The government’s latest consultation on NHS dentistry (July–August 2025) included one proposal that could directly affect dental nurses. It is not confirmed yet, but if taken forward, it could change how fluoride varnish is recognised under the NHS contract.
What the proposal says
The consultation sets out plans to create a new course of treatment for fluoride varnish in children that does not require a full dental examination. The suggested payment would be 0.5 UDAs, and the consultation says this would allow dental nurses to provide fluoride varnish between regular check-ups.
The proposal includes the following expected appointment schedule for children receiving fluoride varnish.
Table taken from the government consultation on NHS dental contract changes.
What this could mean in practice
If agreed, this would be the first time that fluoride varnish appointments delivered by dental nurses could generate UDAs on their own.
For practices, it could open the door to nurse-led fluoride clinics that run between check-ups. For children and parents, it could make it easier to get fluoride varnish at the recommended intervals, without being recalled for examinations.
What would stay the same
- Dental nurses would still need to work under a dentist’s prescription or direction.
- This would not introduce independent prescribing.
- If a child was already booked with a dentist for an examination, fluoride varnish would still be part of that Band 1 course of treatment, not claimed separately.
Important to remember
This is still only a proposal. Nothing has changed yet. The consultation closed on 19 August 2025, and DHSC will review feedback before making any decisions. If it is adopted, the changes could be introduced from April 2026.
Scope of practice
The General Dental Council (GDC) makes clear that dental nurses who have completed additional training can carry out fluoride varnish application. The GDC states that dental nurses may apply fluoride varnish “on prescription from a dentist or directly as part of a structured dental health programme”.
This means that the skill is already recognised within the professional scope of practice.
What is new is that the NHS contract could recognise fluoride varnish as its own course of treatment. This means dental nurses would be able to apply fluoride varnish in between dentist examinations at the recommended 3- or 6-month intervals, and those visits could be claimed separately at 0.5 UDAs.
So the change is not just about how UDAs are counted, but about creating space for dental nurses to deliver fluoride varnish at the right times without every appointment having to be tied to an exam.
In summary
The government is considering a new fluoride-only course of treatment for children, worth 0.5 UDAs, which could be provided by dental nurses between check-ups. It has not been agreed yet, but if it goes ahead, it would be a significant recognition of the preventative work that dental nurses carry out every day.
Resources
https://www.gdc-uk.org/docs/default-source/scope-of-practice/scope-of-practice.pdf
Accredited Fluoride Varnish Courses
Fluoride Course Comparison Chart