Costing the scale-up of a national primary school-based fluoride varnish program for aboriginal children using dental assistants in Australia

There is good evidence that fluoride varnish programs are effective in preventing dental caries in children. This study aims to provide a costing for the scale-up of a child fluoride varnish program in New South Wales (NSW), Australia. Most child fluoride varnish programs are school-based, and a number of studies have examined the acceptability and cost effectiveness of using non-dental providers to apply the fluoride varnish. This paper describes the number of primary schools in Australia that could be targeted using a standard population-based risk criteria based on published data. A costing method was developed for various scenarios of school enrolment and provider types, along with potential revenue from the Child Dental Benefits Schedule (CDBS). Most of the costs of a school-based fluoride varnish program can be covered by the CDBS with assumptions of 80% child consent and 75% CDBS eligibility. While the scale-up of child fluoride varnish programs to prevent dental caries has been recommended by numerous strategic plans and reports, particularly for Aboriginal and Torres Strait Islander children, limited progress has been made. This paper concludes that using a standardized criteria for targeting schools using a combination of ICSEA and Aboriginal enrolments, and aiming at four applications a year, is feasible, and that the main costs of the program could be covered by using the CDBS.