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Barriers and Facilitators to Optimal Fluoride Varnish Application

Sarah L Goff1, Charlotte F Gilson1, Erin DeCou1

  • 1University of Massachusetts Amherst School of Public Health and Health Sciences (SL Goff, CF Gilson, and E DeCou), Health Promotion and Policy, Amherst, Mass.

Academic Pediatrics
|October 6, 2023
PubMed

Insights

Pediatric clinicians face challenges applying fluoride varnish (FV) despite guidelines. Understanding barriers like reimbursement and practice type is key to improving preventive oral health care rates.

Area of Science:

  • Pediatric primary care
  • Implementation science
  • Preventive oral health

Background:

  • National guidelines advocate for fluoride varnish (FV) application in children under six within medical settings.
  • Current FV application rates in primary care remain suboptimal, indicating a gap between recommendations and practice.

Purpose of the Study:

  • To investigate barriers and facilitators influencing guideline-concordant FV application in pediatric primary care.
  • To update the understanding of factors affecting FV implementation in clinical settings.

Main Methods:

  • Virtual semi-structured interviews were conducted with pediatric clinicians and medical assistants in Massachusetts.
  • The Consolidated Framework for Implementation Research (CFIR) guided the study, with data analyzed using a modified grounded theory approach.

Main Results:

  • Key themes included variations in reimbursement adequacy, FV application differences across practice types, and inconsistent protocols.
  • Challenges specific to small practices and the role of quality measures and dental care coordination were identified.

Conclusions:

  • Barriers and facilitators to FV application exist at multiple levels within pediatric primary care.
  • Further research should explore the effectiveness of quality measures and implementation strategies for consistent FV application protocols.
Abstract

Keywords:
fluoride varnishpediatric primary carepolicypreventive oral healthqualitative

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