Recruitment and participation in pre-school and school-based fluoride varnish pilots - the South Central experience

To assess recruitment and participation within seven school/pre-school-based programmes for fluoride varnish applications.

Year-long pilots were undertaken in six primary schools (ages four to seven years) and one pre-school (ages three to four years). Three applications of fluoride varnish were carried out coinciding with the three school terms.

In spite of intensive recruitment efforts, only 78% of the total 589 children were enrolled in the pilot; 15% had to be excluded because no response could be obtained from their parents. At the end of 12 months, 79% of enrolled children (62% of total) had received all three applications. Children did not receive applications because they were absent on the days when the dental team were carrying out the screening or fluoride varnish applications, were ill, or because the child refused. The highest refusal rate was in the pre-school.

Younger children need to be targeted if improvement in the oral health of five-year-olds is to be achieved, the only dental measure in the Public Health Outcomes Framework, but they were less likely to cooperate. More research is needed on approaches to maximise participation in community programmes such as this, if they are to achieve significant population-level improvements in child dental health.