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Introduction
Dental Caries are becoming an increasing problem amongst children. The national
institute of Dental and Craniofacial Research stated 42% of children 2 to 11 have had
dental caries in their primary teeth (NIH, 2004). Fluoride in a varnish form is a safe and
easy method that is applied to children to help prevent dental caries.

uoals

By the end of this presentation, the adult learner will be able to perform a fluoride varnish
treatment on a child following all the steps taught in the presentation.

By the end of this presentation the learner will be able to describe the benefits of varnish
fluoride and indications for application.

After completion of this course learners will be able to implement a fluoride varnish on
children to help reduce their risk for dental decay. This presentation will help educate the
hygienist when to implement this treatment on a child and how it will benefit their
patients. Implementing fluoride varnish treatment on children is a preventative measure
for children and can be applied to existing or incipient caries to help to demineralize the
tooth. Health care providers apply this treatment to high-risk children as an aid in oral
health care.

Performance Objectives:
Using a checklist, the dental hygienist will be able to demonstrate how to place fluoride
vanish in the mouth following all four steps on a child in a dental operatory.

On a sheet of paper, the dental hygienist will be able to identify children who would
benefit from fluoride and explain the benefits with at least 90% accuracy

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The puipose of fluoiiue vainish is to ueciease the patient's iisk foi caiies, aiiest
incipient caiies anu iemineialize the uemineializeu enamel to pievent a cavity
foimation. 0ui goal by applying fluoiiue tieatments is to pievent anuoi ieuuce the
iisk of uecay in piimaiy teeth. Complete a caiies iisk assessment in the chilu to
ueteimine whethei a fluoiiue tieatment is iecommenueu oi not. All tieatment must
be client specific anu uocumentation of the level of caiies iisk anu why is impoitant.
If unsuie of caiies iisk assessment please see chait below foi iefeience.

CBART- REB=BIuB RISK (implement fluoiiue tieatment)
YELL0W= NEBIEN RISK (If chilu piesents with two oi moie yellow
inuicatois (implement fluoiiue tieatment)
uREEN= L0W RISK (Fluoiiue tieatment not necessaiy)



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Benefits of fluoiiue vainish.


Town Name Bate Fluoiiue Level (ppm)
Kincaiuine 0ctobei 2u1S u.14
Scott Point 2u1S 1.7S
Tiveiton 2u1S 2.u
0nueiwoou 2u1S 1.7
Aimoi 2u1S 2.1u
Riply 2u1S 2.14
Whitechuich Septembei 2u1S 1.11
Lucknow Septembei 2u1S 1.8S
Point Claik Septembei 2u1S 2.2S

Recommenueu Bosage: u.8-1.u ppm
Naximum Allowable Level: 1.S
This was a chait I ieceiveu fiom the municipality watei tieatment of Kincaiuine. As
you can see fiom this chait Kincaiuine has the lowest level of fluoiiue in theii watei
anu fluoiiue is natuial anu not auueu to the watei.

LIST 0F BENIFITS

-Nost effective tool t pievents uental uecay.
-Biies immeuiately upon contact with saliva anu easy to apply
-It enhances iemineialization of the tooth suiface.
-Ninimal ingestion uuiing anu aftei tieatment (gieat foi chiluien who can't
expectoiate)
It has a safe anu the taste is well toleiateu by infants, young chiluien, anu -
inuiviuuals with special neeus.
-Inexpensive

NAKE S0RE Y00 0BTAIN TBE PAENTS C0NSENT ANB B0C0NENT IT!!!!












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Apply the fluoiiue vainish

At the enu of this couise you will be testeu on peifoiming a fluoiiue tieatment.
Below is a list of peifoimance objectives I will be looking foi to ensuie you aie
qualifieu to peifoim fluoiiue vainish tieatments on patients.

Given a child who is in your dental chair, the learner will be able to identify (select) if
the child needs a fluoride varnish treatment by using the Caries risk assessment
guidelines.

Given a child that needs a fluoride treatment, the learner will be able to explain 4
benefits of a fluoride varnish treatment by verbally explaining the benefits to the
parents/caregiver using a reference sheet with the list of benefits.

Given an air water syringe, cotton rolls and low volume suction the learner will be able
to demonstrate isolating techniques by isolating the oral cavity and checking the oral
cavity for any moisture/saliva.

Given a fluoride applicator, the learner will demonstrate the application of a fluoride on
a child by Appling the fluoride varnish to all surfaces of the teeth following the 4
application steps.

Using a reference paper that gives the post op instructions for a fluoride varnish, the
leaner will paraphrase the post op instructions of a fluoride treatment to the child and
caregiver using the listed post op instructions provided from the manufacturer as a
reference.

Using a records sheet in the chart, the learner will outline the completed treatment in the
patients chart following the Canadian Dental Hygienist of Ontario guidelines for
documentation.

FOUR STEPS OF APPLYING FLUORIDE VARNISH
1) DRY THE TEETH with cotton roll, air water, gauze
2) MIX UP VARNISH with applicator
3) APLLY SMOOTH EVEN LAYER(S) TO ALL SURACES OF THE TEETH with
varnish applicator
4) GIVE POST-OP INSTRUCTIONS see below for postop PARAPHRASE in your
own words
Post-application Instructions to child and parent.

The child should eat at a soft, non-abrasive diet for the rest of the day.

Do not brush or floss the child's teeth until the next morning.

It is normal for the teeth to appear dull and yellow until they are brushed

STEP FOUR
Documentation
It is important to document all steps. Below is an example of what it should look like.

June 24/2014. Caries risk assessment completed, patient high risk- caries in the last 3
years, Explained benefits of fluoride varnish treatment with mom and obtained verbal
consent for fluoride varnish treatment, applied 5%NaF fluoride varnish- mint flavour,
gave POI to mom and child, patient tolerated care well.

ACTIvITY
1) 0n a piece of papei wiite uown when anu why to apply a fluoiiue vanish
tieatment anu hanu in with you name on the papei.

2) Bieak up into gioups anu piactice applying fluoiiue vainish tieatments on each
othei. Role-play as if one peison is the chilu, one peison the paient anu the othei is
the uental hygienist.

NARKINu!!!!! What I will be looking foi when I passfail you on youi evaluation.


Steps to be
completeu
What to look foi PASS FAIL
Step 0ne Biu they assess the chilu using the caiies iisk
assessment.

Step two Biu they explainlist foui benefits to the
caiegivei anu ask peimission to piefoim
tieatment.

Step thiee Biu they follow the foui steps of applying
fluoiiue.
Biy the teeth Yesno
Nix up fluoiiue Yesno
Apply even layei to all
suifaces
Yesno
uave P0I Yesno

Step foui Biu they uocument pioceuuie in patient's
chait, using all the necessaiy uocumentation.

C0NNENTS







0vERALL NARK 4 PASS FAIL