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Dental caries, also known as tooth decay, is the most common chronic disease in children and five times more common than childhood asthma (Bernstein et al., 2016; Clark et al., [...], Objective: Fluoride varnish (FV) application is now considered standard preventative care in all pediatric primary care clinics. The American Academy of Pediatrics (AAP) recommends FV application for all children, regardless of risk, starting at tooth eruption and continuing until age 5 years. The objective of this quality improvement (QI) project was to incorporate an evidence-based, multifaceted workflow to provide oral health risk assessments (OHRAs) into well-child visits, more specifically, education and screening for all children starting at age 6 months until age 5 years to improve rates of preventative FV application. Methods: A quality gap was identified during a six-month retrospective data collection in FV application rates. The Knowledge-to-Action Model was used to translate an evidence-based, multifaceted workflow into clinical practice to standardize OHRA documentation, oral health education, and FV application. Results: A total of 122 well-child visits for children aged 6 months to 5 years occurred from January 2022 to June 2022. From a preintervention baseline of 0% for screening, oral health examination, and FV, postintervention data showed 110 patients (92%) were identified and screened by the nurse, 107 patients (90%) were documented to have an oral examination by the provider, and 109 patients (91%) received oral health education. Of the 122 well-child visits that qualified, 70 patients (91%) received FV. The total reimbursement rate through Medicaid was $1,275.00. Conclusion: Improving FV rates in a pediatric primary care is sustainable because oral health can be incorporated into practice through an evidence-based workflow. Keywords: Fluoride, dentistry, oral health, quality improvement.