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Recommendations, continued

Fluoride Supplementation
In many areas of the United States, access to community water fluoridation is limited. In these cases, fluoride can be supplemented in the form of liquid, tablet, or lozenge. Fluoride supplements require a prescription from a health professional and must be prescribed judiciously.

The American Dental Association (ADA) has developed evidence-based clinical guidelines for the use of fluoride supplements. A chair-side tool has also been developed by the ADA to help with counseling and decision-making.

When using these resources, remember the following key points:

 
1.
All possible sources of fluoride must be taken into account. These include:
   
Knowing the fluoride content of the child’s primary drinking water source and all other sources of water for the child (eg, other home, child care, school, relative or caregiver’s house, bottled water).
   
Other sources of fluoride, such as prescriptions from the dentist, fluoride mouthrinse in school, or fluoride varnish.
 
2.
If it is determined that fluoride access is limited and the child is at high risk for dental caries, then supplementation should be written.
 
3.
No child younger than 6 months of age and no child older than 16 years of age should be supplemented.
 
4.
No child who has adequate access to (and is drinking) appropriately fluoridated community water should be supplemented.

 
 
If it is determined that fluoride access is limited and a child is at high risk for dental caries, then fluoride supplementation should be written.
 
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 chair-side tool.
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