Fluoride Varnish Standard of Care

  • The United States Preventive Services Task Force (USPSTF) in 2014 recommended that primary care clinicians apply fluoride varnish to the teeth of all infants and children, starting with the appearance of the first primary tooth through age 5, at least every 6 months. USPSTF recommendations were reaffirmed in 2021
    • Recommendation applies to ALL children; no longer a risk-based recommendation
    • Assigned a "B" grade recommendation
  • All children should receive a professional fluoride treatment at least every 6 months in the primary care medical home.
  • Higher risk children should receive fluoride varnish application every 3 months.
  • Though helpful for reducing caries, varnish is not a replacement for appropriate diet, regular brushing, indicated systemic fluoride supplements, or routine dental care.


U.S. Preventive Services Task Force Recommendation Statement. Prevention of Dental Caries in Children from Birth Through Age 5 Years. May 2014. www.uspreventiveservicestaskforce.org/uspstf/uspsdnch.htm

Chou R, Pappas M, Dana T, Selph S, Hart E, Schwarz E. Screening and Prevention of Dental Caries in Children Younger Than Five Years of Age: A Systematic Review for the U.S. Preventive Services Task Force. Evidence Synthesis No. 2102. AHRQ Publication No. 21-05279-EF-1. Rockville, MD: Agency for Healthcare Research and Quality; 2021.

Clark MB, Keels MA, Slayton RL; AAP Section on Oral Health. Fluoride use in caries prevention in the primary care setting.  SECTION ON ORAL HEALTH. Pediatrics. 2020; 146 (6).