Fluoride can now be applied by registered dental assistants, licensed practical nurses

Fluoride treatments to teeth are now legally allowed to be applied by more types of health professionals, under legislation signed late this week by Gov. Kathy Hochul.

Effective immediately, under a dentist's supervision, registered dental assistants and licensed practical nurses can also provide the treatment, a fluoride varnish, which helps prevent tooth decay and strengthens tooth enamel. Parents and guardians under the supervision of a licensed provider can also apply the treatment.

Previously, only dentists, dental hygienists, physicians, nurse practitioners, registered nurses, and physician assistants could apply the varnish. 

“Fluoride is scientifically proven to prevent cavities and protect our kids' teeth,” Hochul said in a news release Saturday. “As a mom, I know how difficult it can be to get an appointment at the dentist's office and how critical it is for our kids to maintain good oral hygiene."

The legislation passed in the spring. Her office didn't return an email seeking more information. 

The issue of fluoride has been in the news in the run up to the expected appointment of Robert F. Kennedy Jr. as President-elect Donald Trump’s health secretary. In contrast with the consensus of health professionals, Kennedy questions the efficacy and safety of fluorinating public drinking water. New York City water is fluorinated; Long Island’s isn’t. Jurisdictions have been fluorinating water since circa 1945; about three-quarters of the American population that is served by public water systems have access to fluorinated water, according to the U.S. government. 

Still, unlike in 14 U.S. states and over 50 countries such as Australia, the United Kingdom and New Zealand, nearly all dental procedures in New York must still be provided by a licensed dentist, according to Laura Brannon, a project manager who works with the National Partnership for Dental Therapy.

In those other jurisdictions, there is a mid-level practitioner called a dental therapist, who is licensed to provide care in some if not all settings to do certain procedures, such as applying fluoride, filling cavities, conducting exams and limited extraction of teeth, she said.

Critics say the status quo in places like New York drives up costs, leads to long waits and effectively denies care to those who can’t afford to pay. Dentist groups argue that allowing non-dentists to do more procedures jeopardizes patient health. They say that more dentists are needed, and there should be loan reimbursements for dentists who will work in public health or in a rural area.

About 68.5 million adults lack dental insurance, according to the 2023 State of Oral Health Equity in America survey by the CareQuest Institute. 

There are parts of the state in which two-thirds of the population live in high needs areas for oral health, according to a study published in July by the Center for Health Workforce Studies School of Public Health at the University at Albany.

By Matthew Chayes

matthew.chayes@newsday.comchayesmatthew

Matthew Chayes, a Newsday reporter since 2007, covers New York City.