Dental – School fluoride varnish programme form

• Please read the whole form, complete your child’s details/answer all the medical questions and sign it at the bottom before it will be submitted.
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What is the a school fluoride varnish programme?

This programme aims to help prevent tooth decay in young children. Tooth decay is still very common in children and it can cause pain, stop children from eating, speaking, sleeping and also learning properly at school. The Department of Health (please see the 'delivering better oral health' document on the government website) recommends that fluoride varnish is applied at least twice a year to protect teeth.

What is fluoride varnish?

Fluoride varnish is a pleasant-tasting sticky protective coating which is easily painted on teeth. The golden coating releases fluoride which strengthens teeth, helps prevent tooth decay and can also stop decay in its early stages. The coating disappears by the next day.

What happens after the coating is applied?

The school will ensure that your child has nothing to eat or drink for 30 minutes after the coating is applied.  Your child’s teeth may be a light yellow colour for the rest of the day - this is nothing to worry about as they will soon return to their normal colour. Please do not brush your child’s teeth on the evening they have the coating applied.

Additional Information

• Please ensure your child has breakfast on the day of the varnish application.
• The fluoride coating contains ethanol - a form of alcohol - and has been approved for medicinal use by the Islamic Shari’ah Council (your school has a copy of this approval) and by Rabbi Adler.
• After a quick look, we will let you know if we notice any problems in your child’s mouth. However, this is not a dental check-up – your child still needs to have regular check-ups by a dentist outside school (see nhs.uk/service-search/find-a-dentist for a local dentist).
• Please note the fluoride varnish is vegetarian and not vegan.

If your child cannot have the coating we will let you know why.

If you have any questions regarding the fluoride coating or the school visit please contact our please contact the Dental Outreach Team on 0300 013 2053 for Newham schools, 0300 013 2055 for Hackney and Tower Hamlets schools, or 0300 013 2051 for Redbridge, Barking and Dagenham, Havering and Waltham Forest schools.