Ontario public health units are mandated under the Ontario Public Health Standards (2008) to offer professionally applied fluoride (PATF) according to specific risk criteria as part of the provision of essential clinical oral health services. Public health in the past had been providing this service in our clinical settings; however, many of our children at greatest risk were not accessing this service.

Fluoride varnish offers protection and helps to largely reduce tooth decay as it re-mineralizes and strengthens tooth enamel. It is brushed on children’s teeth with a small disposable brush and sticks to the tooth surface immediately, eliminating any pain or discomfort with the application and completely eradicating the risk of swallowing. Research found a 38% reduction in tooth decay among high-risk children who received fluoride varnish treatment for at least two years, compared to those children who did not receive the treatment.

We recognized that Parent Support Workers (PSWs) in our agency were seeing this vulnerable population and had already established a relationship with these families through the Healthy Babies Healthy Children Program with their regular visits. As a result, public health dental practitioners provided training and established a policy to enable PSW’s to offer and administer fluoride varnish to children of families they regularly visit. The creative processes used in the development of this practice include:

  • Development of a work plan that included activities, target dates, implementation process details and progress/outcomes
  • Development of policies and procedures
  • Development of a fluoride varnish application kit, permission form, post care instructions
  • Staff training
  • Development of a reporting tool

In the first 7 months of implementing the new method, there has been a 30% increase in the number of at-risk children who have received topical fluoride treatment (as compared to the same time period last year using traditional method only). Staff were able to provide an increased number of topical fluoride treatments via the new method with no increase resulting in staff travel time and/or mileage.

In addition to receiving fluoride varnish, families are also receiving oral health resources, education and preventive and restorative treatment options. The interaction is also recorded in the client’s chart and in many cases oral health has become a family goal that parents and children want to work towards with their parent support worker.

This strategy supports the Ontario Public Health Standards by offering and applying fluoride varnish as an essential clinical service to children at risk of dental decay and by reducing the barriers to services as the application occurs in the comfort of their home by someone they had already established a trusting relationship.

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