# Promoting children's oral health: Identifying provider-, practice-, and community-level characteristics associated with delivery of fluoride varnish in medical offices

> **NIH NIH R01** · RAND CORPORATION · 2022 · $416,857

## Abstract

Project Summary
Low rates of dental visits among populations that experience health disparities contribute to the substantial
disparities observed in children’s oral health—with worse oral health observed among children in low-income
households and Black and Hispanic children. To increase use of preventive oral health services, the US
Preventive Services Task Force recommends that medical providers apply fluoride varnish to the teeth of all
children aged 5 years and younger. Private health plans and all state Medicaid programs cover this primary
pediatric preventive service without cost-sharing. Existing evidence indicates that delivery of fluoride varnish in
medical offices increases utilization and reduces decay. Despite these benefits, few children receive it. Our
parent grant (NIDCR R01-HS027994-02), funded from 08/14/20 to 05/31/24, aims to identify child, provider,
practice, community-, and policy-level factors affecting delivery of fluoride varnish in medical offices in
Massachusetts. In response to Notice of Special Interest: Administrative Supplements to Support Research on
Preventive Interventions with Populations that Experience Health Disparities (NOT-OD-22-159), we propose to
enhance the existing aims of our parent grant by examining racial and ethnic disparities in receipt of fluoride
varnish. We will enhance Aim 1 to describe rates of children receiving fluoride varnish in medical settings by
race/ethnicity and to determine whether differences by race/ethnicity result from where a child receives care
versus children from different racial/ethnic groups receiving different care from the same provider. We will also
enhance Aim 3 to examine the association between measures of structural racism (i.e., racialized economic
segregation and residential segregation) and rates of children receiving fluoride varnish in medical settings.
Our research team is well-suited to complete this work without 12 months because we have existing programs
that can be used for the analysis of the Massachusetts Medicaid data (Aim 1) and because the dataset for Aim
3 has already been obtained and cleaned. This proposal will allow our highly successful interdisciplinary team
to expand our work by examining if there is inequitable access to a primary preventive service that reduces
dental caries across racial/ethnic groups and across communities impacted by racism. These are issues that
we would otherwise not have the resources to address. This innovative and timely supplement has the
potential to inform where to prioritize additional resources to increase receipt of preventive oral health services.

## Key facts

- **NIH application ID:** 10673452
- **Project number:** 3R01DE028530-03S1
- **Recipient organization:** RAND CORPORATION
- **Principal Investigator:** Ashley Kranz
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $416,857
- **Award type:** 3
- **Project period:** 2022-09-15 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10673452

## Citation

> US National Institutes of Health, RePORTER application 10673452, Promoting children's oral health: Identifying provider-, practice-, and community-level characteristics associated with delivery of fluoride varnish in medical offices (3R01DE028530-03S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10673452. Licensed CC0.

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