• Fluoride supplements are recommended only for infants and children at high risk for developing dental caries who drink water that does not contain the optimal amount of fluoride.
• Fluoride rinses are generally not recommended for children.
• Fluoride varnish has gained wide acceptance within the oral health and medical communities as a preventive agent, especially for children with special health care needs.
• Xylitol can be used with other preventive measures such as fluoride, resulting in an additive dental caries preventive effect. Children over age 3 with special health care needs can use xylitol if they are able to chew gum or suck on hard small objects without choking on them.
• Children who severely grind their teeth (e.g., because of cognitive disabilities, cerebral palsy, or autism) may not be candidates for dental sealants because of the flattened occlusal surfaces.
• Some children with special health care needs develop excessive calculus. Scaling with hand or power instruments may be needed.
• Cleaning teeth using a rubber cup prophylaxis is not recommended for general plaque removal in young children, Toothbrushing is as effective for plaque removal and is generally more acceptable to children.