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Key Points
Community water fluoridation is an effective caries-prevention measure.
Water fluoridation was recognized as one of the 10 greatest public health advancements of the 20th century.
0.7 ppm of fluoride is considered optimal fluoridation of water. Learn more.
The fluoride content of water is not affected by use of charcoal or cellulose filters.
The amount of fluoride in bottled water varies but is generally suboptimal.
Fluoride does not pass through human milk.
Infant formula only contains fluoride if mixed with fluoridated water.
Efforts should be made to minimize swallowing of toothpaste, as it is a highly concentrated source of fluoride.
Fluoride supplements are recommended for high-risk children 6 months to 16 years of age whose primary water source is deficient in fluoride.
Pregnant women should not be prescribed fluoride supplements.
The topical effect of fluoride is its most potent effect in caries prevention.
Regular use of fluoridated toothpaste is an inexpensive and effective method of preventing caries.
The CDC strongly recommends the use of toothpaste and fluoride mouthrinses, gels, and varnishes in children.
Fluoride gels and varnishes are applied by a dental or medical professional in the office.
Patients and providers need to determine the fluoride concentration in an individual's water source before supplementing with fluoride.
Well water should be tested to determine the fluoride concentration.
All possible sources of fluoride should be considered before supplementing.
Children at high risk for caries should be supplemented from the age of 6 months to 16 years.
View ADA fluoride supplement chair-side tool.
Fluorosis ranges in severity from mild to severe.
Permanent teeth are more susceptible to fluorosis than primary dentition.
The most susceptible age for fluorosis is between 15 and 30 months.
Enamel fluorosis is increasing in prevalence in the United States.
Children at high risk for dental caries should use fluoridated toothpaste, regardless of age.
Children under 2 years of age at high risk for caries should use a "smear" of toothpaste and all children aged 2-6 years should use a "pea-sized" amount of toothpaste.
Toothbrushing should always be supervised.
Toothpaste should be kept out of reach of young children.
View the Chapter 6 Photo Gallery.