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Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United
States
In August, 2001, the Centers for Disease Control and Prevention (CDC)
issued
Recommendations for Using Fluoride to Prevent and Control Dental Caries
in the United States. These recommendations provide guidance to
health care providers, public health officials, policymakers, and the
general public on how to achieve maximum protection from tooth decay
while minimizing any cosmetic concerns by efficiently using fluoride products and dental care
resources. These recommendations
are summarized below; please refer to the document for more detailed
recommendations.
A
press release on the above document was issued on August 17, 2001.
- Continue and extend fluoridation of community drinking water.
Water fluoridation in the proper amounts (0.7–1.2 parts per million [ppm])
has been accepted as a safe, effective, and inexpensive method of
preventing tooth decay. Adding fluoride to municipal drinking water is
an efficient strategy to reduce dental disease
among Americans of all social strata. It is the most
cost-effective way to prevent tooth decay among populations living in
areas with adequate community water supply systems. Community water fluoridation
is the foundation for sound
community caries-prevention programs.
- Use small amounts of fluoride frequently. Daily and
frequent exposure to small amounts of fluoride will best reduce the
risk of tooth decay for all age groups. The recommendations strongly
support drinking water with optimal levels of fluoride and following
self-care practices such as brushing at least twice a day with
fluoridated toothpaste.
- Counsel parents and caregivers on the use of fluoride
toothpaste by young children, especially those younger than 2 years.
Fluoride toothpaste is a cost-effective way to reduce the prevalence
of tooth decay. However, because they do not have a well-developed
swallowing reflex and may like the taste of the toothpaste, young
children often swallow a large portion of the toothpaste put on their
brush. This fact presents an increased risk of enamel fluorosis (a
whitish discoloration of the tooth enamel) for children younger than 6 years and especially for
those children younger than age 2. Before recommending use of fluoride
toothpaste for children younger than 2 years, the
dentist or other health care provider should consider the fluoride
level in the community drinking water, other sources of fluoride, and
factors likely to affect susceptibility to tooth decay when weighing
the risk and benefits of using fluoride toothpaste. In general, the
recommendation is for parental supervision of the amount (small
pea-size) of toothpaste that is placed on the child's toothbrush
- Parents should monitor the fluoride intake of children younger
than 6 years old. The first 6 years of life are an important
period for tooth development. Overuse of fluoride during this period
can result in enamel fluorosis, a developmental condition of tooth
enamel that may appear as white lines or spots. Monitoring fluoride
sources by parents can reduce the occurrence of white spots while
preventing early tooth decay. Children under age 6 should use only a
pea-sized amount of fluoride toothpaste; parents should consult their
child’s doctor or dentist concerning use of fluoride toothpaste for
children under age 2.
- Use supplements and high concentration fluoride products
judiciously. Fluoride supplements for children may best be
prescribed for those who are at high risk for decay and who live in
communities that have a low fluoride concentration in their drinking
water. High concentration fluoride products, such as professionally
applied gels, foams, and varnishes, also may best benefit children who
are at high risk of decay.
- Label bottled water with the fluoride concentration.
Increased manufacturer labeling of the fluoride content in bottled waters on a voluntary basis will allow
consumers to make informed decisions on their fluoride intake.
- Educate health professionals and the public. Collaborative
efforts by professional organizations, public agencies, and suppliers
of oral care products are needed to encourage behavior change to
facilitate improved, coordinated use of fluoride products and regimens
currently available.
- Further research. Additional studies are needed to learn
more about fluoride use and evaluate the current decay prevention effectiveness of
fluoride modalities (i.e., community water, toothpastes, mouth rinses,
supplements, gels, and varnishes), alone and in combinations. Of
particular interest are groups and persons at high risk for dental
decay, including older adults.
Date last reviewed:
November 21, 2007
Date last modified: August 3, 2006
Content source:
Division of Oral Health, National Center for Chronic Disease Prevention and
Health Promotion |
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