Date of Award


Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Nola A. Schmidt


The most common chronic disease in childhood is dental caries and is more prevalent than asthma and hay fever (HHS, 2000). Data show that in the United States from 2011-2014, 24% of children aged 2-5 years had experienced dental caries in their primary teeth, with 11% having untreated caries (Dye et al., 2017). Primary care clinicians have an important role to play in promoting children’s oral health as much as dentists because they have more contact with children. The purpose of this evidence-based practice project was to integrate an evidence-based oral health program for children in a pediatric primary care practice. A comprehensive literature search utilizing 6 databases and hand search yielded 14 relevant articles. The articles were appraised for quality using the Johns Hopkins Nursing Evidence-Based Practice Research and Non-Research appraisal tools and level of evidence using The Melnyk and Fineout-Overholt’s (2015) Hierarchy of Evidence for intervention questions. The participants of the project comprised of 80 children aged from 6-months up to 6 years old received preventive oral health care services over a 3-month time. Interventions included: a) caries risk assessment, b) application of fluoride varnish, c) caregiver education, and d) referrals to a dentist for establishment of dental home and care for children at risk of developing dental caries. The Health Belief Model (Hochbaum, Kegels, & Rosenstock, 1952) and the Iowa Model Revised (Iowa Model Collaborative, 2017) were used to guide the project. Primary outcomes were fluoride varnish application rate, dental referral success rate, and adherence by caregivers to oral health recommendations. Data were collected using a questionnaire and will be analyzed. Implications of this project for practice will be discussed.