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Fluoride & Fluoridation in Dentistry

One of the Ten Most Important Public Health Measures of the 20th Century

By Dr. Amid I. Ismail

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Additional Information: Summary Of Recommendations for Fluoride Use


  1. Continue and expand fluoridation of community drinking water. Water fluoridation in the proper amounts 0.7 ppm/L is the accepted safe, effective, and inexpensive method of preventing tooth decay. Adding fluoride to municipal drinking water also is an efficient strategy to reduce the inequalities in dental disease among Americans of all social strata. All persons should know whether or not their primary source of drinking water has an optimal level of fluoride. Approximately 100 million Americans currently do not receive the benefit of fluoridation.
  2. Frequent use of small amounts of fluoride. 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.
  3. 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.
  4. Parents should monitor the fluoride intake of children younger than 6 years old. The first six 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.
  5. Label bottled water with the fluoride concentration. Increased labeling of bottled waters on a voluntary basis will allow consumers to make informed decisions on their fluoride intake.
  6. Educating 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.


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