Baltimore City Fluoride Varnish Pilot Program

Tooth decay is a chronic disease that affects thousands of Baltimore children. It causes pain, impairs nutrition, and interrupts learning. Yet tooth decay is largely preventable.  Fluoride varnish applied regularly between the ages of 6 months to 5 years can reduce tooth decay by 46%. 

Lack of access to dental care is especially a concern for young children who typically do not have access to a dentist until after the age of three.

In October 2009, the Baltimore City Health Department, in conjunction with Baltimore HealthCare Access, announced the results of a 19-month pilot program to have fluoride varnish applied to children's teeth at the medical clinic where they receive their vaccinations.

Fluoride varnish is a safe and protective coating that can be painted on baby teeth in under two minutes, and that can reduce tooth decay by 46% when used regularly. It has been used in Europe for over 30 years and is already being applied at many dentists' offices.

The pilot program targeted young kids aged 12 to 27 months at four sites in Baltimore. The goal of the program was to achieve an 85% fluoride varnish application rate during well-child visits for children within the 12 to 36 month age range. At the culmination of the program, nearly 3,000 low-income Baltimore City children received fluoride varnish with clinics reporting that 58% of eligible children received varnish during a well-child visit.

The fluoride varnish program has proven to be an important public health intervention for Baltimore’s children. The National Association of County and City Health Officials (NACCHO) recently designated Baltimore City’s fluoride varnish program as a Promising Practice with the potential of becoming a Model Public Health Program.

[Press Release] [Baltimore City Fluoride Varnish Pilot Program Midterm Review] [DHMH Fluoride Varnish Program]

Innovative Oral Health Program Shows Results - Pediatricians Effectively Providing Fluoride Varnish to Young Children in Primary Care

May 15, 2008. The Baltimore City Health Department has released a progress report on an innovative pilot program in which pediatric clinicians apply fluoride varnish to prevent cavities in young children. The project is a partnership between the Health Department and The University of Maryland School of Dentistry and is coordinated by Baltimore HealthCare Access. [Press Release] [Baltimore City Fluoride Varnish Pilot Program Progress Report] [Fluoride Varnish Program][Lessons Learned during the Baltimore City Pediatric Dental Fluoride Varnish Program]

Frequently Asked Questions:

Why are medical clinics applying varnish to teeth?

Young children regularly visit a doctor or nurse to get vaccinations, and that is a good time to start getting fluoride varnish and to start learning about how to keep baby teeth healthy.

The doctors will refer patients to dentists for follow-up care.

Where do I go if I want my child to receive a fluoride varnish application?

If your child is already seeing a dentist, ask him or her about receiving fluoride varnish. If you want to locate a dentist for your child, you can refer to our resource guide. If your child is in our target age group and is being seen at one of our pilot sites, you can ask your doctor or nurse about getting fluoride varnish.

What else can I do to prevent my child from getting cavities?

• If your infant takes a bottle to bed, make sure it only contains water. Cavity-forming bacteria feeds on milk and anything containing sugar.
• Avoid giving kids sugary drinks and dilute fruit juices by half with water. Most juices contain added sugar and even 100% juice contains a form of sugar that causes cavities.
• Start teaching your kids how to brush early. Kids under 2 should not use fluoridated toothpaste, but can still practice brushing with a child-size wet brush.
• Take your child to a dentist regularly even when young and especially if you see white or brown spots on your child's teeth.

More Resources:

• Video of fluoride varnish being applied.
  • University of Maryland School of Dentistry Fluoride Varnish Video
  • California First Smiles Program (View minutes 7 to 9.5 to focus on Fluoride Varnish Application)
  • Ohio Department of Health (Click on "Applying Fluoride Varnish" under "Videos")
• Information sheets for parents that answer more questions. [English] [Spanish]
• Oral Health Services Brochure: [English] [Spanish]
• Contact information for dentists that see children. [All dentists] [Spanish Speaking Dentists (In English)] [Spanish Speaking Dentists (In Spanish)]

If you have further questions or comments regarding fluoride varnish, please email Dr. Patricia Bell-McDuffie at the Baltimore City Health Department: Patricia(dot)Bell-McDuffie(at)baltimorecity(dot)gov, or call (410) 396-4501.