidance is to provide detail regarding consent requirements (including mature minor consent) for students to access the Smile Squad school dental program and what the school’s duty of care responsibilities are to support them to access the program.

This guidance is only applicable to Smile Squad. Schools engaging private providers should follow the Dental Services Policy on the Policy tab of this topic and ensure private dental providers comply with the requirements set out in the School council health services licence agreement – dentist between the school and the provider, including consent requirements.

Consent

The law recognises that as children become older and more mature, they are more capable of making their own decisions, including about seeking and obtaining their own health care. Young people may reach this stage before they turn 18 years of age. These young people are referred to as 'mature minors'.

For Smile Squad, it will be the Smile Squad clinician (oral health therapist, dental therapist, dentist) who will assess if the young person is a mature minor with respect to the issue for which they are seeking dental treatment. The Smile Squad clinician must be satisfied that the student has sufficient understanding of the risks, benefits, and possible complications of their condition and proposed treatment to give informed consent. This is in line with ordinary practice for young people accessing dental services in the community. The Dental Board of Australia’s code of conduct states that good practice involves considering the young person’s capacity for decision making or consent.

In seeking consent, dentists and dental clinicians should comply with the Dental Board of Australia’s code of conduct as part of their registration requirements, and be guided by the Australian Dental Association’s Guidelines for Consent for Care in Dentistry (PDF).

Students attending a government primary, secondary, P–12 or specialist school in Victoria will be provided with access to Smile Squad.

Consent will be required for all students to access dental services through Smile Squad.

Parent/carer consent must be received for primary school aged students. Consent for secondary school students may be provided by a parent/carer or the student if they are considered to be a ‘mature minor’ by the treating clinician.

Consent processes

There are 2 consent processes included in the program:

• written consent collected via the Smile Squad consent form prior to a dental examination. This will be included as part of a consent pack that will be provided to all students
• verbal consent sought from parents/carers (usually via telephone) or from the students themselves for any follow-up treatment at the end of the dental examination.

Consent packs

All parents and carers who have a child at a school participating in Smile Squad will be informed about the program prior to the program visiting their child’s school.

All students will receive a consent pack which will include:

• Smile Squad information sheet
• Smile Squad consent form
• financial consent form for CDBS bulk-billing
• medical questionnaire
• oral health questionnaire.

The purpose of the consent pack is to provide parents/carers/students with information about Smile Squad, to obtain health information about students, and to obtain informed parent/carer/mature minor consent to provide oral health examinations.

Smile Squad will provide consent packs to the participating school for them to distribute to students prior to Smile Squad’s visit to the school.

Consent requirements for primary school aged students

Parent/carer consent must be sought for primary school aged students to receive an examination or follow up treatment from the Smile Squad school dental program.

Consent to receive Smile Squad dental services can be obtained from parents/carers using the ‘Smile Squad consent form’.

Consent requirements for secondary school aged students

Students aged 18 years and over can generally consent to an examination and/or treatment themselves.

Consent for secondary school students may be provided by a parent/carer or the student if they are considered to be a ‘mature minor’ for this purpose by a Smile Squad clinician.

To be considered a mature minor, the Smile Squad clinician must be satisfied that the student has sufficient understanding of the risks, benefits, and possible complications of their condition and proposed treatment to give informed consent. A student may be considered capable of making some dental treatment decisions but not others.

In circumstances where the Smile Squad dental clinician does not consider the student to be a mature minor, the clinician will discuss this with the student and seek consent from the parent or carer prior to any dental treatment. The clinician may also encourage the student to attend the local community dental agency with a parent/carer. Consent cannot be sought from or provided by principals or school staff.

Consent to receive Smile Squad dental services can be obtained from the parent/carer/student using the ‘Smile Squad consent form’.

If a student is accessing Smile squad and has consented as a mature minor, they should be informed that their parent may be able to see in their student profile that they attended a health and wellbeing – Smile Squad appointment.

Students attending specialist schools

All students attending specialist schools will receive Smile Squad consent packs as above.

Primary school aged students attending specialist schools must receive parent/carer consent to receive an examination or follow up treatment from the Smile Squad school dental program.

Secondary school aged students attending specialist schools are able to fill in the ‘Smile Squad consent form’ themselves (or with assistance) to provide consent for their own dental examination and follow up treatment.

It will then be the responsibility of the Smile Squad clinician to assess whether the student is considered to be a mature minor for the purpose of consenting to receive Smile Squad dental services at schools.

To be considered a mature minor, the Smile Squad clinician must be satisfied that the student has sufficient understanding of the risks, benefits, and possible complications of their condition and proposed treatment to give informed consent. A student may be considered capable of making some dental treatment decisions but not others.

In circumstances where the Smile Squad dental clinician does not consider the student to be a mature minor, the clinician will discuss this with the student and seek consent from the parent or carer prior to any dental treatment. The clinician may also encourage the student to attend the local community dental agency with a parent/carer. Consent cannot be sought from or provided by principals or school staff.

Consent to receive Smile Squad dental services can be obtained from the parent/carer/student using the ‘Smile Squad consent form’.

Consent for follow up treatment

Each student will receive a post-care report from the Smile Squad clinician at the end of the dental examination to take home.

Verbal consent for any follow-up treatment will be sought from parents/carers (usually via telephone) or from the student themselves (in the case of a mature minor) at the end of the dental examination. Smile Squad staff will discuss the specific type of follow-up treatment that is recommended as part of the post-care report, including the risks and benefits, and seek verbal consent.

In the case of where a student has been deemed a mature minor for the purpose of consenting for their oral examination, the dental clinician will assess whether the student is capable of providing consent for further follow-up treatment. They will also be provided with an individual care plan and will be encouraged to discuss this with their parents/carers.

School responsibilities to manage absences from class

Consistent with duty of care obligations, schools must monitor student attendance records of when students are absent from class to attend a health and wellbeing appointment. This includes a Smile Squad school dental program visit.

Primary school aged students

As part of this process, schools with primary school aged students should maintain their own record of parent/carer consent for their child to leave class to attend the program.

When informing parents/carers about Smile Squad visiting the school, schools should ensure parents/carers are aware and informed that when they are consenting to their child receiving dental services from Smile Squad, their child will be withdrawn from class to receive dental services in a room in the school/dental van during school hours.

Schools should make a note on the student’s record via their school’s student management software system that the student attend a health and wellbeing – Smile Squad appointment.

Secondary school aged students

Secondary school aged students are considered mature minors for the purposes of leaving class to attend onsite appointments. This is only for the purpose of leaving class to attend an appointment.

Schools should make a note on the student’s record that the student was out of class to attend a health and wellbeing – Smile Squad appointment.

Schools should also:

• work closely with Smile Squad to establish processes for managing student examinations and treatment
• obtain, for their records, a list of students who have received or provided consent to be seen, supplied by Smile Squad
• document a student’s absence from class to attend Smile Squad services as ‘attending a health and wellbeing – Smile Squad appointment’ in their school’s student management software
• be aware of when Smile Squad is going to be at the school and students who will attend Smile Squad services – this should be clearly communicated to all staff (including casual relief teachers, specialist teachers and ES staff)
• include reminders in school newsletters, encouraging parents/carers to sign the consent form
• remind parents/carers of Smile Squad’s arrival when services commence on the school grounds.

Related departmental policies

Mature Minors and Decision Making

Information sharing and privacy

Smile Squad will:

• only collect, use and share personal and health information about students where necessary to determine a student’s dental health needs, provide health services, meet duty of care obligations and where required or authorised by law to do so
• store this information in the student’s dental record, managed by Dental Health Services Victoria (DHSV), and keep it confidential and secure
• store, maintain and use this information consistently with the Privacy and Data Protection Act 2014 and the Health Records Act 2001
• in some circumstances share student information with school staff if it is necessary to support the student’s safety, health or wellbeing.

School staff will not have access to a student’s dental record. Only authorised Smile Squad personnel (from DHSV and Victorian community dental clinics) have access to this.

School staff will:

• use and manage any student information collected by the school (including information collected in connection with the Smile Squad program in accordance with the department's Schools’ privacy policy)
• share information about a student with Smile Squad if it is necessary to support a student’s safety, health and wellbeing whilst they are accessing Smile Squad services at school.

Smile Squad employees will not have access to school or department systems such as CASES21, Compass, HART or SOCS (or any other student information management system or student files), nor should they be provided access by school staff.

Further information and contacts

Smile Squad website

For general queries about Smile Squad, please contact: smilesquad@health.vic.gov.au

If you have school-related questions about school requirements or responsibilities, please contact the department's Physical Activity and Healthy Eating team, Wellbeing Health and Engagement Division: health.advice@edumail.vic.gov.au

Resources

Department resources

To engage private dental services (‘mobile dental vans’), schools must have a licence agreement in place. The School council health services license agreement – dentist is available below.

School council health services licence agreement – dentist (DOCX) (staff login required)

For information regarding this process, visit the Legal Services website, at Health Services (staff login required). If required, schools may contact the Legal Division to review the completed draft licence agreement before providing it to the external provider, by emailing legal.services@education.vic.gov.au

External resources

Dental Health Services Victoria (DHSV) aims to improve the oral health of all Victorians, including school aged children, and provides clinical dental services to eligible Victorians.

For information on:

• the location of dental clinics where many children are eligible to receive free public dental care, refer to: Community dental clinics
• eligibility criteria for children and young people, refer to: Dental care for kids and teens
• special needs vans that deliver general dental care to children with a variety of physical and intellectual disabilities, refer to: Special needs dental health services.

Smile Squad

Smile Squad provides free dental care to all Victorian public primary and secondary school students, with a free annual dental health examination and free follow up treatment as needed

Mature-minor FAQs for parents/carers (DOCX) – contains practical information for parents and carers regarding how their child can access the Smile squad program, including consent and confidentiality requirements

Mature-minor FAQs for schools (DOCX) – contains operational information regarding the Smile Squad program, including consent requirements, scheduling of appointments and managing students who are considered mature minors