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Module 3: Prevention of Tooth Decay

3.5 Who Needs Fluoride Supplements, and How Much Fluoride is Enough?

Fluoride supplements are recommended only for infants and children ages 6 months or older at high risk for developing dental caries. For infants and children at low risk for developing caries, dietary fluoride supplements are not recommended, and other sources of fluoride should be considered as a caries-prevention intervention. Risk-assessment forms from the American Academy of Pediatric Dentistry and the American Dental Association (from birth to age age 6 and over age 6) can help clinicians determine risk.

The following table provides fluoride dosage schedules as recommended by the American Dental Association.

Table 1. Systemic Fluoride Supplements: Recommended Dosage
  Fluoride Ion Level in Drinking Water*
Age < 0.3 ppm 0.3-0.6 ppm > 0.6 ppm
Newborn-6 months None None None
6 months-3 years 0.25 mg/day** None None
3-6 years 0.50 mg/day 0.25 mg/day None
6-16 years 1.0 mg/day 0.50 mg/day None

*1.0 ppm = 1 mg/L.
** 2.2 mg sodium fluoride contains 1 mg fluoride ion.

Adapted with permission from Rozier GR, Adair S, Graham S, Iafolla T, Kingman A, Kohn W, Krol D, Levy S, Pollick H, Whitford G, Strock S, Frantsve-Hawley J, Aravamudhan K, Meyer DM. 2010. Evidence-based clinical recommendations on the prescription of dietary fluoride supplements for caries prevention: A report of the American Dental Association Council on Scientific Affairs. Journal of the American Dental Association 141(12):1480–1489. Table 3 on p. 1485. Available at

©2010 American Dental Association. All rights reserved. Reproduced by permission.