Current Position Information
Physician, Kaiser Permanente, Lancaster, California
Scholarly Research Project
Increasing Implementation of Fluoride Varnish at Well-Child Visits in
1-4 Year Olds
Fluoride varnish is important in preventing dental caries in children. Because young children ages 1-4 years see primary health providers for well-child visits, these encounters provide a great opportunity to apply fluoride varnish, especially for children who do not often see dental providers or have limited access to them.
This project has aimed to increase rates of fluoride varnish application for pediatric patients at the UPMC Shadyside Family Health Center. All health care providers including faculty and residents have been required to complete certification in fluoride varnish application, including new interns every academic year. Reminders to apply fluoride varnish have been incorporated into office huddles, and providers are periodically sent feedback on their rates of application via staff messages.
Rates of application of fluoride varnish in the FHC have been periodically reviewed to assess effectiveness of interventions that encourage the procedure. On recent review of data, there has been a slight increase in rates of fluoride varnish application, from 20-21% to 26-27%. Based on surveys and feedback, the biggest barriers to varnish application appear to be time constraints, provider willingness to perform the procedure, and patients having upcoming or recent dental appointments.
While we do have rates from the FHC, we do not know the overall rate of fluoride varnish applications because we do not have data on which patients received this procedure elsewhere. We have been successful, however, in establishing a system to train all faculty and residents including incoming residents to apply fluoride varnish.