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We have third grade students in North Dakota whose dental care needs are not being met. Programs, providers, and initiatives need to focus on providing equal access to preventive dental care supplies and educational resources to support good dental hygiene. Children attending schools where more than 50% of the students are eligible for the national school lunch program (NSLP) have a significantly higher need for early or urgent dental care and a higher rate of rampant decay compared to those attending schools with less than 50% of students eligible for the NSLP