Formal Research Proposal

To: Dr. Erika Paterson

From: Helene Tran

Date: October 17, 2021

Subject: Proposal for expanding the ‘Lift the Lip’ fluoride varnish program

Introduction

‘Lift the Lip’ is a fluoride varnish program offered by Interior Health. It is a free program that is available for children 12-47 months of age and provides preventative education and fluoride varnish applications for children that meet the eligibility requirements. Currently, children are referred to the program through public health nurses, dental offices, and self-referrals.

Fluoride is commonly used in dentistry to prevent cavities by strengthening enamel, which is the outer layer of the teeth. When bacteria in the mouth break down sugar and carbohydrates, they produce acids that remove minerals in the tooth enamel. This loss of minerals is called demineralization. Weakened tooth enamel leaves teeth vulnerable to bacteria that can cause cavities. Therefore, fluoride helps to re-mineralize tooth enamel, which can prevent cavities and reverse early signs of tooth decay. As a result, fluoride varnish applications can help to prevent early childhood caries (cavities).

Statement of Problem

Early childhood caries (ECC) is a complex and multifactorial chronic disease that is influenced by diet, bacteria, and social determinants of health. The disease is infectious, transmissible, diet-dependent, and may progress rapidly. It has a lasting detrimental impact on both baby and adult teeth. In fact, ECC is the most common childhood disease and dental surgery for ECC under general anesthesia is the most common day surgery procedure at most pediatric hospitals in Canada. Some of the potential consequences of ECC are acute and chronic pain; interference with the child’s eating and sleeping; tooth loss and misaligned teeth; increased expenses for dental care throughout life; and compromise of general health. The prevalence of ECC in Canadian preschool children is a growing concern.

Proposed Solution

The proposed solution is to expand the ‘Lift the Lip’ fluoride varnish program to include daycares and preschools. ‘Lift the Lip’ is currently available to children 12-47 months of age; however, the referral sources are limited. By offering the program to more locations and facilities, the program will be able to garner increased attention and hopefully, this will entice families to participate. More parents will have access to oral health information and more children will have the opportunity to have fluoride varnish applied, which will ultimately lower the overall risk of ECC.

Scope

To assess the feasibility of the proposed solution, I plan to write a report to Michael McAuley, the Allied Health Manager at Interior Health, analysing the current ‘Lift the Lip’ program and providing recommendations for improvement. The report will address the following inquiries:

1. What are the positive points and negative points of expanding the ‘Lift the Lip’ program?
2. What are the costs and additional resources needed to expand the program?
3. How will the program expansion lead to significant results?

Methods

One of the primary sources of data would be to distribute surveys to parents of children attending daycare and preschool to gauge the interest in expanding the fluoride varnish program. Interviews from staff would also service as primary sources of data. Secondary sources of data include research papers studying and comparing fluoride efficacy in reducing ECC and reference to publications regarding the effectiveness of fluoride varnish programs.

My Qualifications

I am in my first year of the Bachelor of Science in Dental Sciences (Dental Hygiene) degree completion program, and as a registered dental hygienist and an Interior Health employee, I believe that I am well versed on ECC, the effects of fluoride and the fluoride varnish program.

Conclusion

Cavities are the most common chronic childhood disease in Canada, with more than 50% of children between the ages of 6 to 11 having had a cavity. Cavities are also increasing in toddlers between the ages of 2 to 4 years. Prevention is a key component to reducing the risk of ECC. Therefore, providing more resources such as oral health education and fluoride varnish programs will help to achieve this goal.