Pediatricians seek collaboration after new task force recommendation on fluoride varnish

Michelle Manchir


In support of the development of practice partnerships with pediatricians, the ADA Council on Access, Prevention and Interprofessional Relations is informing dentists of recent changes to federal regulations regarding fluoride varnish treatments that may result in more pediatricians providing oral health screenings and referrals to dentists.
In 2014, the United States Preventive Services Task Force released its updated recommendation on fluoride varnish use in the medical setting. The new recommendation advises medical providers to apply fluoride varnish to primary teeth starting with the eruption of the first tooth through age 5 years.

As part of the Affordable Care Act, all preventive interventions graded as an A or B by the USPSTF, including fluoride varnish, are fully covered services within medical insurance plans sold within the state or federal marketplace. As a result of this change, more physicians may be providing oral health preventive services, including caries risk assessment, anticipatory guidance, fluoride varnish treatments as appropriate and referrals to dentists in their community to establish a dental home.

“(Pediatricians) will undoubtedly need support from local dentists to help answer oral health questions they might have and to refer children to. Collaborative relationships between pediatricians and dentists will be vital,” said Dr. Jane Gillette, CAPIR chair and dentist member of the American Academy of Pediatrics’ Section on Oral Health.

The ADA has a long history of promoting child well-being and medical-dental partnerships. The ADA House of Delegates in 2004 passed policy stating that physicians and their properly supervised and trained designees “be allowed to provide preventive dental services to infants and young children.”

To strengthen dentist-pediatrician relationships, the ADA in July hosted a webinar for members on developing and integrating professional relationships with physicians into dental practices. This webinar, which included Dr. David Schirmer and pediatrician Grant Allen, M.D., both ADA CAPIR members, demonstrated clear roadmaps for bidirectional referrals and interprofessional practice.

Meanwhile, the AAP has said it will reinvigorate its Chapter Oral Health Advocate network (an initiative started with funding from the American Dental Association Foundation) that trains pediatricians in most states to advocate for children’s oral health and teach their peers how to integrate oral health into established “well baby” visits. The AAP says its pediatrician members are also looking for opportunities to expand and enhance partnerships with community dentists.

“We’ve been working with our pediatric and family dentists to accept referrals as young as 1 year of age,” said Dr. Allen, who is also a member of the AAP Section on Oral Health. “We are happy to do oral health risk assessment and fluoride varnish but we want our patients in a dental home around age 1 year.”

Added Dr. Lisa Jacob, chief of pediatric dental medicine at Dell Children’s Medical Center in Austin, Texas, and also a member of the AAP Section on Oral Health, “By joining forces, we can help reinforce a number of important issues including the importance of good oral hygiene, promoting healthy diets, having adequate fluoride exposure and the importance of overall safety.”

Dentists can visit the AAP Section on Oral Health web site,, or email for more information. Dentists can also become members of the AAP Section on Oral Health.