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Fluoride Varnish Application in the Primary Care Setting. A Clinical Study
S J Rolnick1, J M Jackson1, T A DeFor1
1From Health Partners Institute for Education and Research, Minneapolis, Minnesota, USA.
Insights
Fluoride varnish (FV) programs were successfully implemented and sustained in primary care settings for young, low-income children. Tracking medical care utilization for these children is feasible, supporting future oral health prevention research.
Area of Science:
- Public Health
- Pediatric Dentistry
- Health Services Research
Background:
- Low-income children face significant disparities in oral health.
- Early intervention with fluoride varnish (FV) is crucial for preventing childhood caries.
- Primary health settings offer a potential venue for widespread FV application.
Purpose of the Study:
- To evaluate the implementation and sustainability of a fluoride varnish (FV) program in primary care for young, low-income children.
- To assess the feasibility of tracking medical care utilization in this pediatric population for future research.
Main Methods:
- A cohort of 12,067 children aged 1-5, insured by a government program, received care between July 2010 and April 2012.
- Data collected included demographics, clinic encounters, FV eligibility, and receipt.
- Medical care utilization (primary, specialty, urgent care, hospitalizations) was tracked to assess data feasibility.
Main Results:
- 85% of eligible children received fluoride varnish (FV), with higher rates in younger children and Black children.
- Implementation and sustainability of the FV program in primary care were demonstrated.
- Tracking medical care utilization was feasible, with primary care visit and hospitalization data available for a larger percentage of the cohort.
Conclusions:
- Fluoride varnish (FV) programs can be effectively introduced and sustained within primary health care settings.
- Long-term follow-up of such cohorts is achievable, enabling future studies on oral health prevention.
- Further research is warranted to capture the health and cost benefits of preventive oral health interventions.
Objectives:
The study objectives were twofold: 1. To examine how an intervention to apply fluoride varnish (FV) in a primary health setting to all young, low-income children was implemented and sustained and 2. To assess the feasibility of tracking medical care utilization in this population.
Study Design:
The study included children age 1-5, insured through a government program, seen (7/1/2010-4/30/2012). Data on age, race, sex, clinic encounter, eligibility for and receipt of FV was obtained. The level of data in primary care, specialty care, urgent care and hospitalizations to assess feasibility of future patient tracking was also acquired..
Results:
Of 12,067 children, 85% received FV. Differences were found by age (youngest had highest rates). Small differences by race (81%-88%, highest in Blacks.) was found. No differences were found by sex. Ability to track over time was mixed. Approximately 50% had comprehensive data. However, primary care visit and hospitalization data was available on a larger percentage.
Conclusions:
FV programs can be introduced in the primary care setting and sustained. Further, long-term follow up is possible. Future study of such cohorts capturing health and cost benefits of oral health prevention efforts is needed.
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