Translating research to practice: Implementing fluoride varnish during well-child vists in a primary care safety-net system

This presentation will discuss the pathway and successes of adopting fluoride varnish applications in primary care clinics in a safety net system. Fluoride varnish is a professionally applied topical resin that has been shown to significantly reduce early childhood caries. In California, fluoride varnish application became a paid Medi-Cal benefit for children younger than 6 years of age in 2006, yet in 2009, only 4.7% of eligible California children aged 1 – 5 years received one fluoride varnish application. Contra Costa Regional Medical Center is the safety net hospital and clinic system serving the majority of low-income children in Contra Costa County. In partnership with the UCSF School of Dentistry's Center to Address Disparities in Children's Oral Health (CANDO), in 2009 we initiated an interdisciplinary work group to pilot routine application of fluoride varnish to children ages 1 -5 during well child exams. To date, we have demonstrated that with intensive training and support, a large safety net clinic system can successfully apply fluoride varnish to 79% of eligible toddlers and significantly reduce staff perceptions of barriers to the procedure. Session speakers will outline the development of this quality initiative, along with addressing perceived barriers and assuring sustainability of this effort.