Early childhood caries (ECC) is the most prevalent chronic disease in Latin America, affecting 60-95%. ECC is associated with high risk for caries in permanent teeth, pain, chronic infection, and impaired development. In Roatán, Honduras by age 2, more than 60% of the children have dental caries. Preventative measures such as oral health education and fluoride varnish (FV) application can significantly reduce the risk of ECC. A FV program in 4 vaccination clinics was started in 2009 to promote oral health. The purpose of this study is to assess the cost-effectiveness of implementing the FV program to help motivate local administrators collaborate with UCSF and Roatán healthcare community in delivering this intervention to the children in Roatán.