This story is part of a series on the challenges and solutions related to oral health in Michigan, Indiana, and Ohio. It is made possible with funding support from the Delta Dental Foundation.
On the wall behind Dr. Anna Novais’ desk hangs a bulletin board covered with handmade thank-you cards from patients of all ages who came to her in pain and left able to smile again.
Next to it, a color-coded chart details staffing assignments across the 12 dental clinics she helps oversee. Each color represents a hygienist, dentist, or assistant working to make oral health more accessible to thousands of Cincinnatians served at six school-based dental centers and six Community Health dental centers.
For Novais, assistant dental director at the
Cincinnati Health Department, the wall is a daily reminder of the lives touched by a program that has become a national model for school-based dental care.
“We get teachers who walk students into our dental centers saying, ‘This kid has been crying with pain, not able to eat, not able to pay attention in class,’” Novais says. “Being able to help them right there at school changes everything.”
Thanks to a decades-long partnership with the
Delta Dental Foundation and several other local partners, Cincinnati now operates 12 dental centers, six of which are embedded in public schools. Each provides year-round, comprehensive care not only for students but for their families and the broader community.
Oral health care services include exams, sealants, dental cleanings, fluoride treatment, fillings, root canals, extractions, and dental prostheses like dentures and crowns. Students also benefit from immediate dental emergency care for situations ranging from sports trauma to untreated dental abscesses.
“At the 11 sites we’ve had open so far, we’ve been able to see about 24,000 patients a year, with nearly 52,000 visits,” Novais says. “With our newest clinic at the Roberts Academy, we’ll add another 2,200 patients. Hundreds of students will also be bused into the new school dental center for first-time comprehensive oral care.”
Lifting barriers
The initiative was born out of necessity. School nurses were overwhelmed by the number of students coming in with tooth pain and infections. With limited options beyond acetaminophen or antibiotics, they needed a solution. Oral health is critical to overall health, yet tooth decay is one of the most chronic childhood diseases in the United States, even more than asthma and diabetes.
The Cincinnati Health Department responded with an ambitious idea: build dental clinics inside schools. With support from the
Cincinnati Public School District, the Delta Dental Foundation, and other critical local partnerships, including the
Community Learning Center Institute, the
Cincinnati Dental Society, and
Interact for Health, the concept took off.
The Delta Dental Center at Oyler opened in the fall of 2013 as the first school-based dental center in the country.
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Cincinnati Health DepartmentThe Cincinnati Health Department dental team, from right to left: Kelsey McClanahan (CDA), Joan Cox (CDA), Dr. Anna Novais, and Tricia Waddell (EFDA).
“We provide comprehensive dental services,” Novais says. “In some schools, the dental center is inside the building. In others, it’s in a nearby building with access into the school. We also have a portable prevention team that visits schools without a center. Consented students receive all necessary exams and prevention services, and those who need restorative treatment and extractions are bused into our main sites for follow-up care.”
The program not only reduces barriers for families, many of whom lack transportation or time off work, but it also addresses the lack of providers who accept Medicaid. “It’s expensive, and access is limited,” Novais says. “Without this program, most of these kids wouldn’t get care.”
Beyond treatment, the school-based dental centers offer something else: continuity.
“We see students year after year. Even if they can’t finish treatment in one visit, they come back and continue where they left off,” Novais says. “It’s one of the reasons we’ve been able to reduce untreated decay, which affects nearly 60% of Cincinnati Public Schools students.”
An inviting space
Novais, originally from Brazil, has been with the Cincinnati Health Department for a decade. Her path to dentistry was inspired by her own childhood trauma as a dental patient and her professional interest in creating health equity and addressing social determinants of her patients’ health. She wanted to offer a more compassionate experience for others, regardless of their ability to pay and their socioeconomic background.
“Dentistry is hands-on. It’s artistic. But it’s also immediate and life-transforming. You can help someone in pain and see the results right away,” she says. “There’s also a lot of psychology involved. People are scared of the dentist. Creating a space that’s welcoming is just as important as the treatment itself.”
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Cincinnati Health DepartmentAfter receiving dental care at the Delta Dental Center at Oyler, a student gets their face painted while waiting for the bus back to school.
Now assisting with managing a clinical team of almost 100, including 14 dentists and 12 hygienists, Novais is driven by the bigger picture: improving community health through equitable access.
“It’s a win-win,” she says. “The schools provide space and support. We manage care. And with help from Delta Dental Foundation, we’ve been able to expand and innovate.”
The program has earned recognition from the
Ohio Dental Association, the Cincinnati Dental Society, and national health organizations. Cincinnati has become a model for what’s possible when cities prioritize dental health in schools.
“A lot of our school centers are also part of community learning centers,” Novais says. “These aren’t just schools. They’re hubs for health services, mental health support, job training, food pantries – everything a family might need.”
In her office, surrounded by children's drawings and clinic schedules, Novais speaks with passion about the program’s impact.
“Educated students are healthier students,” she says. “And healthier students are more educated students. That’s what inspires me to continue with efforts to expand dental care for everyone through the amazing and impactful work of our dental team.”