Instructions for
Conducting the Fluoride
Rinse Program
West Virginia Department of Health and Human Resources
Bureau for Public Health
Office of Maternal, Child and Family Health
Oral Health Program
Children’s Dentistry Project
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Fluoride Rinse Program
Tooth decay, also called dental caries, is a public health problem because it is a disease which
is so widespread.
The battle against dental caries is never ending. Dental treatment provides an essential
defensive maneuver, but the procedure of choice is that of prevention. Prevention is more
effective over the long term and is unquestionably more economical.
Overwhelming evidence exists to prove the effectiveness of community water fluoridation.
Drinking optimally fluoridated water is not harmful to one’s health and is still the best way to
prevent tooth decay.
It is accepted by health care professionals that the most effective and least expensive way
to reduce dental decay on a group or community basis is through fluoridation of public water
supplies. In many cases, this practice is neither available nor possible. Alternatives for such
situations must be sought to derive the dental health benefits of fluoride. It has been
demonstrated that fluoride applied to the surfaces of teeth significantly increases resistance
to decay. Research studies and control programs by the National Institute of Dental
Research have established that weekly rinses with a 0.2 percent neutral sodium fluoride
solution can also decrease the incidence of dental caries by 35 percent.
Mouth rinsing with a 0.2 percent sodium fluoride solution in the schools has the following
distinct advantages:
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Little time is required for the procedure;
The technique is simple and easy to learn;
Few materials are needed;
Non-dental professional personnel with minimal orientation can easily supervise the
procedure;
The procedure can be administered with minimal interruption of a school’s academic
program.
The sodium fluoride oral rinse procedure is an effective caries prevention program which is
simple to execute, relatively inexpensive, adaptable to large numbers of children, and
complementary to existing professional dental programs.
The program is not intended to take the place of regular dental care and preventive
procedures in the private dental office. Actually, the program should promote the utilization
of dental services by promoting an awareness and concern for better dental health for the
children.
Since the mouth rinsing program will be voluntary, parent or guardian permission will be
required for a child to participate. Preference for the program will be given to:
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Areas with a non-fluoridated water supply;
Newly fluoridated areas;
Areas where the natural fluoride content in the water is inconsequential.
The mouth rinsing program is restricted to school grades one through six. However, the
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mouth rinsing program may be conducted in Kindergarten Classrooms as long as there is
adequate supervision of the children to assure that they do not swallow the rinse solution.
Materials and Supplies
All of the following supplies are provided free of charge by the Oral Health Program to
schools participating in the Fluoride Mouth Rinsing Program:
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Polyethylene bottles, 1500 ml volume;
Plastic dispensing pumps to fit the polyethylene bottles; each pump dispenses 10 ml per
stroke;
Sodium fluoride neutral solution- 0.2 percent;
Disposable cups-size three to four ounces;
Paper towels.
Note: Supplies will be shipped via UPS in cardboard boxes. When storing these supplies, it is
recommended that the boxes be placed in tightly sealed plastic bags to avoid insect
infestation.
Weekly Supplies for Each Participating Student
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10 ml. of 0.2 percent neutral fluoride solution;
One paper cup, 3 to 4 ounce size-broad base;
One paper towel.
Program Procedure
1.
In each school, it is important that only one person, namely the principal, a teacher or
a business office employee, be given the responsibility for the distribution of the oral
rinse supplies to the classrooms and for their proper and safe storage when they are
not in use. Sodium fluoride powder is not usually stored at schools, but when it is, the
plastic or paper packets containing the fluoride should be stored in a safe place under
lock and key. The packets must never be accessible to students or unauthorized
individuals. Large dosages of sodium fluoride are considered to be toxic.
As the 30-week oral rinse program progresses, it will be the weekly duty of the
appointed person to distribute a sufficient number of pre-filled containers to each
participating classroom. Empty containers with attached caps and dispensing pumps
should not be discarded. They should be retained for program use the following year.
2.
Orientation sessions for teachers, teacher’s aides, parent-volunteers, etc., may be
conducted by the Oral Health Program staff or by previously trained personnel.
3.
Parental Information/Permission Forms are to be sent home with each student. The
“Parent Information/Permission Form” is located in the back of this brochure and
should be duplicated as needed, based upon student enrollment. A date is to be
designated for the return of the forms, preferably one or two days after the forms
are sent to the homes. Teachers should encourage children to return the forms on the
designated day.
Teachers are to conduct the mouth rinsing sessions once a week and on the same day
4.
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of each week. The sessions are to be executed only on the designated day. There is
to be no rescheduling of mouth rinse sessions if a holiday or some other intervention
causes a session to be omitted on the designated day. By the same token, there will
be no make-up sessions for individual students who may be absent during a scheduled
session.
5.
The mouth rinse solution will be dispensed in appropriate plastic containers. The supply
of solution will be stored under the control of each teacher or under the supervision of
the school’s business office, to be delivered as needed to each classroom on the day
designated for the session. It is recommended that the mixed fluoride be stored in a
refrigerated area. Dispensation of the other supplies, e.g., fluoride and cups and
towels will be on the same pattern basis.
6.
A cup and a paper towel will be provided for each participating student for each weekly
mouth rinse session.
7.
At each session, each participant will be given 10 milliliters (exact dosages will be
dispensed by one stroke of a pump-plunger on the container) in the cup.
8.
Rinsing with the solution:
a.
Before each rinsing, the children should be reminded that at no time during the
procedures should the solution to be swallowed.
b.
At a previously designated signal given by the teacher, the participating
children empty the contents of their cups into their mouths. Starting
simultaneously, they “swish” the solution for 60 seconds with their lips tightly
closed and their upper and lower teeth in contact. A watch or clock with a
sweep-second hand is recommended to time the rinsing.
c.
After one minute of rinsing, all participants are to spit out the mouth rinse
solution back into the cups.
d.
The paper towel is used to wipe the mouth and then stuffed into the paper cup
with spit.
9.
In order to realize maximum results from the oral rinse procedure, if feasible,
students are instructed not to eat or drink for a period of at least 30 minutes
following rinse participation.
10.
It is important that the teacher visually observe the remaining quantity of solution in
the container and make certain to ask the “container supervisor” for a refill at the
appropriate time.
11.
The filled container of mixed fluoride and tap water must be discarded after three
weeks. Never use the mixed solution after three weeks-discard it and mix a new
solution when needed. Refrigerate the unused fluoride solution in between weekly
rinsing sessions.
Note: The leftover solution will taste fresher longer, if stored in a cool place or
refrigerator.
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Important
I.
Do not discard the Fluoride Rinse Program Classroom Treatment Record. Please record
the number of students enrolled in the class and the program. Forms will be collected
after completion of the school year.
II.
Please do not discard empty bottles, caps and pump-plungers. They should be
collected by the end of the school year and be cleaned and stored for use the
following year.
First Aid Measures
Eye contact:
Flush eye with large amounts of water for 15 minutes. If irritation persists,
contact the Poison Control Center at 1-800-222-1222, or doctor.
Skin contact: Wash area with water.
Ingestion:
Drink milk to relieve GI symptoms. If an amount is ingested that is greater
than the prescribed dose, seek medical advice or call the Poison Control Center
at 1-800-222-1222.
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FLUORIDE MOUTH RINSE PROGRAM
Additional Instructions for Teachers
The purpose of this program is to make available to the children in your class the benefits of
topical fluoride for achieving a reduction in the incidence of dental decay. You are urged to
follow the procedures listed below to achieve maximum effectiveness.
1. Distribute Parental Information/Permission Forms to each child in your class at the
beginning of the school year.
2. Urge children to return forms within two or three days. Please follow-up on those
children who do not return forms.
3. Follow routine described under Program Procedure.
4. Record participation numbers on the Fluoride Rinse Program Classroom Treatment
Record Form according to instructions: (The form is found in the back of this
instructional manual and may be reproduced as needed.)
a.
Complete information pertaining to school, grade, county, teacher, school year,
number of students enrolled, etc.
b.
On designated day, starting with first session, indicate record of participation
by following instructions on the form.
5. Turn the record sheets in at the end of the 30-week program to office personnel so
that they may be collected by your county’s program coordinator. If you have any
questions, please contact us at the address or telephone number below. These record
sheets must be sent to the following address by your county’s program coordinator:
West Virginia Bureau for Public Health
Office of Maternal, Child and Family Health
Oral Health Program/Children’s Dentistry Project
350 Capitol Street, Room 427
Charleston, West Virginia 25301-3714
Telephone: (304) 558-5388
Toll-free: 1-800-642-8522 or 1-800-642-9704
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FLUORIDE RINSE PROGRAM
CLASSROOM TREATMENT RECORD
TEACHER____________________________ COUNTY________________________
GRADE______________________________ YEAR___________________________
SCHOOL______________________________________________________________
Check or initial the weeks your class participated. Date is optional.
Month
First
Week
Second
Week
Third
Week
Fourth
Week
Fifth
Week
September
October
November
December
January
February
March
April
May
Total number of students enrolled in your class this year ________________________
Total number of students enrolled in the rinse program this year __________________
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FLUORIDE RINSE PERMISSION FORM
Dear Parents:
The _______________________ County Public School System, in cooperation
with the West Virginia Department of Health and Human Resources, Bureau for Public
Health’s Children's Dentistry Project, is providing a school-based program concerned
with the prevention of dental decay. Participation in the program is open to children in
grades kindergarten through sixth in the county.
The Fluoride Rinse Program will require your child to perform a weekly rinse with
an 0.2 percent neutral sodium fluoride solution. This procedure has been shown to
reduce the number of new cavities 35 percent when it is implemented regularly. The
children rinse the solution around and between their teeth for 60 seconds during each
rinse. This dental decay prevention program is being provided for your child's benefit
this school term and will continue through the sixth grade.
Participation is voluntary and entirely without cost. You may withdraw your child
from the program at any time. We encourage you to allow your child to participate in
this valuable school preventive dental health project. On the form below, please
indicate and sign whether or not your child may participate. Whatever your indicated
desire, you are urged to continue the personal and professional dental hygiene
recommended for your child by your dentist.
---------------------------------------------------------------_____ I would like for my child to participate in the Fluoride Rinse Program.
_____ I do not want my child to participate in the Fluoride Rinse Program.
Name of Child____________________________________________ Age__________
Name of School__________________________________________ Grade________
Name of Homeroom Teacher________________________________ Date_________
Signed________________________________________________________________
Signature of Parent or Legal Guardian
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