The purpose of this study was to study implementation of preventive oral health interventions by primary care providers in a rural pediatric population. Acknowledgement of dental caries as a preventable communicable disease indicates that activities and interventions to prevent oral complications are being expanded to multiple disciplines. Primary care providers are acknowledged as partners in health and prevention of chronic illness. Practices including oral risk assessment and fluoride varnish are proposed interventions recommended by dental care providers to be included in primary care in rural or high risk populations not receiving dental services. Collaboration between dental services and pediatric primary care in the communities of central and northwestern North Dakota is proposed as a method to bridge the gap of health disparities between urban and rural counterparts. The study included five rural clinics and involved 25 providers in education regarding fluoride varnish application and oral risk assessment. Rating of oral health knowledge before the intervention and after the intervention on a 1 to 10 scale by primary care providers was 6.05 (n=23) and 6.33 (n=18) respectively. Following education and introduction of fluoride varnish into practice, 16.7% (n=18) primary care providers indicated using fluoride varnish. Nurses were the majority of respondents in the study and the most likely to perform fluoride varnish. Implications from the study indicate further incentives will be necessary to increase the number of primary care patients treated with fluoride varnish. The North Dakota Oral Health program reports 4,609 Medicaid claims were filed for oral prevention services by primary care providers in 2012-2014, the period during which concerted efforts to educate providers and implement fluoride varnish were initiated.