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A TIME STUDY ANALYSIS OF FLUORIDE VARNISH APPLICATION DURING PEDIATRIC WELL VISITS IN GEORGIA

Abstract

Dental decay is an important and ongoing public health concern and impacts children from low-income households and from racial and ethnic minorities at higher rates than the rest of the population. As young children are much more likely to visit a primary care provider than a dentist, including appropriate and effective preventive oral health services (POHS) at pediatric well-visits has the potential to dramatically improve children's oral health. Fluoride varnish (FV) application is one such POHS for which insurance programs will reimburse for children in the primary care setting, yet only a small minority of physicians apply FV. The most common barrier cited is lack of time during a well visit. The goal of this research is to remove the primary process flow barrier (lack of time) currently dissuading physicians from providing FV during pediatric well-visits. Our research team conducted on-site visits at six pediatric clinics in Georgia to collect videos to determine both the total standard time for the overall fluoride varnish treatment process as well as the actual time to apply FV to children's teeth. Regression analysis was employed to develop a predictive model for estimating total FV treatment time based on significant predictor variables, such as age, gender, provider, and clinic. Our results show that it takes just over 2 minutes, on average, for the overall FV treatment process (i.e., donning gloves, opening the FV packet, FV application method, apply FV, and wipe mouth) after obtaining parental consent, and less than 50 seconds, on average, to apply FV during a well-visit. Findings from thsi study support the inclusion of FV application during pediatric well-visits.

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