P2.K203: “Improving Dental Health and Awareness with Fluoride Varnish”

Purpose/Objectives: Early Childhood Caries (ECC) is a chronic disease that destroys tooth structure leading to pain, infection and loss of chewing function in children. 23% of children are affected between 2 to 5 years of age. Fluoride varnish helps reduce the risk of ECC by inhibiting tooth demineralization, enhancing remineralization, and inhibiting bacterial metabolism. There is a huge need for fluoride supplementation in our community due the lack of water fluoridation in Louisiana. Therefore, we implemented fluoride varnish application as a part of primary medical care for our pediatric patients ages 6 months or at tooth emergence to 2 years old and up to 5 years old not in the care of a dentist at the Our Lady of the Lake Children’s Pediatric Academic Clinic (PAC). Our primary aim is to increase the percentage of patients who establish care with a dentist by 50% by 2024.

Design/Methods: To achieve the project aim, we utilized the Plan-Do-Study-Act (PDSA) quality improvement method. We obtained baseline data by conducting a retrospective chart review in Epic from August-October 2021 of all PAC patients between the ages of 6 months to 5 years of age who was seen for a well child visit and have a documented oral health risk assessment. Our first intervention included fluoride varnish application and providing dental office resources that began February 2022 to present. Our second intervention, we provided educational handouts on oral health. We obtained data from 1 year post collection of our baseline data to compare if our patients have established a dental home and reduced their cariogenic diet.

Results: Baseline data showed that 37% of children had a dentist prior to initiating fluoride application. 64% of patients had a cariogenic diet and risk for dental caries. After one PDSA cycle, we have completed fluoride varnish application on 494 children at well child visits which will potentially impact dental health in our patient population. 1 year post collection data showed that 66% of our children have a dental home and 33% of patients had a low cariogenic diet.

Conclusion/Discussion: Patients ages 6 months to 5 years see their pediatrician more than the dentist so preventative interventions will potentially have a greater impact on dental health in the primary medical care setting. Since starting fluoride at Our Lady of the Lake Children’s PAC, parents are more involved in at home dental care. Overall, the prevention will help with better health outcomes in children.

Future goals: Our third intervention will be initiating fluoride supplementation prescriptions to patients from 6 months to 16 years of age in EBR Parish. We will apply for grant money to continue to apply fluoride varnish and will continue to provide educational handouts on oral health.