The Experience of Medical Clinicians Implementing Fluoride Varnish in Connecticut

Purpose: The purpose of this study was to evaluate the success and barriers encountered by Connecticut medical clinicians providing and billing for infant oral health screenings and fluoride varnish. Methods: Clinicians trained and registered in providing oral health services were surveyed about practice demographics, training effectiveness, and implementation barriers. Results:Fifty-seven of 156 surveys (37 percent) were returned and analyzed. Most respondents were female (61 percent), worked at least 10 years (74 percent), and had at least 25 percent of their patients on Medicaid (79 percent). Respondents varied in how prepared they felt to offer services (P<.00). Sixty percent felt "well prepared" to provide oral screenings vs. 40 percent and 39 percent for fluoride varnish and billing services, respectively. Only 30 percent of respondents provided fluoride varnish. Clinicians were more likely to provide fluoride varnish and bill for the services if they felt well prepared after the training (P<.00). Referrals for an age one dental visit were not routine; 23 percent of clinicians did not refer, and 50 percent reported barriers. Conclusions: Few trained and registered clinicians provide fluoride varnish and bill for oral health services, despite feeling prepared to provide them. Additional support is required to help medical clinicians provide oral health services more consistently.