# 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 · 2020 · $430,890

## Abstract

Project Summary
Tooth decay is preventable, yet costly. Spending on dental treatment for children totaled $8.7 billion in 2013—
making it the fifth most costly child health condition. Preventive oral health services, like fluoride varnish, can
prevent tooth decay in young children. However, fewer than 50% of children have an annual dental visit, likely
due to cost, dentists’ reluctance to treat young children, and dental workforce shortages. To increase use of
preventive oral health services, private health plans and all state Medicaid programs now cover delivery of
fluoride varnish in medical offices to all children younger than 6 years. Existing evidence indicates that delivery
of fluoride varnish in medical offices increases utilization and reduces decay in publicly insured children.
Despite these benefits, few children receive fluoride varnish in medical offices. In 2014, only 5% of eligible
children received this service in Massachusetts. Prior studies to identify barriers and strategies have focused
on publicly insured children and relied on self-reported provider information, thus a new “big data” approach is
needed to identify provider, practice, community-, and policy-level factors affecting delivery of fluoride varnish
in medical offices. Our mixed-methods study will use Massachusetts All Payer Claims Dataset, which includes
both medical and dental claims for publicly and privately insured children, to (1) describe children receiving
preventive oral health services, (2) estimate the causal impact of mandatory medical coverage on children’s
receipt of preventive oral health services, (3) examine the mechanisms affecting delivery of preventive oral
health services in medical offices, and (4) use a qualitative positive deviance approach to identify strategies
and contextual factors promoting or deterring medical providers’ delivery of preventive oral health services.

## Key facts

- **NIH application ID:** 9971853
- **Project number:** 1R01DE028530-01A1
- **Recipient organization:** RAND CORPORATION
- **Principal Investigator:** Ashley Kranz
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $430,890
- **Award type:** 1
- **Project period:** 2020-08-14 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9971853

## Citation

> US National Institutes of Health, RePORTER application 9971853, Promoting children's oral health: Identifying provider-, practice-, and community-level characteristics associated with delivery of fluoride varnish in medical offices (1R01DE028530-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9971853. Licensed CC0.

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