Oral Health Services

Dental Care for Tennesseeans

The Dental Care for Tennesseans map lists dental and health clinics across the state.  These clinics help connect families to dental care.  Some clinics may charge a lower fee. Dental services may be dental treatment, dental referrals or a voucher (coupon) program.  Click on a county for a list of clinics in the county and surrounding area.  Please call the clinic first to discuss being seen.

For a pdf (printable) copy of Dental Care for Tennesseans, click here.

Tennessee Public Health Clinics - Region-by-Region

The Tennessee Department of Health (TDH) is divided into seven rural regions and six Metropolitan regions.  Each region’s dental programs are administered by a local Regional Dental Director, maintains an active Tennessee license and is an important member of the public health team. 

There are 45 dental clinics operating statewide in Tennessee's local health departments and in four, of Tennessee's six, metropolitan regions. Clinical dental services are provided on a part-time or full-time basis, depending on the location.

Public health dental clinics provide basic dental services and emergency care for uninsured adults and children in Tennessee. who would otherwise not receive care. The clinics also provide services for TennCare members.

Below is a region-by-region, county-by-county list of contact information for the dental clinics located in county health departments.

Oral Health Topics of Importance

Community Water Fluoridation

Community Water Fluoridation (CWF) is the process of adjusting the amount of fluoride in drinking water to a level recommended for preventing tooth decay. More than 75 years of research and experience shows CWF is a safe and healthy practice. CWF is recommended by nearly all public health, medical, and dental organizations. It is recommended by the American Dental Association, American Academy of Pediatrics, US Public Health Service, and World Health Organization.

History of Community Water Fluoridation in Tennessee

Tennessee took an important step toward improving oral health in 1951 when the City of Milan in Gibson County became the first community in the state to fluoridate its public water supply. Fluoride is a naturally occurring mineral that helps prevent tooth decay. Within five years of fluoridation, tooth decay among six-year-old children in Milan dropped by 57%—a change quickly recognized by parents, dentists, and healthcare providers. As a result, fluoridation spread across Tennessee and the nation as a safe and effective prevention tool.

Nearly eight decades of scientific research in the United States—and more than 70 years of experience in Tennessee—continue to show that community water fluoridation:

• Is safe
• Is effective
• Protects and improves oral health across the population

Comparisons of dental health before and after fluoridation in Tennessee showed a 75% decline in tooth decay in children’s permanent teeth from the early 1950s to the late 1980s.

As of 2023, approximately 88.3% of Tennesseans served by community water systems receive fluoridated water. Although this is lower than the 95.2% rate reached in 2004, Tennessee continues to follow U.S. Department of Health and Human Services guidance to adjust fluoride to 0.7 mg/L—the recommended level for preventing tooth decay.

CWF Basics

Fluoride is naturally found in all water. CWF simply adjusts the fluoride concentration to the recommended level shown to prevent cavities.

Key facts:

• CWF is natural, cost-effective, and community-wide prevention.
• Children without access to fluoridated water have a 20–40% higher risk of tooth decay.
• The CDC recognizes CWF as one of the Top 10 Public Health Achievements of the 20th Century.
• The annual cost is about 50 cents per person, far less than the cost of treating even one cavity.

Know Your Water Fluoride Level

Consumers use My Water’s Fluoride (MWF) to look up the fluoride level in their water, check water system data, and get along with system population and water source information.

Benefits of Community Water Fluoridation

Tooth decay (dental caries) is the most common chronic and infectious disease of childhood, but it is preventable. Good oral health:

• Improves self-esteem
• Supports learning and school success
• Reduces medical and dental costs
• Enhances lifelong well-being and economic opportunity

Water fluoridation is especially important for those who:

• Cannot afford regular dental care
• Lack support for daily oral hygiene
• Rely on preventive services provided at a community level

Additional benefits:

• Every $1 invested in CWF saves $38 in dental treatment costs.
• 51 million U.S. school hours are lost annually due to dental-related illnesses.
• CWF helps protect Tennessee’s most vulnerable children from unnecessary dental pain and complications.

Surveys in Tennessee show that underserved populations experience disproportionately higher levels of dental disease, which increases treatment costs to families and to the state. Maintaining CWF helps reduce these disparities.

Tennessee CWF Resources

The Division of Water Resources of the Tennessee Department of Environment and Conservation provides technical expertise, monitoring and surveillance of fluoridating communities to ensure that the fluoride content of the water supply is maintained at an optimal level.

Situated in the center of Tennessee, the Fleming Training Center (FTC) offers training, certification and technical assistance to water and wastewater systems and personnel throughout Tennessee.  FTC is located at 2022 Blanton Drive, Murfreesboro, TN 37219, (615) 898-8090, fax (615) 898-8064. Hours of operation are weekdays from 8 a.m. – 4:30 p.m., Central. Click for more on the Fleming Training Center.

Additional CWF Info

Nutrition and Your Oral Health

Your body is a complex machine. The foods you choose—and how often you eat them—can affect your general health and the health of your teeth and gums.

Limit Sugar

Eating or drinking foods high in sugar increases the risk of tooth decay. When sugar mixes with plaque, it produces acid that attacks and weakens tooth enamel, leading to cavities.

Tooth decay is the most common chronic disease of childhood — but it is preventable.

Foods and beverages that commonly contain added sugars include:

• Soft drinks and sports drinks
• Juices
• Candy
• Cookies, pastries, and sweet snacks
• Breakfast cereals
• Flavored yogurt
• Flavored milk

Reducing how much and how often you consume sugary items can help protect your teeth.

Make Healthy Food Choices

Read Nutrition Facts labels and choose foods and drinks lower in sugar. Balanced nutrition helps your mouth fight infection and reduces the risk of gum disease — a leading cause of tooth loss in adults.

For healthy eating guidance, visit ChooseMyPlate.gov, a U.S. Department of Agriculture resource with age- and activity-appropriate nutrition recommendations. If you follow a special diet, consult your healthcare provider before making changes.

For good dental health:

• Drink plenty of water
• Eat a balanced mix of:

Whole grains
Fruits and vegetables
Lean protein (lean meats, poultry, fish, beans, lentils)
Low-fat or fat-free dairy foods

Limit Snacking

It’s not only what you eat, but when you eat. Foods eaten as part of a meal are less harmful to teeth because meals stimulate more saliva. Saliva helps wash away food and neutralize acids that cause cavities.

Try to:

• Limit snacks between meals
• When snacking, choose healthier options such as:

Fresh fruit
Vegetables
Cheese

Some foods — like cheese and peanuts — can even help counter acid attacks. Sugar-free gum with the American Dental Association (ADA) Seal of Acceptance can also reduce acidity.

Keep Brushing

A nutritious diet works best when combined with good dental care. Remember to:

• Brush twice daily with fluoride toothpaste that has the ADA Seal of Acceptance
• Floss every day
• Visit your dentist regularly

Routine dental care prevents many problems and allows early treatment while issues are still easy to manage.

Tobacco Use & Oral Health

• Tobacco use has serious effects on the oral health of users.  Cigarettes, smokeless tobacco, and other forms of tobacco cause oral cancer, gum disease, and other oral health problems.
• Those who smoke are 3-times more likely to lose all of their teeth, and about 43% of adults aged 65 or older who currently smoke cigarettes have lost all of their teeth.
• Untreated tooth decay is higher in people who smoke cigarettes. Over 40% of adults aged 20 to 64 who currently smoke cigarettes have untreated tooth decay.
• Adults aged 65 or older who smoke cigarettes are twice as likely to have untreated tooth decay as those who never smoked.

For Help Quitting

Professional Topics in Oral Health

Evidence-Based Dentistry (EBD)

Evidence-based dentistry integrates three essential components in clinical decision-making:

1. The dentist’s clinical expertise

2. The patient’s needs and preferences

3. The most current, clinically relevant scientific evidence

Together, these elements support high-quality, personalized patient care. Evidence-based care is now widely regarded as the gold standard in healthcare delivery.

ADA Resources for Evidence-Based Practice

The American Dental Association (ADA) established the ADA Center for Evidence-Based Dentistry as a trusted resource for dental professionals. The Center, guided by the ADA Council on Scientific Affairs:

• Provides tools and training to incorporate research into daily practice
• Helps close the gap between scientific evidence and clinical care
• Promotes the use of high-quality evidence to improve patient outcomes

The ADA Clinical Practice Guidelines offer scientifically grounded recommendations—but are not standards of care—to support informed clinical decisions.

Why EBD Matters

Oral health is closely connected to overall health. Conditions such as diabetes, cardiovascular disease, and respiratory illness often have oral health implications. EBD helps dental professionals:

• Apply the latest findings from clinical research
• Navigate the overwhelming amount of health information available online
• Guide patients toward credible, science-based solutions
• Improve treatment outcomes and quality of life

As dental professionals, we play a critical role in helping patients understand which information is trustworthy and how scientific evidence supports their care.

Tennessee Department of Health Commitment

The Tennessee Department of Health, Oral Health Services supports the use of evidence-based dentistry statewide. We are committed to:

• Connecting providers to current, credible research
• Encouraging consistent use of EBD in all settings
• Supporting efforts to deliver safe, effective, and high-quality dental care

Infection Control in Dental Settings

Infection control procedures are critical safeguards used in health care settings to prevent the spread of disease. Our goal is to support dental professionals in applying evidence-based guidelines and recommendations in everyday practice—maintaining the highest level of safety and well-being for both patients and dental health care personnel.

The Tennessee Department of Health, Oral Health Services aims to increase awareness of trusted resources for infection control in dental settings. While the foundational principles of infection control remain consistent, advancements in materials, technologies, equipment, and research call for ongoing evaluation of current practices. Because dental procedures, instruments, and clinical environments are unique, they require specific strategies to prevent pathogen transmission.

Ensuring compliance with established standards is essential across all dental care settings. Having quick access to credible, up-to-date resources supports effective infection control and reduces risk.

We encourage you to review the CDC’s Summary of Infection Prevention Practices for Dental Settings: Basic Expectations for Safe Care. These evidence-based recommendations:

• Guide infection prevention practices nationally and globally
• Inform dental professionals, patients, and policymakers
• Drive advancements in safety-focused dental technologies

Dietary Fluoride Supplements

Dietary fluoride supplements are an effective option for protecting the teeth of children ages 6 months to 16 years who consume water with low fluoride levels (0.6 ppm or less). These supplements—available as daily tablets, drops, or fluoride-vitamin combinations—provide systemic protection for developing teeth and topical benefits for teeth already erupted.

When appropriately prescribed and taken as directed, fluoride supplements offer the same level of protection as drinking optimally fluoridated water over time. However, improper use may increase the risk of enamel fluorosis. For this reason, supplements should not be prescribed to children who receive optimally fluoridated community water (0.7 ppm fluoride).

Due to an observed increase in mild dental fluorosis associated with excessive fluoride intake, a conservative, evidence-based approach to supplementation is recommended. If a child’s primary water source comes from a well, spring, or non-fluoridated community system, a water sample must be tested to determine the fluoride concentration before prescribing supplements.

Fluoride Ion Level in Drinking Water (ppm)*

Source: Fluoride Supplement (Tablets and Drops) Dosage Schedule 2010 (Approved by the American Dental Association Council on Scientific Affairs)

*1.0 part per million (ppm) = 1 milligram per liter (mg/L)

**2.2 mg sodium fluoride contains 1 mg fluoride ion

Responsible Opioid Prescribing in Dentistry

Dental professionals play an essential role in combating the opioid crisis by ensuring opioid prescribing aligns with current clinical evidence and best practices.

Controlled Substance Monitoring Database Program (CSMD)

The Tennessee Department of Health has contracted with Bamboo Health to integrate CSMD information into approved Electronic Health Records (EHRs) and Pharmacy Management Systems (PMS) using Bamboo Health’s PMP Gateway service.

Currently healthcare providers login to the CSMD web portal to query patient data. This integration simplifies the process by automating the request to the CSMD and making the patient report available in the healthcare provider’s clinical workflow. The workflow integration will, in many cases, eliminate the need for providers to navigate to the CSMD website, log in, and enter their patient’s information. Instead, controlled substance prescription records may be obtained within the clinical workflow inside the EHR and PMS.

If your organization is interested in integrating your Health IT system with the CSMD, visit connect.bamboohealth.com/ and create an account.

For more detailed information about this initiative, please review the TN CSMD Gateway Integration Welcome Packet.

Opioid Education for Dental Professionals

Resources are available to support safe, evidence-based opioid prescribing and patient care:

• American Dental Association - Opioid education for dentists
• Substance Abuse Services – Programs and support for Tennesseans affected by substance use
• Substance Use Best Practice Tool Guide – Evidence-based guidance for clinicians
• Find Help Now – A real-time substance use treatment locator based on needs, insurance options, and location

Oral Health Initiatives in Tennessee

The Tennessee Department of Health is committed to improving oral health outcomes for all Tennesseans, especially children, rural communities, and underserved populations. The following key initiatives expand access to preventive and restorative dental services across the state.

Health Smiles Initiative

Launched under the leadership of Governor Bill Lee in 2021, the Healthy Smiles Initiative convened a diverse working group—including TennCare, Tennessee’s dental colleges, safety-net dental clinics, private practitioners, nonprofit organizations, and dental payers—to develop a comprehensive five-year plan to strengthen oral health statewide.

The group’s recommendations focus on:

• Expanding the dental workforce, starting with early recruitment into dental careers
• Training providers to serve rural and high-need populations
• Offering incentives for practice in underserved communities
• Expanding safety-net dental services
• Strengthening Tennessee Department of Health capacity through advanced training for dental assistants
• Improving access to restorative care, including dentures for patients served in charitable care clinics

These efforts prioritize populations with the greatest barriers to dental care while supporting long-term improvements to access and outcomes.

School-Based Dental Prevention Program (SBDPP)

The School-Based Dental Prevention Program delivers preventive oral health services directly to children in Title I–eligible schools, serving students from kindergarten through eighth grade using portable dental equipment.

Services include:

• Dental screenings and referrals for needed care
• Application of preventive sealants
• Silver Diamine Fluoride (SDF) and fluoride varnish
• Oral health education
• TennCare eligibility and application support for families

Program Recognition & Impact

• Identified as an ASTDD Best Practice Approach Model (2009, 2016)
• Awarded the Tennessee Public Health Association – Public Health Work Group Award of the Year (2017)
• More than five million dental sealants placed on Tennessee children since program inception

These school-based services help prevent cavities, reduce school absences due to dental pain, and connect families to ongoing care.

Nurses Fluoride Varnish Program

The Tennessee Department of Health, Oral Health Services developed a medical–dental partnership to help reduce dental disparities among Tennessee’s youngest children. Through this program, nurses apply fluoride varnish during medical visits, expanding access to early preventive dental care. Oral health screens and fluoride varnish application services are primarily targeted to children birth through age five, and are available to all patients up to age 20.

This program supports the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) schedule by integrating dental services into routine well-child visits. During the first year of life, a child may see a healthcare provider up to six times; these visits allow nurses and nurse practitioners to:

• Perform dental screenings
• Apply fluoride varnish to protect against early childhood caries (ECC)
• Provide oral health education for parents and caregivers
• Ensure early referrals for both routine and needed dental care

The Nurse’s Fluoride Varnish Program is offered in all 95 counties at the 126 public health departments across the state. 

Because many children do not visit a dentist until they are school-age—or when pain begins—this program offers essential preventive care during a critical period of growth and development.

Training and guidance materials are available through the following links.