Models for delivering school-based dental care.

School-based health centers (SBHCs) often are located in high-need schools and communities. Dental service is frequently an addition to existing comprehensive services, functioning in a variety of models, configurations, and locations. SBHCs are indicated when parents have limited financial resources or inadequate health insurance, limiting options for primary care and preventive services, or within low-access areas such as dental health professional shortage areas. Poor health and concomitantly poor oral health can lead to attendance problems. Oral health services in school-based setting are often the only access to services a child may have. Children who attend schools with SBHCs have immediate access to services that are coordinated with the student'sfamily and school personnel or administrators. Comprehensive services can be collaborative, with support or administration provided by more than 1 organization. For example, the Children's Aid Society (CAS), Columbia University School of Dental and Oral Surgery (CUSDOS), and Columbia University Mailman School of Public Health developed, implemented, and currently operate SBHCs in 2 communities in the northern Manhattan section of New York City (Central Harlem and Washington-Heights/Inwood). The clinics operate in or are affiliated with public schools in New York City. All CAS and Columbia University sites include dental components, using a variety of delivery models. Determining which dental delivery system to use for a particular community or population is a complex decision. The models, reasons for selection, and sustainability of each system are described.