Vol.:(0123456789) 1 3 European Archives of Paediatric Dentistry https://doi.org/10.1007/s40368-020-00539-5 ORIGINAL SCIENTIFIC ARTICLE A service evaluation of an intervention to increase application of topical fuoride varnish in general dental practice in South Yorkshire L. Timms 1  · C. Hume 1  · V. Wilson 1  · L. McClean 2  · Z. Marshman 3  · H. Zaitoun 1 Received: 21 November 2019 / Accepted: 3 May 2020 © European Academy of Paediatric Dentistry 2020 Abstract Purpose Dental caries is still common in children in the UK despite many available preventative interventions. Application of topical fuoride varnish can reduce caries experience. National and international guidance recommends at least twice- yearly application of topical fuoride varnish, however guidance is not always followed. This project aimed to frst identify the proportion of patients receiving fuoride varnish by their primary care dental practitioner prior to their referral to a secondary care service and subsequently increase this rate by introducing an intervention. Methods The intervention required the referring practitioner to document the date of which topical fuoride was applied prior to referral. Referrals without this information were rejected. Data were collected pre and post this change in policy to ascertain fuoride application rates. Parents and children were questioned about the frequency of application, and referral forms were reviewed for practitioner-reported application. Results Topical fuoride application rates improved by 19% points for patient-reported application, and 31% points for practitioner-reported application. The biggest increase in application rate was in the cohort of patients receiving 6-monthly fuoride application. Conclusion This study demonstrated that a simple intervention, mandating that primary care dental practitioners record the most recent application of topical fuoride before referring a patient to secondary care, can improve the rates of topical fuoride varnish application in the UK. Keywords Caries prevention · Topical fuoride · Fluoride varnish Introduction Caries afects a signifcant proportion of children in the UK and there is strong evidence for the association between prevalence of dental caries and socio-economic status (Schwendicke et al. 2015; Health and Social Care Informa- tion Centre 2013 2015). Topical fuoride application is an evidence-based intervention to reduce caries (Marinho et al. 2013). A Cochrane review found a caries reduction of 37% in the primary dentition and 43% in the permanent denti- tion with the use of topical fuoride varnish (Marinho et al. 2013). UK National guidelines recommend at least twice annual application of topical fuoride varnish for children, at an increased frequency for those at a higher risk of caries (Public Health England 2017). This guidance is congruent with European guidance advising topical fuoride varnish application 2–4 times a year (Toumba et al. 2019). As the majority of regular dental care is carried out in primary care, primary care dental practitioners must be engaged in deliver- ing evidence-based prevention. Despite published national and international guidance, professional application of fuoride varnish seems to remain low (Bonetti and Clarkson 2016). In a secondary referral centre in Shefeld, United Kingdom, patients are referred from primary care when specialist paediatric dental treat- ment is required. For these referred patients, the rate of topi- cal fuoride applied in primary care is anecdotally lower than * L. Timms ljhtimms1@shefeld.ac.uk 1 Paediatric Dental Department, Charles Cliford Dental Hospital, Shefeld Teaching Hospitals NHS Trust, Shefeld, UK 2 Paediatric Dental Department, University of Manchester Dental Hospital, Manchester Foundation Trust, Manchester, UK 3 Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Shefeld, Shefeld, UK