Principal Lisa Votaw is still holding a goodie bag filled with a toothbrush, mini toothpaste and floss when she opens the door to Aiken High School.
“I wasn’t sure I was going to make it,” Votaw says. “I forgot that I’d booked my cleaning right before you were arriving.”
Votaw believes in school-based health so earnestly that she makes her twice-yearly dentist appointments at her school’s very own dental clinic, a four-chair facility that’s open to Aiken students and members of the community.
As she winds through school corridors, which are clearly undergoing summer cleaning, she explains that even though school is “closed” for the summer, the dental clinic is still caring for students and community members. Indeed—each operatory has a patient in a chair.
“We know that there are four big barriers to kids receiving dental care: access to care, cost, transportation and the ability to take time off,” says Votaw. “School-based dental care alleviates all four.”
According to Votaw, if kids are already at school and can receive care there, parents and caregivers don’t need to take time off or find another means of transportation to bring them to the dentist.
Instead, school-based dental centers work closely with teachers and administrators to minimize interruptions. This means kids spend more time in the classrooms—both because they’re healthier and because they don’t need to travel to and from a provider who may not be local.
Signing up is easy—enrollment packets are provided in the back-to-school packets that all children receive, and parents and caregivers can enroll their children at any time by calling or walking in.
The history of school-based health
The first school-based health center opened in Cambridge, Massachusetts, in 1967. At that time, a nurse practitioner was assigned to an elementary school to deliver primary care to Medicaid enrollees.
Today, there are more than 2,500 school-based health clinics nationwide. Some offer only medical care, but others offer behavioral health services, dental care and even optometry. School-based dental centers are often operated by state health departments and federally qualified health centers, which provide care to everyone, regardless of insurance status or ability to pay.
In Cincinnati, dental services are available at five (soon to be six) schools, many of which have received grant support from the Delta Dental Foundation, and these locations serve students, teachers and the local community.
About 15 percent of children don’t see a dentist at least once a year. As a result, over 34 million school hours are lost annually because of acute and unplanned dental care. These lost school hours, combined with dealing with dental pain, can put kids with tooth decay at a disadvantage.
At the end of the day, healthier kids are kids who are best positioned for academic success.
From the data to the personal testimonies, it’s clear that school-based dental care—and school-based health in general—gets and keeps kids healthy, all while eliminating common barriers to care. Ohio Governor Mike DeWine even reaffirmed his support for school-based care at the 2025 Ohio School-Based Health Alliance annual conference and in his 2025 State of the State Address.
So why aren’t more school districts in other states getting involved?
“They’ll tell you it’s about space,” says Dana Bierman, Aiken’s community resource coordinator. “Sometimes that’s true, but I think if people were being really honest, they’d tell you it’s about district buy-in.” One of Bierman’s responsibilities is aligning district-wide initiatives and community involvement to strengthen services for students and families. School-based health is just one of those initiatives.
Bierman suggests that when you have a champion in a school principal or superintendent, like Votaw, they’ll move mountains to make school-based health happen.
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| Dana Bierman, Aiken's community resource coordinator, proudly sporting an Aiken High School Falcons T-shirt. (Photo by Jen Anderson) |
That seems to be true, at least in Cincinnati: Few of the school-based dental centers are wholly new, standalone structures. Aiken’s clinic was built into a retrofitted biology lab, and Oyler’s dental clinic, where hygienists pass each other in a narrow corridor with instrument trays held high to avoid collisions, seems to have had a past life as a closet.
But it works.
During the 2022–2023 school year, school-based dental centers in Cincinnati saw more than 24,000 children, performing more than 51,000 services.
Coordination among medical, dental, school teams means better care
“We can meet kids where they are,” says Nicole Hail, one of Aiken’s dental assistants. “If they’re having pain, we can see them even if they don’t have an appointment. If their parents have already consented to care, there’s no need to bother them.”
In cases where children have not been preemptively consented for care, Hail explains that they can make a call right then and there for permission, with paperwork following later. Ultimately, the goal is getting the child out of pain and into a healthier state as quickly and as seamlessly as possible.
Critically, the dental team at Aiken High School can coordinate with the medical team, which operates out of a small health center upstairs. This isn’t uncommon in the school-based health world.
“[The medical center] will call me. If they’ve got a kid up there that came in with a toothache, they’ll ask if they can send them down. Sometimes the kids don’t know we’re down here, so they’ll go to the nurse and they’re like, my tooth hurts,” Hail says.
On the flip side, if the dental team notices something when a student is in for an appointment, they can send them upstairs to the medical team. Hail recalls one student who seemed to have symptoms of uncontrolled diabetes. When they asked the student if she was taking medicine or whether she knew what her blood sugar was, the patient said no.
“We finished the appointment, but then we said, ‘hey, would you mind going upstairs and getting your blood sugar checked?’ And we called ahead, and the student went upstairs. The medical team got her an appointment and got rolling with some care,” Hail says. “It’s nice to have that connection.”
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| Ciara Rainey and Nicole Hail. (Photo by Jen Anderson) |
The team here takes pride in what they do—and there’s no shortage of school spirit. At Aiken, many of the providers wear purple under their gowns, and one hygienist even had custom Falcon pride T-shirts made.
"I swear this is the one day I haven't worn purple," Hail confesses. "I need to do laundry. But usually I'm representing Aiken."