Fluoride

Fluoridation of community water supplies began in 1945 and has been proven to be the most cost effective way to reduce caries rates. Fluoridated water provides a brief topical effect followed by systemic effects of increased fluoride in saliva and plasma surrounding developing teeth. Epidemiologic data within the last half-century indicate initial reductions in caries rates of 55 to 60% and recent data still shows caries reduction of approximately 25%. About three-quarters of the United States population currently has access to fluoridated tap water. Importantly, most brands of bottled water do not contain optimal fluoride levels.

In areas where the water does not contain optimal levels of fluoride, and after careful consideration of the other dietary sources of fluoride and the child's age (i.e., stage of dental development), fluoride supplements may be prescribed for children at high risk of caries. Decisions concerning the administration of additional fluoride should be based on the unique needs of each patient and fluoride supplements should not be routinely prescribed to children at high caries risk, as the child may be adequately exposed to fluoride from other diet sources.

The table shows the current fluoride supplement recommendations. Although infants can be given fluoridated water from birth, systemic fluoride supplements are not recommended for any infant younger than 6 months of age.

Fluorosis

Table 1. AAPD Recommended Supplemental Fluoride Dosage Schedule.

Dietary Fluoride Supplementation Schedule
Age	<0.3 ppm F	0.3 to 0.6 ppm F	>0.6 ppm F
Birth to 6 months	0	0	0
6 mo to 3 years	0.25 mg	0	0
3 to 6 years	0.50 mg	0.25 mg	0
6 to at least 16 years	1.00 mg	0.50 mg	0

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