A time study analysis of fluoride varnish application in pediatric well visits to address health disparities among children

Dental decay is the most common chronic disease in children. Fluoride Varnish (FV) is a preventive oral health service with proven effectiveness in reducing dental caries in dental and primary care settings. The objective of this study was to determine how long it takes to apply FV treatments during primary care well visits to address one of the most common barriers as reported by pediatricians – lack of time. FV treatment videos were collected at six clinics in Georgia, and rigorous time studies were conducted on each video to determine the standard time for the FV treatment process, the FV application component of the process, and the reasons for delays. Median standard times varied by clinic, ranging from 67.7 seconds to 166.9 seconds, with an overall median of 109.7 seconds. This results in, per FV application, labor costs of approximately $2.38 for pediatricians, $1.16 for registered nurses, and $0.53 for medical assistants. Findings from this study support the inclusion of FV applications as a common practice during primary care well visits.