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School Name If your child is enrolled in Health Smiles Ontario please include the HSO M/F DOB day/month/year Phone please print Address Postal Code Does your child have any allergies Yes No PLEASE LIST Has your child been diagnosed with Asthma Yes If your child has asthma do they require asthma medication daily Please note if your child has asthma and requires or any bronchodilators they need to have these medications at the school on the day of the fluoride varnish application. I consent to...
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How to fill out school fluoride varnish program

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How to fill out school fluoride varnish program

01
Start by gathering all the necessary supplies such as fluoride varnish, disposable gloves, applicator brushes, bibs, and patient consent forms.
02
Ensure that you have a designated area to perform the fluoride varnish program, such as a dental office or school clinic.
03
Obtain the necessary permission and support from the relevant authorities, such as the school administration or parents/guardians.
04
Prior to the program, educate the students and their parents/guardians about the benefits of fluoride varnish and address any concerns or questions they may have.
05
On the day of the program, set up the designated area with the required supplies and ensure proper infection control measures are in place.
06
Have the students sit comfortably and explain the procedure to them in a child-friendly manner, emphasizing the importance of keeping their mouths open during the process.
07
Wear disposable gloves and use applicator brushes to apply a thin layer of fluoride varnish to the surfaces of the students' teeth. Make sure to cover all tooth surfaces, including the back molars.
08
Allow the fluoride varnish to set for the recommended time, usually a few minutes.
09
Once the set time has elapsed, instruct the students to avoid eating or drinking for at least 30 minutes to allow the fluoride varnish to fully penetrate the teeth.
10
Provide each student with a bib to wipe off any excess varnish and ensure their comfort before they leave the designated area.
11
Maintain accurate records of each student treated and follow up with any necessary documentation or reports as required.
12
Regularly evaluate the effectiveness of the school fluoride varnish program and make necessary adjustments or improvements to ensure optimum oral health benefits for the students.

Who needs school fluoride varnish program?

01
School fluoride varnish programs are beneficial for children and adolescents who are at a higher risk of developing tooth decay.
02
Children from low-income families or those with limited access to regular dental care can greatly benefit from school fluoride varnish programs.
03
Students who have a history of dental cavities or are prone to tooth decay should participate in a school fluoride varnish program.
04
Schools in areas where the community's water supply does not have sufficient fluoride levels may consider implementing a fluoride varnish program.
05
The program can also be beneficial for children with developmental disabilities who may require additional dental care support.
06
Parents or guardians who are interested in providing their children with additional preventive dental care may opt for the school fluoride varnish program.
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The school fluoride varnish program aims to prevent tooth decay in children by applying fluoride varnish to their teeth.
Dentists or dental professionals who provide fluoride varnish treatments in schools are required to file the program.
The program can be filled out by providing information on the number of students treated, dates of treatment, and any adverse reactions.
The purpose of the program is to improve dental health in children and reduce the risk of tooth decay.
Information such as the number of students treated, dates of treatment, and any adverse reactions must be reported on the program.
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