Cavity-Free Kids: CHOP's Smart Fix With Dental Varnish

A CHOP study shows how quality improvement strategies rapidly increased fluoride varnish use in young children’s checkups.

One of the most prevalent health challenges in childhood is dental cavities. Fluoride dental varnish is a safe solution to prevent the decay of young teeth. According to expert recommendations, such as those of the American Academy of Pediatrics, children under 6 years old should receive a varnish every 3-6 months during a dental appointment. However, even with a no-cost plan available through both private and Medicaid insurance, very few children receive it.

Children have worse oral health as a result of the COVID-19 pandemic, which necessitated more urgency in preventive care. In order to close this gap, researchers at the Children's Hospital of Philadelphia (CHOP) tried to figure out how to make varnish a common practice in pediatric examinations ().

Dental Caries in Children can be Prevented With Fluoride Varnish
Dental caries in small children can be avoided with fluoride varnish application, according to a report by the German Institute for Quality and Efficiency in Health Care.

TOP INSIGHT

Did You Know?
From 3.7% to 30.5% in just a year, dental varnish usage has drastically improved with CHOP’s initiative! #toothdecay #dentalvarnishes #oralhealth #dentalhealth #medindia

The Challenge: Big Gaps in Care

Before the project began, only 3.7% of eligible visits included varnish application.

Only 0.7% of the visits made by commercially insured kids received varnish.
Medicaid-insured children only made up 9.1% of visits.

Despite equal coverage, provider habits, workflow barriers, and assumptions contributed to the gap.

Prevent Tooth Decay in Children by Using Dental Sealants
Dental sealants are considered as the quickest, safest and pain-free method to prevent cavities. Dental sealants are also known as pit and fissure sealants.

Focus on Quality Improvement

CHOP rolled out a step-by-step quality improvement (QI) program across its 33 pediatric practices, serving more than 100,000 young children. Key strategies included:

Electronic Health Record (EHR) prompts reminding doctors to apply varnish
Education sessions for providers
Certification credits linked to professional learning
Financial incentives tied to performance

These changes were adjusted along the way based on real-time feedback from doctors and staff.

Dental Check-Up
It is commonly recommended that you visit the dentist twice a year to clean your teeth and gums and also do the basic check–ups.

Visit Rates Increased

The impact was dramatic:

Visit rates jumped from 3.7% to 30.5% in less than a year.
The proportion of children receiving at least one varnish annually doubled from 25% to over 50%.
The 33 practices embraced the use of varnish, all with financial viability being demonstrated through a growth in reimbursements.
The gains were comparable across all races, ethnicities, and insurance types and bridged the existing gaps.

Tooth Decay - Causes, Symptoms, Diagnosis, Treatment & Prevention
Tooth decay in toddlers, children and adults, also called dental caries, is a bacterial infection causing demineralization and destruction of the hard tissues of the teeth.

Preventive Dental Care is Essential

This project demonstrates that preventive dental care can be scaled in a short time and with the help of a proper combination of technology, training, and incentives. The CHOP model demonstrates that varnish not only protects smiles but is also cost-effective for health systems.

A Smile-Friendly Future

CHOP’s success highlights how primary care practices can make dental varnish a normal part of child checkups nationwide. By integrating prevention into everyday visits, pediatricians can help ensure that every child—regardless of race, background, or insurance—grows up with healthier teeth and fewer cavities.

“We hope other networks adopt these strategies to boost varnish rates for kids across the U.S.,” said Dr. Brian Jenssen of CHOP.
Reference:

Enhancing Pediatric Dental Health: New Initiative to Boost Varnish Application Rates at CHOP Primary Care Network - (https://clinicalfutures.research.chop.edu/enhancing-pediatric-dental-health-new-initiative-boost-varnish-application-rates-chop-primary-care)

Source- Children's Hospital of Philadelphia