In 1936, the dental health program of the Tennessee Department of Health was established as one of the first dental public health programs in the United States.
In March 1951, Milan became the first city in Tennessee to add trace amounts of fluoride to its community water supply for the prevention of dental caries. It was the second community in the Southeast to initiate fluoridation. Today, 91.4% of all Tennesseans on community water systems are served water containing optimal levels (0.7 ppm) of fluoride.
In 1953, the program was elevated to division status and granted legislative authority with state appropriations included it in the budget of the Department of Health.
In 1954, Tennessee was one of the first states to conduct pre-fluoridation surveys of caries prevalence among school children 6-14 years of age.
In 1961, the Dental Guide for Teachers in Tennessee was published. It was one of the first publications of its kind in the U.S., providing teachers with age appropriate oral health instructional materials.
In 1962, Tennessee became the first state to erect signs on highways leading into communities advertising that the public water system was approved and fluoridated.
In 1964, Tennessee became the first state to offer financial assistance to small communities in order to fluoridate their water systems. Consequently, more communities began fluoridating, and dental caries rates began to decline.
In 1972, Tennessee became the first state to conduct pit and fissure sealant programs in school systems as a public health preventive measure.
In 1979, Tennessee teamed up with the Centers for Disease Control and Prevention to establish a National Fluoridation Training Center at the Fleming Training Center in Murfreesboro, Tennessee.
In 1979, a second statistically valid statewide oral health survey of school children ages 5-17 years was conducted to monitor changes in caries prevalence and oral health status.
In the 1980's, many of the clinical trials required for approval of second and third generation dental sealants were conducted by the Oral Health Services Section.
In 1988, a third statistically valid statewide oral health survey was conducted to monitor oral diseases and disease trends in Tennessee.
In 1989, a second Oral Health Guide for Tennessee Teachers was published and placed in all primary and secondary public schools in Tennessee.
In 1989, the first edition of the Standards of Practice for Dental Public Health was written and placed in all public health dental clinics in Tennessee.
In 1992, the Oral Health Services Section received funding from the Preventive Health Services Block Grant to initiate statewide sealant projects for all public health regions.
In 1996, the Quality Assurance Review for Public Health Dental Practice was written and first used to evaluate the quality and appropriateness of care provided in public health dental clinics.
In 2004, legislation was passed amending the Dental Practice Act to allow nurses to apply fluoride varnish in public health clinics. Tennessee is the fifth state in the nation to initiate a statewide fluoride varnish program based upon a medical-dental partnership.
In 2008, a statewide survey of school children was completed and the data collected is used to monitor oral health status and disease trends.