Prevalence and Associated Factors of Fluoride Varnish Application.

Objectives: To determine rates of fluoride varnish (FV) application at a tertiary care center between 2018 and 2021 and factors associated with receipt of FV application in the medical setting.

Design: A retrospective chart review and case-control study, matching children who had received FV application and those who had not during a well-child examination, were conducted.

Measures: Current Procedural and Dental Terminology and International Classification of Diseases codes from an electronic medical record were used to determine the rates of FV application.

Analytic strategy: Bivariate and multivariable analyses were conducted to determine factors associated with FV application.

Results: The rate of fluoride applications was low but increased significantly from 0.1% in 2018 to 1.6% in 2020 (P < .0001). Among White, Black, and Hispanic subjects, 39.5%, 65.2%, and 68.9%, respectively, received FV application during well-child exams. Advanced registered nurse practitioners (ARNPs) and physician assistants (PAs) provided 0.05% of FV applications. Multivariable results for 788 patients identified "Black, Hispanic, or other" race and ethnicity or Medicaid insurance type as factors positively associated with receipt of medical FV.

Discussion: This study showed an increase in FV application rates, which may be attributed to a quality improvement project and provider advocates. The prevalence was low and analyses show race and ethnicity and insurance factors associated with the receipt of FV application.

Conclusion: The associated factors suggest medical clinicians may evaluate race and ethnicity or insurance type to determine FV recipients. The results showed ARNPs and PAs may be underutilized clinicians for this preventive treatment.