School Fluoride Varnish Programs Prove to Be Effective Tool in Fight Against Childhood Caries
A major systematic review confirms that school fluoride varnish delivery programs significantly reduce tooth decay and narrow oral health disparities among children at high risk. The findings support national expansion of school-based preventive care, especially in underserved communities.
Untreated tooth decay affects millions of children in the United States with significant impacts on nutrition, speech, learning, and quality of life. A recent systematic review by the Community Preventive Services Task Force delivers compelling evidence that school fluoride varnish delivery programs are a powerful tool in combating this public health challenge, especially for children in low-income areas.
The review examined dozens of studies involving preschool through high school students, most from socioeconomically disadvantaged communities. Results showed that school fluoride varnish delivery programs were effective in preventing both the initiation and progression of dental caries. They also increased the number of fluoride varnish treatments received and helped reduce disparities tied to income and access. These programs typically apply fluoride varnish twice a year, starting as early as the eruption of a child’s first tooth, and often include screenings, referrals, oral hygiene education, and supply distribution.
Crucially, the review found no difference in effectiveness based on the type of provider delivering the varnish, supporting the use of trained lay workers alongside dental professionals. This could make programs more affordable and sustainable, especially when reimbursement policies lag. Currently, Medicaid reimbursement varies by state and often limits billing to physicians, nurse practitioners, or oral health professionals, restricting the program’s scalability.
While minor complaints were occasionally reported, the review found no evidence of harm related to fluoride varnish use, including concerns around systemic fluoride exposure. The benefits extend beyond oral health; literature suggests that reducing decay improves school performance and attendance, though this specific review didn’t measure those outcomes directly.
Despite their success, school fluoride varnish delivery programs remain underused. Only about 70% of state oral health programs have at least one in operation, and few use trained lay workers despite their proven potential. Click here to read the study in its entirety.
