Application of Fluoride Varnish Tip Sheet

Incentives will be paid on an annual basis, following the end of Quarter 4. For additional information, refer to the 2021 and 2022 CBI Technical Specifications.

• History of dental caries is an important predictor of risk for future disease.
• Children with early childhood decay are more likely to get more decay in their lifetime. Baby teeth are in a child’s mouth until age 11 or 12.
• Decay can go beyond pain and it affects:
  • Speech
  • Ability to eat.
  • Ability to learn.
  • The way children feel about themselves.
• Fluoride varnish helps prevent dental caries and, in some cases, reverse early dental caries. Fluoride can reduce decay by 30-63%, depending on if it is coupled with dental health counseling.
• Because of the high efficacy of fluoride varnish, it is now being applied in non-dental settings.
• The application is quick, easy, and painless, and can be delegated to nursing and medical assistant staff.

• Application of topical fluoride varnish by a physician or other qualified health care professional CPT Code: 99188.
• Topical application of fluoride varnish CDT Code: D1206. 

Data for this measure will be collected using claims and provider data submissions via the Data Submission Tool (DST) on the Kws Kho Mob Lub Chaw Tswj Xyuas Tswvcuab Cov Ntaub Ntawv. To find gaps in data:

• Run a report from your electronic health record (EHR) system: or.
• Manually compile patient data (Example: Download your Care-Based Incentives Measure Details report on the Provider Portal and compare to your EHR/paper charts).

This measure allows providers to submit fluoride varnish codes to the Alliance from the clinic EHR system or  paper records by the DST contractual deadline. This includes fluoride varnish applications that were completed before the member was eligible for Medi-Cal or during a gap in coverage. To submit, you may upload data files to the DST on the Kws Kho Mob Lub Chaw Tswj Xyuas Tswvcuab Cov Ntaub Ntawv. To be accepted, data must be submitted as a CSV file. Step-by-step instructions are available in the Data Submission Tool Guide on the Kws Kho Mob Lub Chaw Tswj Xyuas Tswvcuab Cov Ntaub Ntawv.

• United States Preventive Services Task Force (USPSTF) recommends that PCPs apply fluoride varnish to the primary teeth of all infants and children starting at the age of primary tooth eruption.
• American Academy of Pediatrics (AAP) recommends application of fluoride varnish at least once every 6 months, and preferably every 3 months, starting at tooth eruption.

• Fluoride Varnish Helping Smiles Stay Strong brochure for parents and caregivers.
• Child Health and Disability Prevention (CHDP) Dental Training: Fluoride Varnish.
• CHDP Fluoride Varnish Protocol and Standing Order.
• CHDP Steps to Implement Fluoride Varnish in Your Medical Practice.
• CHDP County Offices.
• AAP Oral Health Prevention Primer.
• Smiles for Life: A National Oral Health Curriculum.
• Key Elements to Incorporate Oral Health in the Pediatric Electronic Health Record AAP Section on Oral Health.