4.1 Fluorides

Fluoride Supplements

Fluoride supplements are recommended only when an infant’s (age 6 months or older) or child’s ingestion of fluoride is less than optimal. Infants or children suspected of primarily ingesting water that is not fluoridated should be considered for fluoride supplementation.

In determining whether to prescribe fluoride supplements, oral health professionals need to determine the primary sources of the infant’s or child’s drinking water and whether it contains the optimal amount of fluoride. The amount of natural fluoride in well water varies, and for children primarily ingesting private well water, the water needs to be tested before supplements are prescribed. Bottled water usually does not contain fluoride, but this is not always the case. If fluoride content is not indicated on the bottle, contact the manufacturer. Parents who have bottled water delivered to their home may also request fluoridated water from their water company.

If fluoride supplements are indicated, consider whether the child can chew, swish, and spit and whether parents understand the proper dosage and frequency of supplements. Tablets are intended to be chewed or sucked to maximize the topical effects. Fluoride drops may be easier to use than tablets for infants (ages 6 months or older) and for children with oral motor problems, since drops can be placed directly in the mouth. If prescribing liquid supplements, oral health professionals should ensure that parents understand the difference between “a dropperful” and “a drop.” Parents also need to understand that fluoride in large doses can be harmful.

The following table contains the dosage schedule for fluoride supplementation:

Table 1. Systemic Fluoride Supplements: Recommended Dosage.*

*Reproduced from ADA Council on Access, Prevention and Interprofessional Relations. 1995. Caries diagnosis and risk assessment: A review of preventive strategies and management. JADA 126 (June supplement):1S-24S. Table on page 19S. Disclaimer and Copyright ©1995 American Dental Association. All rights reserved. Reproduced by permission.