Fluoride varnish application is an effective intervention in early childhood to prevent dental caries formation. Fluoride varnish can be applied readily in the primary care setting, and it offers an effective way to reach patients who may not have routine access to dental providers. Fluoride varnish should be applied twice a year to children up to age 6. This service is reimbursed by insurance plans. Changes in the billing process may have raised questions about who is eligible to provide fluoride varnish application in the office. For children on Medicaid managed care plans and most commercial plans, fluoride varnish application can be delegated to staff members who have received appropriate training. The Partners For Kids quality improvement (QI) coaching program has a project focused on helping practices incorporate this into their office workflow. Contact the Partners For Kids QI Coaching program at PFKQICoaching@NationwideChildrens.org if you are interested or have questions.