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The decision to supplement with fluoride should not be taken lightly. Fluoride supplements are not recommended unless the level of fluoride in the community water supply is known. |
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This dosage schedule for fluoride supplements for infants and children younger than 16 years (updated in August 2001) is scaled to the fluoride concentration in the community drinking water. It has been jointly recommended by the ADA, AAPD, and AAP. |
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One alternative to fluoride supplementation is to encourage the family to use fluoridated bottled water (eg, Dannon or Crystal Springs). Questions may arise regarding the amount of bottled water that should be consumed to meet daily requirements. At this time, guidelines for daily bottled water consumption do not exist because the data that were collected evaluated only the primary water supply and not bottled water. However, when providing guidance, it is important to understand that unlike vitamins or medications that are absorbed in the gastrointestinal tract and moved systemically to a therapeutic site of action, fluoride’s primary, therapeutic site of action is topical. When determining if fluoride supplementation is needed, the child health professional should encourage parents to select one primary source of water for consumption and then base the decisions to supplement on the fluoride concentration of that water. |
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As mentioned previously, the risk of fluorosis is greatest in children who are younger than 6 years because most permanent teeth have not fully mineralized. An example of fluorosis is seen on the next slide. |
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