Monday, October 3, 2011

Deciding If Your Child Needs Fluoride

Dental hygiene and fluoride for a child…there seems to be a ton of confusing information out there.  The current recommendation is that the parent should start examining the child’s mouth at age 6 months and gently brushing gums and any teeth present.  The child should have their first dental exam at a dentist’s office by age 3.  Some states require a child to have had a dental visit by the time they start kindergarten.  The U.S. Environmental Protection Agency (EPA) sets the maximum allowable level of fluoride in the community drinking water to range from .7ppm -1.2ppm.  If you and your family drink well water or filtered water, there is probably no fluoride in it.   There has been a movement in the past few years to filter water before drinking and also to start using all-natural toothpaste with no fluoride.  This has led to an increase in cavities in very young children.  If your child is not exposed to any fluoride, they will get cavities. 
I realize most parents filter water to rid it of lead, toxins, and other impurities, but if you filter your water, you have to give your child fluoride from other sources.  It’s important to use toothpaste with fluoride in it.  Children should use a pea size amount of toothpaste and try not to swallow too much when brushing.  Children can overdose on fluoride, but it’s really rare.  Overdosing on fluoride is hard to do and unless your child craves eating toothpaste by the tube, it probably won’t happen.

What is also important is giving your child fluoride treatments.  Fluoride supplements are available as a liquid for younger children and as tablets for older children.  Parent’s need to get the prescription for the fluoride liquid or tablets from their child’s pediatrician or dentist.  It’s one of the best things your can do to protect their teeth from cavities.  If your child needs fluoride and how much depends on how much is in the drinking water.  I’ve posted the chart below to help parents determine if their child needs extra fluoride supplements:

Recommended Dietary Fluoride* Supplement Schedule

0-6 months
6mo-3 years
.25 mg/d
3-6 years
.5 mg/d
.25 mg/d
6-16 years
1.0 mg/d
.50 mg/d

*Sodium fluoride (2.2 mg =1 mg fluoride ion)

I know this chart can be confusing at first, but once you figure out where your child fits on it, it’s very helpful.  You will have to call your water treatment center, look online, or look at the yearly water report to find out exactly how much fluoride is in your drinking water.  This is key to knowing how much fluoride in the form of a liquid or tablets to give your child, if any. 

For example, if your drinking water has more than .6ppm of fluoride in it, your child has enough fluoride exposure to adequately protect their teeth.  As long as you brush their teeth and use common sense with normal teeth hygiene, they should be fine.

If the fluoride in the water falls between .3 to .6ppm, then when your child reaches 3 years old until they are 6 years old, you give them .25 of fluoride mg/day.   When they are 6-16 years old, you give them .50mg of fluoride/day.

If you child has less than .3ppm of fluoride in their drinking water, or no fluoride, then at 6 months to 3 years of age, you give them .25 mg /day of fluoride.  At age 3-6 years old, you give them .5mg of fluoride/day.  At 6-16 years old, you give them 1mg of fluoride per day.

Hopefully this information will help clear up some of the incorrect information that is floating around about fluoride and how it should be used to correctly prevent tooth decay and cavities.  For your child, it’s best to use multiple sources of fluoride, like fluoride tablets and also fluoride toothpaste.  There are also children’s mouthwashes with fluoride in them.  Always check with your dentist or pediatrician before starting fluoride supplementation treatments.  Parents need to get the fluoride prescription from a pediatrician or dentist anyway.  Depending on your dentist or pediatrician, their dosing schedule may be a little different, but what I’ve posted is the current recommendation at this time.  It’s the schedule I would use.  Nothing can guarantee your child won’t get any cavities, but getting an adequate amount of fluoride will set them on a path to have a healthy mouth and good dental hygiene.