|Title:||Administration of Fluoride Varnish by Non-Dental Practitioners|
|Document ID:||Operational Directive OD 0667/16|
|Date of issue:||Wednesday, 6 April 2016|
|Description:||The Operational Directive for Administration of Fluoride Varnish by Non-Dental Practitioners aligns with the Poisons Act 1964 and the Poisons Regulations 1965, and intends to provide guidance on the authority scope of non-registered dental practitioners with the handling of fluoride in the context of the Fluoride Varnish Program.|
|Applicable to:||Stakeholders of the Fluoride Varnish Program, including:
- Aboriginal Health Workers, School Health Nurses, Child Health Nurses and Remote Area Nurses
- Dental practitioners
- Contracted training provider: Central Institute of Technology
- Aboriginal Medical Services
|Period of effect:||from 8 March 2016 to 8 March 2026|
|Review date:||31 January 2017|
|Authorised by:||Dr D.J. Russell-Weisz, Director General, Department of Health WA, 04-Mar-2016|
|Print version:||View print version|
Administration of Fluoride Varnish by Non-Dental Practitioners
The Operational Directive for Administration of Fluoride Varnish by Non-Dental Practitioners aligns with the Poisons Act 1964 (the Act) and the Poisons Regulations 1965, and intends to provide guidance on the authority scope of non-registered dental practitioners with the handling of fluoride in the context of the Fluoride Varnish Program.
This Operational Directive follows the establishment of the Fluoride Varnish Program; an initiative that forms part of the Improving Ear, Eye and Oral Health of Children in Aboriginal Rural and Remote Communities (EEO Project).
Aboriginal children have higher levels of dental decay in both their deciduous and permanent teeth compared to their non-Aboriginal counterparts. Additionally Aboriginal children aged 5 years and under have almost one and a half times the rate of hospitalisation for dental related care as compared to other Australian children. This figure is further increased when factoring in geographic remoteness [i].
The oral health component of the Improving Ear, Eye and Oral Health Initiative includes the oral health assessment/referral, anticipatory guidance and the implementation of a fluoride varnish program.
Fluoride varnish is a valuable tool in the prevention of dental decay in both deciduous and permanent teeth. Studies have demonstrated a 25 – 45% reduction in the decay rate with the use of fluoride when applied 6 monthly.
Application of fluoride varnish by non-dental practitioners is not a new concept, with child health personnel within public health programs in Europe and North America applying fluoride varnish for a number of years [ii].
3. Fluoride varnish
Fluoride is classified as a Scheduled poison in the Standard for the Uniform Scheduling of Medicines and Poisons (SUSMP).
Fluorides for human use are exempt from SUSMP scheduling in preparations for supply to dentists or when approved by an appropriate authority, which includes approval by the CEO.
On 24 October 2014, the Director General of Health approved the administration of fluoride varnish - trade name: Duraphat® (Colgate), a 5% solution of fluoride in a resin and ethanol base - by Aboriginal Health Workers, School Health Nurses, Child Health Nurses and Remote Area Nurses under the agreed eligibility and conditions outlined in the chain of custody and authority scope below.
The approval relates to the personal administration of the varnish by the authorised person only and does not extend to further supply or fluoride products in any other manner or for any other purpose.
3.1 Eligibility to obtain, possess and administer Duraphat® for non-dental practitioners
The following criteria must be met by the above-mentioned non-registered dental practitioners in order to administer Duraphat®:
3.2 Duraphat® chain of custody
The table below outlines the chain of custody that tracks the journey of Duraphat® in line with the above-mentioned CEO Approval (24 October 2014) and Duraphat® Safety Data Sheet.
3.3 Authority Scope
The table below summarises the authority scope of handling Duraphat® in the context of the Fluoride Varnish Program. This takes in consideration the poison chain of custody and the CEO approval for non-registered dental practitioners to administer fluoride varnish.
It is the responsibility of the individual health professionals to ensure compliance with the above conditions and all the aspects of the Western Australian Poisons Act 1964 and 1965 Regulations when handling Duraphat®. If health professionals don’t comply with the requirements of the Fluoride Varnish Program, they will be subject to the controls of the Poisons legislation.
Definitions used in this document
[i] Jamieson et al. 2007, Shearer & Jamieson 2012
[ii] Northern Territory Government 2011
Dr D.J. Russell-Weisz
This circular last updated: Wednesday, 6 April 2016 at 2:23pm