Module 4: Anticipatory Guidance, Fluoride Varnish, and Referral

Key Points

  • Anticipatory guidance helps parents understand what to expect during their child’s current and approaching stages of development. Primary medical care providers can provide parents with anticipatory guidance to promote children’s oral health.
  • The three most frequently discussed anticipatory guidance topics are:
    • reducing the chance of bacterial transmission
    • reducing frequency intake of foods and beverages containing sugar
    • optimizing toothbrushing with fluoridated toothpaste
  • Fluoride varnish has been found effective in preventing caries in primary and permanent teeth.
  • Supplies needed to apply fluoride varnish include disposable gloves, a paper towel or disposable bib, 2" x 2" gauze sponges, fluoride varnish (preferably single-dose containers), and a disposable mouth mirror (optional).
  • A provider should refer a child to a dentist immediately if:
    • the provider observes non-cavitated white spot lesions or cavitated lesions
    • the child is at moderate or high risk for dental caries
    • a dental emergency is evident
  • In situations where it is difficult or impossible for primary medical care providers participating in Healthchek to identify a dentist who accepts children enrolled in Medicaid, parents should be referred to the Web site of the Ohio Department of Health, Oral Health Program; the county or city office that issued the Healthchek coverage; or the Medicaid managed care plan.