This paper presents strategies for the clinical nurse specialist (CNS) in the school setting to use in case management of migrant children with dental disease. Although dental disease is the major health problem of all school-age children in the nation, the problem is even more severe for children of migrant farmworkers. Leininger's transcultural care theory serves as a useful model for the CNS working with migrant children. The concept of cultural congruent care specifies cultural, social, group, and health system variations as the basis for nursing care decisionmaking. Congruent care also aims to provide quality care to clients of diverse cultures that is meaningful, satisfying, and beneficial to them. The CNS must examine the influence of economic factors, educational factors, cultural values and lifeways, and technological factors on the incidence of dental disease. The role of the CNS in case management involves: (1) conducting dental screenings; (2) providing instruction to children, teachers, and parents in prevention and correction of the problems; (3) serving as an advocate and liaison for migrant children in the political arena; and (4) linking children with health resources and dental hygiene programs. A model program, the Children's Dental Project in Santa Cruz County, California, provides dental treatment from volunteer dentists for migrant and low income children. Clinical nurse specialists should evaluate and document the cost-effectiveness of their role in the school setting. This document contains 2 figures and 23 references. (KS)