Fluoride Action Network


Key points

  • Shows that NHS claims for applications of fluoride varnish and fissure sealant by NHS dental professionals were low for children of primary school age.
  • Shows that NHS claims indicating radiographic exposures for children of primary school age were low.
  • Suggests that guidelines relevant to prevention and diagnosis for children had not consistently been followed.

Introduction Clinical guidelines related to diagnosis and preventive interventions for children are well established; however, childhood caries incidence remains high.

Methods Secondary analysis of routinely collected data from the NHS Business Services Authority for children treated by general dental practitioners across a five-year period in four local authorities in South West England was used to assess whether children of primary school age attending general dental practices were receiving radiographs, fluoride varnish and fissure sealant applications in line with current guidelines.

Results In total, 40,780 claims had been submitted in the five-year time period for the 4,805 children included in the study: 4.9% of children had ten or more claims that indicated fluoride varnish application; 4.0% of children had claims indicating they had been provided with four or more fissure sealants; and 7.6% of children had claims indicating two or more radiographs had been exposed. Increased filling experience was associated with increased fluoride varnish applications. For the children that had ten or more examinations and five or more fillings provided in the five-year time period, 27.2% had ten or more fluoride varnish applications, 7.6% had four or more teeth fissure sealed and 17.2% had two or more radiographs exposed in the five-year time period.

Conclusion The claim data did not provide reassurance that guidelines relevant to prevention and diagnosis for children had consistently been followed.

*Original abstract online at https://www.nature.com/articles/s41415-022-4253-3




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Author information

Authors and Affiliations


Nathan Brown contributed to conceptualisation, data collection, analysis of the data, writing the article and approval of the final version. Rebecca Northover and Sara Harford contributed to writing the article and approval of the final version. Rosie Power contributed to analysis of the data, writing the article and approval of the final version.

Corresponding author

Correspondence to Nathan Brown.

*Original abstract online at https://www.nature.com/articles/s41415-022-4253-3