Something to smile about

If you can't see the slides below, click here to view the PowerPoint.

Fluoride Varnish at CCRMC and HC

I wanted to share some results from what began as a “small test of change” to improve dental health in children here in Contra Costa County. Fluoride application is one improvement in our health care system that stands out as having a positive and immediate impact.

The protective effect that fluoride varnish provides for kids is remarkable. Just one annual application is dropping the rate of dental cavities as much as 50% and two applications dropping it by 75%. In spite of the fact that this quick, painless procedure has been a covered Medi-Cal benefit for young children since 2006, less than five percent of eligible children received even one annual varnish application in 2009. Unfortunately, few low-income children see a dentist on a regular basis – if at all.

We realized that our young patients didn’t need to be sitting in a dentist’s chair to receive this treatment, but in fact could have it applied during their well-child visit at our primary care clinic. Physicians, nurses and certain other personnel are legally permitted to perform the varnish application, which only takes between 1-3 minutes. Contra Costa County, in partnership with UCSF School of Dentistry’s Center to Address Disparities in Children’s Oral Health (CANDO), embarked on a program to train staff to provide this very basic service to our youngest patients. What started as a pilot in two of our health centers has now been expanded to all eight.

The results have been impressive. More than 70% of eligible children have received the varnish through our primary care clinics. We’ve also increased our education on oral health for parents as well as all patients. Our Health Plan has begun to train community providers about the varnish application.

Although it’s gratifying to be able to make such a significant difference with this simple procedure, we know that it is not enough to protect children’s dental health. We are also moving forward with efforts to expand dental care for children in our dental clinics. There are many negative consequences as a result of not seeing a dentist. If you’ve ever suffered a toothache yourself or been with one of your children while they did, you realize how much children suffer from this pain that we know could be avoided in most cases. They also risk serious and chronic infections and along with the pain are major causes of school absences. I hope to be able to report on our progress in this area in the not-too-distant future.

More very soon.
Anna