Advice on fluoride supplements for children in non-fluoridated areas
(Content under development)
The following question was submitted by a practicing dentist: As I now practice in a newly “non-fluoridated” area I am looking at my recommendations for supplemental fluoride for my pediatric population. Are there any universally adopted guidelines available?
JCDA Editorial Consultants Drs Felicity Hardwick of Nanaimo and Sarah Hulland of Calgary provided this initial response for consideration:
Since the question relates to a newly non-fluoridated area we would firstly recommend that the dentist check that water fluoride status is indeed below the recommended optimal level of 0.7 ppm.
Before prescribing fluoride supplements, a thorough clinical examination, dental caries risk assessment and informed consent from patients/caregivers are required.
The dentist should also review the use of fluoridated dentifrice and all home and child care water sources. Approximately 30% of the Canadian population does not drink tap water, so even in a fluoridated zone this does not translate into sufficient fluoride exposure.
The CDA position paper on fluoride use is an excellent resource for the practitioner, detailing the use of fluoride supplements., water fluoridation as well as other sources of fluoride. There is also an excellent resource on fluoride supplementation that has been created by the Province of Alberta.
The dentist should revisit, at least annually, with the parents/caregivers, the child’s consumption of fluoride from all sources. Parents/caregivers may also ask for advice about non-fluoride caries preventive agents. The American Dental Association produced a report about the evidence underpinning the efficacy of such agents in 2011.
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