RESidENcy PROGRAM Scholarly and Community Medicine Projects

Jessica Dalby, MD
Family Medicine Resident
University of Wisconsin
Department of Family Medicine
Community Medicine Project
April 2011
Project: Fluoride Varnish for Prevention of Early Childhood Caries
Background: Early childhood caries are a serious cause of childhood morbidity, leading to pain,
infection, missed school and/or work for their caregivers and even surgical intervention requiring
general anesthesia. Children under the age of three rarely see a dentist, but will make many visits
to their primary care clinic during those first important years. Children on Medicaid in our
community are a high-risk group for dental caries and have additional difficulty accessing dental
care. Fluoride varnish applied in the primary care office at routine well child checks has been
shown to reduce the incidence of childhood caries in high-risk populations.
Intervention: I invited our colleagues from the Dane County Public Health Department to
Wingra during one of our Well Child Check extravaganzas. They provided fluoride varnish and
dental care supplies to children seen that day, but more importantly they instructed some of the
medical assistants on how to apply the varnish. I then visited the Southside Access clinic, where
this intervention is part of their routine, to learn how to incorporate this service into our clinic
flow. Working with clinic staff, fluoride varnish was ordered. I presented to MA and nursing
staff the technical aspects and purpose of this intervention. Voila! We now offer fluoride varnish
routinely at WCC at Wingra, fighting cavities one tooth at a time!