Healthy teeth and fluoride guidelines for kids

Healthy teeth – the role of fluoride

Fluoride helps harden the enamel on teeth, preventing cavities.  It is effective when applied to the surface of teeth, but can cause pitting and discoloration if used excessively.  The American Academy of Pediatrics refined their recommendations about fluoride this year to help guide us on getting the right balance.

Fluoride supplements used to be prescribed commonly at the age of 6 months, but now are only recommended for those children at high risk of cavities who do not have access to fluoridated water. This would include children age 6 months to 16 years who use only well water that has been tested and found to have low fluoride levels (less than 0.6 parts per million). City water here in Metro Detroit has 1 part per million concentration of fluoride, which is considered adequate.

Bottled water does not usually show its fluoride level and therefore is not a reliable source of fluoride. Reverse osmosis treatments in home removes most of the fluoride from water.

An important way to ensure adequate fluoride, which was just published in August by the American Academy of Pediatrics, is to use fluoridated toothpaste starting at the first eruption of teeth. Only a smear of toothpaste should be used until a child is 3 years old. Then a pea sized amount should be applied until the child can consistently spit, around age 6 years old. Children should spit the toothpaste out, but not rinse afterward.

Remember that carbohydrates are the biggest cause of cavities, so avoiding juice, and giving candies, cookies, and other sugary foods only as a special treats is a great way to also protect your children’s teeth. Never put juice in a bottle, and if you do decide to give it, dilute it with water. Juice is the same as candy, and does not add any nutrition to your child’s diet. Encourage brushing twice per day, and especially after sugary snacks.

From the American Academy of Pediatrics: Clinical Report: Fluoride Use in Caries Prevention in the Primary Care Setting.  Melinda B. Clark, Rebecca L. Slayton, and SECTION ON ORAL HEALTH.  Pediatrics 2014; 134:3 626-633; published ahead of print August 25, 2014, doi:10.1542/peds.2014-1699