Regulation for the School Dental Service

[2] 1 The Department of Health and Social Affairs (Department) is responsible for the organization and supervision of the school dental service (SDS) in collaboration with the Association of Dentists of Canton Ticino (OMDCT).

2 The Department is assisted by the Cantonal Commission for the School Dental Service (Commission), appointed every four years by the State Council and composed of 10 members, of which 5 are dentists proposed by the Steering Committee of the OMDCT. The Departments of Education, Culture and Sport and of Health and Social Affairs must be represented therein.

3 The Commission has in particular the following tasks

- to propose measures for collective prophylaxis;

- to propose implementation directives for the SDS for dentists and prophylactic assistants (hereinafter referred to as dental prevention operators);

- to control the activity of school dentists and dental prevention operators;

- in cases of dispute or irregularity, to carry out appropriate investigations and formulate proposals to the Department.

[2] Art. modified by R 26.6.2007; in force from 1.9.2007 - BU 2007, 514; previous modifications: BU 1992, 123; BU 2002, 76.

[3] **1** The SDS addresses every student of public and private compulsory schools, domiciled or resident in the Canton.

**2** It provides, up to a maximum amount of CHF 700.-- per student and year, prevention services such as collective prophylaxis, individual prophylaxis, diagnosis, as well as treatment services.

Access to services [4]

[3] Art. amended by R 26.6.2007; in force since 1.9.2007 - BU 2007, 514.

[4] Marginal note amended by R 26.6.2007; in force since 1.9.2007 - BU 2007, 514.

[5] Collective prophylactic services are mandatory, while the other services referred to in Art. 2 are provided only to those registered with the SDS.

[5] Art. amended by R 26.6.2007; in force from 1.9.2007 - BU 2007, 514.

1 Enrollment in the SDS takes place at the beginning of each school year by means of a declaration from parents or guardians, recorded in the control booklet.

2 Students who seriously and habitually neglect prophylactic measures (especially dental hygiene and limiting the consumption of sweets) may be excluded from the SDS, following written notice to their families.

3 Students who are not enrolled in the SDS may be admitted in subsequent years on the condition that they first have their teeth restored at their own expense. [6]

4 The decisions referred to in paragraphs 2 and 3 are made by the Office of Health, after hearing the school dentist. [7]

5 An appeal against the decision of the Office of Health may be lodged in accordance with Art. 4 para. 3 of the Law concerning the Organizational Competencies of the Council of State and its Departments of 25 June 1928. [8]

[6] Para. amended by R 26.6.2007; in force from 1.9.2007 - BU 2007, 514; previous amendment: BU 1994, 459.

[7] Para. amended by R 26.6.2007; in force from 1.9.2007 - BU 2007, 514; previous amendment: BU 1994, 459.

[8] Para. introduced by R 26.6.2007; in force from 1.9.2007 - BU 2007, 514.

1. Treatment is entrusted to the district school dentist. Exceptions may be authorized by the Office of Public Health. [9]

2. The competence for appointing school dentists is delegated to the Department. Appointments are made following a public tender and with the allocation of respective districts.

3. Only dentists authorized to practice independently in the Canton may be appointed. The term of office is generally four years.

[9] Para. modified by R 24.8.1994; in force since 1.1.1995 - BU 1994, 459.

[10] **1** Municipalities, Consortia, and private educational institutions shall utilize the dental prevention operator to intensify their efforts in the field of dental prophylaxis in their respective nursery and elementary schools.

**2** The dental prevention operator is tasked with instructing students on healthy eating, correct oral hygiene, and appropriate tooth cleaning techniques, in accordance with the directives issued by the Department upon proposal of the Commission.

**3** The operator must possess the following requirements

a) Minimum requirements

- aptitude for contact with nursery and elementary school children;

- good teaching skills and correct command of the Italian language;

- certificate of attendance of the specific training course;

b) Preferential requirements

- qualification to teach in municipal schools or training in the field of healthcare professions.

**4** The position of dental prevention operator is assigned by the Municipality (respectively by the Consortial School Delegation), following a public competition, after consulting the school dental surgeon. The decision regarding the appointment is communicated to the Department, to the inspectorates of municipal schools, to the Commission, and to the school dental surgeon. The appointment is tacitly renewable year by year. It entails the obligation to participate in continuing education courses indicated by the Commission.

[10] Art. amended by R 7.3.2018; in force from 9.3.2018 - BU 2018, 89.

[11] 1 For the purpose of calculating the family contribution to care costs, the Department shall prepare, in accordance with Art. 47a para. 6 of the Law, an indicative table of contributions for the attention of the Municipalities.

2 The Department shall approve the table of contributions and set the threshold below which no contribution may be imposed on families.

[11] Art. amended by R 26.6.2007; in force since 1.9.2007 - BU 2007, 514.

[12] 1 The services offered by the SDS must be performed according to the directives issued by the Department on the proposal of the Commission.

2 Dental treatments that exceed the maximum amount referred to in Art. 2 and those not covered by the tariff agreement are offered to families upon explicit consent and directly invoiced to them.

Prevention [13]

[12] Art. amended by R 26.6.2007; in force since 1.9.2007 - BU 2007, 514.

[13] Marginal note amended by R 26.6.2007; in force since 1.9.2007 - BU 2007, 514.

1 In schools, the management and teachers shall ensure that sweets which promote the development of tooth decay are neither sold nor consumed.

2 School cafeterias must, when preparing meals, respect the principles and criteria of anti-caries prophylaxis.

3 The SDS may promote collective prophylaxis actions also aimed at pupils in nursery schools and daycares. [14]

[14] Para. amended by R 7.3.2018; in force since 9.3.2018 - BU 2018, 89; previous amendment: BU 2007, 514.

School authorities, delegated and school doctors, within the scope of their duties, must provide full cooperation to the SDS.

[15] In every elementary or middle school, a person responsible for the SDS must be designated, who may be the director or a member of the School Board.

He/She must, in particular

- communicate to the school dental surgeon, within 15 days from the beginning of the school year, the nominal lists of pupils in individual classes;

- collaborate with the school dental surgeon in organizing initial check-ups and treatment sessions;

- transmit the summons for treatment to the interested pupils, ensure that they are respected, and organize transport in agreement with the Municipality or, respectively, the middle school management;

- communicate to the school dental surgeon at least one day in advance the impossibility for one or more pupils to keep the appointment.

[15] Art. amended by R 7.3.2018; in force from 9.3.2018 - BU 2018, 89.

The class teacher prepares and updates the dental care booklets, ensures their delivery to parents or guardians for enrollment in the service and subsequently for notification of the results of the check-up, and promptly returns them to the dental surgeon, who keeps them in custody.

1 Pupils who withdraw from the SDS during the school year must submit a written declaration of withdrawal from their parents or guardian to the school administration and the school dentist.

2 The class teacher hands over the control booklet to pupils who change schools during the year, informing the dentist. The booklet must be delivered to the dentist of the new district, who will indicate when and how treatment should be resumed.

3 The clinical record, however, remains with the dentist, who is obliged to transmit important information to the new dentist. The family may obtain a copy at their own expense.

4 At the end of primary school and middle school, the booklet is definitively handed over to the pupil.

1 The State Council enters into a tariff agreement with the OMDCT for services provided within the scope of the SDS.

2 Performance reports from dentists must be submitted to the Department, which prepares the definitive statements and sends them to the dentists for verification.

3 The payment of advances is permitted. Final payment is due by the end of September.

1 The Municipality is obliged to contribute to the expenses of the SDS for all students domiciled or resident within its territory, to the extent prescribed by Articles 47 and 47a of the law, based on the calculations prepared by the Department. [16]

2 These calculations also serve to levy contributions from families, in accordance with Article 7.

3 The Municipality cannot claim reimbursement from the State for sums that, for any reason, it was unable to collect from families.

4 The remuneration for dental prevention operators, as indicated in the specific departmental directives, and the material necessary for their activity (toothbrushes, fluoride gels, napkins, educational material, etc.) are borne by the Municipalities or Consortia, respectively by private Institutions.

[16] Para. amended by R 26.6.2007; in force since 1.9.2007 - BU 2007, 514.

1. Transportation of pupils from school to the dental practice is organized by the Municipalities for primary schools and by the school administrations for secondary schools.

2. For primary schools, it is the responsibility of the Municipalities to ensure the necessary supervision of pupils, both during transportation and during their waiting time at the dental practice. Any remuneration for the accompanying person is borne by the Municipality.

3. In secondary schools, a supervisor may be requested by the dentist for groups of 5 pupils or more. Any remuneration for the supervisor is borne by the State.

4. ... [18]

[18] Paragraph repealed by R 27.6.2017; in force since 1.8.2017 - BU 2017, 188.

[19] 1 Transport costs shall be borne by the State, provided that they are reasonable and that the following order of priority is observed in the choice of means of transport

a) transfer on foot;

b) transfer by means provided by the school or the Municipality;

c) transfer by public transport service;

d) transfer by means of a private company.

2 In the case of transfer by means of a private company, the Municipality, or the Secondary School Board, respectively, shall submit to the Office of Health, at the beginning of the school year, a letter of justification and, save for exceptions previously authorized by the Office, the offers from the companies invited in compliance with the procedure set forth in Art. 6 para. 1 lit. c of the Public Procurement Act of February 20, 2001 (LCPubb), indicating the selected company. [20]

3 The transport costs referred to in paragraph 2 shall be borne by the State if previously approved by the Office of Health.

4 Expense notes for students and one accompanying person per secondary school shall be submitted by the Municipality, or the Secondary School Board, respectively, in a single submission, to the Department by July 31.

[19] Article introduced by R 27.6.2017; in force since 1.8.2017 - BU 2017, 188.

[20] Paragraph amended by R 19.8.2020; in force since 21.8.2020 - BU 2020, 269.

1. The SDS Regulations of February 23, 1968, are hereby repealed.

Furthermore, Government Resolutions No. 7894 of December 16, 1986, and No. 302 of January 28, 1987, concerning the introduction of the municipal prophylactic assistant, are also repealed.

2. These regulations shall enter into force [21] upon their publication in the Official Bulletin of Laws and Executive Acts.

Published in OB 1989, 317.

[21] Entry into force: December 15, 1989 – OB 1989, 317.