Skip to main content
Back To Top Top Back To Top
This website publishes administrative rules on their effective dates, as designated by the adopting state agencies, colleges, and universities.

Rule 5160-4-33 | Application of topical fluoride varnish by non-dentist providers.


(A) Payment may be made not more frequently than once per one hundred eighty days for the topical application of fluoride varnish to the teeth of a child younger than six years of age by any of the following practitioners:

(1) A physician;

(2) A physician assistant; or

(3) An advanced practice registered nurse.

(B) As part of the application of fluoride varnish, a practitioner provides three related services:

(1) An oral assessment for the identification of obvious oral health problems and risk factors, which may be omitted if an oral assessment is conducted or has been conducted during an early and periodic screening, diagnostic, and treatment (EPSDT) visit;

(2) Communication with the parent or guardian about the fluoride varnish procedure and proper oral health care for the child; and

(3) If the child has obvious oral health problems and does not have a dental provider, referral to a dentist or to the county department of job and family services.

(C) Payment for the application of fluoride varnish is made separately from payment for a well child visit or a sick child visit.

Last updated May 1, 2021 at 9:03 AM

Supplemental Information

Authorized By: 5164.02
Amplifies: 5164.02
Five Year Review Date: 5/1/2026
Prior Effective Dates: 7/1/2006, 12/31/2012 (Emer.), 3/28/2013, 1/1/2016