Fargo Cass Public Health presented a proposed fluoride‑varnish oral‑health program on July 12 designed to expand preventive dental care for disadvantaged populations in Cass County.

Larry Annison, director of Health Protection and Promotion, said the agency supports student practicum projects and introduced Jacob Schroeder, a master’s of public health student from North Dakota State University who is developing a fluoride‑varnish program, associated procedures and a sliding‑fee approach for uninsured patients.

Schroeder described the intervention as “a quick, safe and effective method to improve oral health,” noting that North Dakota Medicaid covers fluoride varnish. He said staff plan to offer varnish during existing clinic visits so patients receive prevention at the point of contact and to provide educational pamphlets; if patients decline, staff will not administer fluoride.

Schroeder presented state and county context: the U.S. Department of Health and Human Services recommends 0.7 milligrams per liter of fluoride in drinking water. He said North Dakota ranks among the top states for water fluoridation, with 21 of 53 counties having all public water systems fluoridated; Cass County has 31 public water systems, 26 of which are fluoridated and which serve about 99% of the county’s population, with an average fluoride level of roughly 0.65 mg/L.

He reviewed national and state evidence on varnish effectiveness, citing systematic reviews showing 25%–45% reductions in dental cavities with topical varnish use and noting safety reviews; Schroeder also acknowledged research discussing fluoride exposure thresholds (National Toxicology Program analysis) and explained that the recommended drinking‑water level (0.7 mg/L) is well below levels associated with adverse findings in those studies.

Board members asked practical questions: how the varnish would be described to children, how the mobile unit could reach rural and homeless populations, and whether partnerships with shelters and community agencies would be pursued. Schroeder and Annison said the program is in an early policy and procedure phase; they plan outreach to shelters and partner agencies and to integrate varnish services with Fargo Cass Public Health’s planned “wellness on wheels” van to reach rural residents.

Why this matters: oral health disparities disproportionately affect disadvantaged and rural populations; the program aims to increase preventive care access, especially for children and people with limited dental access.

Next steps: staff will finalize procedure and policy guidance for LPNs/RNs, pursue outreach and partnerships, and consider sliding‑fee implementation; no formal board vote was taken at this meeting.