Physicians and qualified personnel, including nurse practitioners, registered nurses, licensed practical nurses, physician assistants, and medical assistants, seeking to apply fluoride varnish to MassHealth children under the age of 21 are required to complete a MassHealth-approved training program.

Physicians and qualified personnel have the option of completing:

  1. a MassHealth-approved office-based training; or
  2. a MassHealth-approved self-administered Web-based training.

Physicians and qualified personnel must maintain proof of completion of the training (CME credit documentation or certificate - see below) and provide such documentation to MassHealth upon request.

MassHealth Training Options

MassHealth has approved the following training programs for physicians and qualified personnel to apply fluoride varnish to eligible MassHealth members:

Office-based Training

From the First Tooth, in collaboration with the MassHealth Dental program, provides training that uses the Smiles for Life curriculum (see below) and provides hands on training on the application of fluoride varnish and assistance with office flow and billing. One CME credit is available upon completion of the Smiles for Life training, as described below. To schedule training, contact Flor Piedrasanta, DentaQuest Outreach Coordinator/MassHealth Dental Program, or 617-886-1797.

Web-based Training

  1. The Smiles for Life, a National Oral Health Program (endorsed by the Society of Teachers of Family Medicine) (One CME credit is available through the American Academy of Family Physicians (AAFP) upon completion.)

    This is a web-based training program that includes an online course (Course 6 on the right hand side of the home page). No official application is necessary. Physicians and qualified personnel are expected to self-report only.
    • Upon completion of the training, participants must retain a copy of the Smiles for Life certificate of completion.
  2. The American Academy of Pediatrics (AAP) Oral Health Risk Assessment Training for Pediatricians and Other Child Health Professionals (one CME credit available)

    This training includes an online presentation and requires the completion of a post-presentation test to receive AAP CME credit.

For questions about either training modality, please contact Flor Piedrasanta, DentaQuest, Outreach Coordinator/MassHealth Dental Program at or 617-886-1797.


Implementing Fluoride Varnish in Your Office

Once on-line training is completed, physicians and qualified personnel may schedule an in-office visit with the MassHealth outreach coordinator to reinforce how to implement the use of fluoride varnish in your office and how to bill for the service. To schedule an in-office visit, contact the outreach coordinator directly at or 617-886-1797.


Additional Information and Resources for Using Fluoride Varnish in Your Practice

MassHealth Transmittal Letters

This information is provided by MassHealth.