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 Academy of Pediatrics, American Dental Association, and the American Academy of Pediatric Dentistry have developed a dosing schedule for fluoride supplementation. When using this schedule, 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, 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.