Off-campus South Dakota State University users: To download campus access theses, please use the following link to log into our proxy server with your South Dakota State University ID and password.

Non-South Dakota State University users: Please talk to your librarian about requesting this thesis through interlibrary loan.

Document Type

DNP - University Access Only

Award Date


Degree Name

Doctor of Nursing Practice (DNP)


Graduate Nursing

First Advisor

Linda Burdette


Bright Futures, primary care providers, fluoride varnish, pediatrics, early childhood caries, educational seminar, access to care


Objective: Early childhood caries are the most common chronic health condition among children, and are completely preventable with good oral health measures (SDDOH, 2014). Access to dental health is problematic for underserved and rural children. The goal of this project was to improve the knowledge and attitudes of primary care providers (PCPs) to promote the use of oral health assessment, anticipatory guidance, referral, and preventive oral health services as part of their well-child care (WCC) practices.
Methods: Providers participated in an educational seminar, based on the Bright Futures Oral Health curriculum. PCPs completed a pre-test knowledge and confidence survey before participating in the education, and then after the seminar completed the identical post-test surveys to determine if there was an increase in confidence and knowledge. PCPs as well as ancillary staff were given a demonstration, prior to distributing the fluoride varnish for use, to properly explain best practices to applying the fluoride varnish. Impact from education on knowledge and confidence was statistically analyzed using the paired t-test, McNemar’s, and Sign tests. Clinical significance was measured using a CPT code review to determine if gained knowledge translated into a practice change based on the number of times PCPs billed for fluoride varnish application.
Results: A total of 11 participating PCPs completed both pre- and post-tests and participated in the educational seminar. Eight weeks after the intervention, the providers displayed statistically significant results in both their confidence and knowledge relating to oral health concepts. The CPT code review revealed in the eight weeks post-intervention 32, CPT codes were billed for fluoride varnish application, proving clinical significance.
Conclusions: Bright Futures Oral Health Curriculum was effective in increasing the confidence and knowledge of pediatric oral health concepts. When delivered in a seminar environment along with a demonstration on proper technique in applying fluoride varnish, the curriculum promoted improved confidence and knowledge scores that translated into a practice change to include oral health into WCC. PCPs are effective at helping bridge the gap between underserved children and oral health care.

Library of Congress Subject Headings

Children -- Dental care
Dental Public health
Health education -- South Dakota
Mouth -- Care and hygiene
Teeth -- Care and hygiene


Includes bibliographical references (pages 86-92)



Number of Pages



South Dakota State University


In Copyright - Educational Use Permitted