Provider applied fluoride varnish for pediatric populations within the rural primary care setting

Abstract

A six-week quality improvement project using the PDSA framework included an oral health risk assessment screening with the Oral Health Risk Assessment Tool (OHRAT) and fluoride varnish (FV) application training of primary care providers used as a preventative treatment for pediatric-age children within the rural health primary care setting. The intended outcome aimed to improve oral health assessments, opportunities for oral-health provider-to-parent education and enhance overall oral health for generations of patients. At the project conclusion, participation included thirty-nine [n=39] patients during phase I and twelve [n=12] during phase II. Due to repeat participation, n=5, patients were excluded. During phase I, 10.5% of participants received FV treatment, however, 71% refused FV treatment due to having recent dental care. In phase II, 68% of participants received FV treatment with 33% refusing due to recent dental care. The implemented workflow achieved an increase in the number of pediatric patients receiving FV treatment and risk screening versus the clinic baseline of zero. Due to low participation numbers, it is difficult to determine clinical effectiveness on overall long-term oral health outcomes. Changes in workflow measures clearly were an effective process that could be replicated as a financially feasible and worthwhile procedure to any primary clinical setting. The process promoted provider engagement with patient/parent oral health discussion which overall improved potential for access to dental care.