Fluoride Varnish: What are you waiting for?

In celebration of National Children’s Dental Health Month, take a minute to make sure your practice is doing everything it can to promote good oral health to your patients and families. Have you incorporated questions about oral health into your well visit templates? Do you ask about a dental home? Do you promote the AAP initiative of “Brush, Book, Bed?”

It has been more than three years since the U.S.Preventive Task Force (USPSTF) recommended that fluoride varnish application be provided in the primary care setting to reduce the risk of dental caries. The USPSTF recommends fluoride varnish be applied 2-4 times per year for all children ages 6 months through 5 years (to the 6th birthday). Under the ACA, this preventive service should be provided to all children with no cost-sharing.

For practices that have not started routinely applying fluoride to your young patient’s teeth, why not? It’s easy, it’s good care and it pays well! Medicaid has been paying well for several years to apply dental varnish in 49 states. Dental caries is a significant medical problem among our most vulnerable population. But even in affluent communities, most children are not seeing a dentist until age 2 and some of the worst caries I’ve seen are in children who are breastfeeding all night long for the first two years of life.

The AAP has great resources regarding policy and advocacy for oral health. There are practice tools available including where to buy supplies and links to your state chapter oral health advocate who can help you get training and understand the regulations in your state about who can apply the varnish and often.

There are multiple ways in OP to set up your fluoride varnish and get paid. Some practices have a procedure template with appropriate notes. Some practices put the wording in their well visit template and have a standing order for a task. Ask your OP colleagues how they do it and what works best for them. Make it a QI project and start with just the 9 month or 12 month visit. Get your workflow down then broaden your reach. It’s good care and good business.

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