CHOP Researchers Unveil Framework for Boosting Children’s Oral Health
Philadelphia, PA – A new quality betterment initiative developed by researchers at Children’s hospital of Philadelphia (CHOP) has demonstrated a meaningful increase in the request of dental fluoride varnish – a key preventative measure against tooth decay in young children. The findings, published today in the journal Pediatrics, offer a potentially scalable model for improving children’s oral health nationwide.
Despite being a safe and effective procedure with no co-pay under most insurance plans (including Medicaid and commercial insurance), national rates of dental varnish application remain low. Prior to the study, fewer than 10% of children with medicaid and 5% with commercial insurance received varnish applications during routine pediatric visits.
The CHOP study, conducted between July 2023 and October 2024, aimed to address this gap. Researchers implemented a multifaceted approach including electronic health record prompts, practice-level education, certification audits, and financial incentives.The goal was to increase varnish application rates for children aged 6 months to 5.99 years from 5% to 20% within one year, and to achieve equitable improvements across all insurance types, races, and ethnicities.
The results exceeded expectations. Across 92,056 eligible preventive care visits, varnish application rates rose from 3.7% pre-intervention to 30.5%. More than half of children (50%) received varnish annually, a substantial increase from the 25% baseline. Adoption of the new practices expanded from 6 to all 33 network sites. Furthermore, insurance reimbursement for varnish applications increased during the study period.
“Our study shows that with a few quality improvement strategies, we can considerably improve the rates of dental fluoride varnish application across a pediatric network and may have an easy-to-implement model that could help improve rates at a national level,” said Brian Jenssen, MD, Primary Care Pediatrician at CHOP and Associate Director of Clinical Impact at clinical Futures at CHOP.
The study’s success highlights the potential for targeted interventions to improve preventative dental care for young children, ultimately contributing to better long-term oral health outcomes.
Source: Children’s Hospital of Philadelphia
journal Reference: Jenssen, B. P., et al. (2025) Increasing Dental Varnish Rates in a Large Pediatric Care Network: A Quality Improvement Effort. Pediatrics. doi.org/10.1542/peds.2024-069877.
