Improving Pediatric Fluoridation at Providence Southeast Family Medicine
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Publication Date
2025
Abstract
Dental caries are the most common preventable chronic condition effecting children worldwide. The patient population at Providence Southeast Family Medicine (PMG SE) are disproportionally affected by high caries rates due to lack of fluorinated water supply, low socioeconomic status, and limited access to pediatric dental services. Although application of topical fluoride is an effective strategy for prevention of caries, it is not routinely completed during office visits. PMG SE did not have an established workflow for fluoride application in clinic. We implemented a quality improvement (QI) project to increase the rate of fluoride application in children ages 6 months through 5 years old during Well Child Checks (WCCs) to a target of a 25% success rate. We completed a detailed root cause analysis and stakeholder interviews that informed the development of our QI project. Through a series of four Plan-Do-Study-Act (PDSA) cycles, we implemented a new clinical workflow to improve process measures of 1) provider education, 2) identifying eligible patients, 3) provider and medical assistant reminders through chart scrubbing, and 4) providing parent education. We achieved our target of successfully applying fluoride for 25% of WCCs after PDSA #1 and sustained a success rate of greater than 40% by the end of completion of PDSA #4. This project demonstrates the impact and success of implementing a simple workflow within the outpatient clinical setting to improve dental health for our at-risk patient population.
Specialty/Research Institute
Graduate Medical Education
