Fluoride varnish application, a quality improvement project implemented in a rural pediatric practice.

OBJECTIVES

The United States has a public health crisis of dental caries in children's primary teeth. Fifty-five percent of children have dental caries by age 8. The majority of these children are nonwhite and poor. Caries could be decreased by 40% if fluoride varnish (FV) application started with tooth eruption.

DESIGN AND SAMPLE: A four-month FV application QI project was implemented in a rural pediatric practice. The staff was trained by the Vermont Department of Health using the From the First Tooth protocol. Children aged 9, 18, 24, and 30 months.

MEASURES: Pre- and postproject questionnaires were completed. A caries risk tool assessed a child's risk and access to dental care. Completed FV applications were recorded and staff interviewed weekly.

INTERVENTION: FV application was offered at well child checks (WCCs).

RESULTS

Fifty-six percent of sample patients received FV at their WCCs. Qualitative themes included the following: reasons subjects did/did not receive FV, ease of FV application, increased oral hygiene education, visit flow, application time, older children's FV need, and billing issues.

CONCLUSION

This economical, FV application program can be readily implemented by nurse practitioners and nurses in pediatric practices where children have inadequate dental care.