5% Sodium Fluoride Varnish Pediatric Oncology Provider Training

5% Sodium Fluoride Varnish Pediatric Oncology Provider Training

Intro and Purpose
According to American Academy of Pediatrics (AAP) and American Dental Association (ADA), fluoride varnish is recommended for children every 3-6 months from age of tooth emergence to reduce caries/cavities. Pediatric oncology patients are at a higher risk for cavities due to oral side effects, such as xerostomia, related to oncological treatments. The purpose of this study is to assess precepted understanding of importance, comfortability, and willingness to integrate fluoride varnish into pediatric oncology patient care. An interprofessional team of health sciences students developed a provider training for pediatric oncology providers, including a learning lab. The student team included dentistry (DDS), dental hygiene (RDH), medical school (MD), physician assistant (PA) and health informatics information management (HIIM) students.

Methods
Pre/posttest survey. Participant pool: 9. Data was collected using QR codes and assimilated in Qualtrics. A 5-question pretest survey was given to interprofessional peds-oncology licensed providers regarding fluoride varnish and caries risk assessment. Next, the student team presented a provider training using PowerPoint, based on APA and ADA guidelines focused on etiology of caries in pediatric oncology patients, caries reduction strategies, and fluoride varnish. A hands-on lab allowed opportunity for fluoride application to tooth models and oral health education role play. A 5-question posttest survey implemented.

Results
Participants included nursing, oncology, physician assistant and “other”. Prior to the provider training, zero participants indicated including fluoride varnish in treatment. Following the training, 45% of providers will consider varnish in pediatric oncology treatment planning, 82% of participants indicated that they felt comfortable conducting pediatric caries risk assessment and 73% of participants would be comfortable applying fluoride varnish.

Conclusions
Oncology teams are interested in learning about fluoride and oral health’s role in pediatric patient treatment regimens. It’s essential to educate practitioners and clinical protocol decision makers about the role of oral health and fluoride varnish in reducing cavities in pediatric populations. The learning lab provided option for sustainability. Decision makers in Pediatric Oncology now have a foundational knowledge and can explore current evidence-based recommendations to determine if adding fluoride varnish to their protocols is a “good fit” for their department and beneficial to patient outcomes and quality of life.

Recommendations
Integrate fluoride oral health into primary care curriculum.
Annual updates regarding scope of practice and evidence based medical/dental recommendations to protocol decision makers.
Continued collaboration among medical and dental providers to provide patient-centered comprehensive care.