Nurse Referral Program

KCCDHN

Nurse Referral Program
The referral process is easy and children get their decay treated by a local pediatric dentist, free of charge. When a school nurse or health aid identifies a child who has visible decay (watch video), the Nurse Referral/Dental Treatment System can be a link for free dental treatment. The process is simple. Just complete the brief referral form, fax it to our office, and our staff will facilitate an appointment with one of our three local pediatric dentists.

All necessary medical forms and assistance for parents will be completed by phone by our program staff. At the first dental appointment, medical forms will be reviewed and signed by the parent. Translation services, if needed, are also provided.

Upon completion of the child’s dental caries treatment, he/she will also receive a cleaning and a fluoride treatment. If the child has her/his permanent molars, sealants will be applied to prevent decay.
Prior to the child beginning the treatment process, parents will receive dental health education materials that will support maintaining good oral health hygiene for their child. Information will include the importance of caring for baby teeth, proper brushing skills, and the effect fluoride has on preventing and strengthening their child’s teeth. In an effort to support the family in establishing a dental home for their child, we will send a six-month check up reminder notice. The Nurse Referral /Dental Treatment System does not include the cost of six-month visit; yet our program staff is available to link the family to a dentist. To locate a dentist in your area contact Barbara Antongiovanni at 661.377.0328.

The Nurse Referral System is available to children ages 0-5 who have visible decay or are experiencing pain.
Referrals can be submitted throughout the year.
Referral forms are brief and easy to complete.
Staff is bilingual and available to provide information to nurses/health aids and parents.
Referrals can be submitted by fax to 661.377.0329. If you are interested and would like to receive a screening and referral forms, please contact Paula Salcido at 661.377.0322.
Resources

Nurse Referral Form

Nurse Referral Screening Form

KCCDHN Nurse Referral Program Brochure

PM160 Dental Classification Guide
The American Dental Association's "Classification of Treatment Needs" is a tool to use when referring children for dental services.

Identifying Decay in Public Settings Video

Documents listed with are available as PDF (portable document format) files. To be able to read these files, please download a free copy of Adobe Acrobat Reader.

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