Dr. Smith has raised a question concerning the practicality of applying fluoride varnish three times in a single week. We have adapted this protocol to our private practice at the university by being very flexible about when the families bring in their children, and by delegating the application to a dental assistant.
We have found that the protocol of applying fluoride varnish three times in one week, or perhaps 10 days, can easily be implemented in public health programs, and in preschool programs such as Head Start, even when a private dentist and his or her staff are doing outreach. We have advocated that multiple applications of topical fluoride be permitted by programs such as Medicaid without intervals, as was previously so common. Children who might otherwise miss out on typical six-month follow-ups may benefit from the more intensive protocol we have studied.
Researchers at the Northwest/Alaska Center to Reduce Oral Health Disparities at the University of Washington are studying this protocol currently in a high-caries-risk Head Start population in work sponsored by the National Institute of Dental and Craniofacial Research.
