Implementation of Fluoride Varnish Application and Education in an Otolaryngology Clinic: Feasibility and Acceptability Study

Tuesday, October 14, 2025

8:30 AM - 8:36 AM EDT

Location: 128

Disclosure(s):

Megan L. Durr, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Mary Jue Xu, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Dental care after radiation therapy is crucial in preventing serious sequelae of head and neck cancer (HNC), but access to dental care is a significant barrier for patients. Our program integrates preventative dental care into HNC post-treatment surveillance by implementing fluoride varnish application and education in an otolaryngology-head and neck surgery (OHNS) clinic. We aim to characterize acceptability, appropriateness, and feasibility of the intervention.

Methods: From September 2024 to January 2025, we prospectively enrolled adult HNC patients of an urban, safety net hospital at routine surveillance visits. Inclusion criteria were prior or ongoing radiation therapy, dentition, and no access to routine dental care. In alignment with American Dental Association recommendations, patients were administered fluoride varnish by an OHNS health care provider at visits every three to six months. A 9-item modified Acceptability, Appropriateness, and Feasibility Intervention Measures questionnaire (AIM-IAM-FIM) was given to patients after fluoride application and education. Education consisted of a video on radiation side effects and oral health management. A 4-item modified AIM-IAM-FIM was given to medical assistants, a nurse practitioner and a physician assistant. The primary outcome was patient and staff acceptability, appropriateness and feasibility of integrated fluoride varnish and education.

Results: Modified AIM-IAM-FIM was given to 15 patients and seven OHNS staff members. Fluoride treatment was acceptable, appropriate and feasible in 83%, 87%, and 86% of patients respectively. Fluoride education was acceptable, appropriate and feasible in 82%, 85%, and 92% of patients respectively. Fluoride treatment was acceptable, appropriate and feasible in 86%, 100%, and 100% of providers respectively. Fluoride education was acceptable in 100% of providers.

Conclusions: Preventative fluoride varnish application and dental education during HNC surveillance is a novel model of care and was found to be highly acceptable, appropriate and feasible from the perspective of patients and providers.

Presenting Author(s)

KJ

Kennedy N. Johnson, BS

Student
University of California, San Francisco
Philadelphia, PA, United States

Disclosure information not submitted.

Co-Author(s)

Shauna A. Brodie, RN, MS, FNP

Nurse Practioner
Zuckerberg San Francisco General Hospital
San Francisco, CA, United States

Disclosure information not submitted.
Alyssa M. Civantos, MD, MS

Resident Physician
University of California - San Francisco
San Francisco, CA, United States

Disclosure information not submitted.
YP

Yogin Patel, DMD

University of California, San Francisco, United States

Disclosure information not submitted.
Alonn Ilan, RN, CNS-BC

Nurse Manager
Zuckerberg San Francisco General Hospital
San Francisco, CA, United States

Disclosure information not submitted.
SL

Su Li, RN

Zuckerberg San Francisco General Hospital, United States

Disclosure information not submitted.
Yasmin Eltawil, BS

Medical Student
UCSF
San Francisco, CA, United States

Disclosure information not submitted.
YA

Yousef Alqasieer, BS

University of California, San Francisco, United States

Disclosure information not submitted.
Megan L. Durr, MD

Professor
University of California - San Francisco
San Francisco, California, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
LR

Lori R. Ross, PA

Physician Assistant
University of California, San Francisco
san Francisco, CA, United States

Disclosure information not submitted.

Senior Author(s)

Mary Jue Xu, MD

Assistant Professor
University of California - San Francisco
San Francisco, California, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.