Policy on Use of Fluoride/ Guideline on Fluoride Therapy

Department of Pediatric Dentistry
Resident’s Name: Jessica Wilson
Program: Lutheran Medical Center - Providence

Article title: Policy on Use of Fluoride/ Guideline on Fluoride Therapy

Author(s): AAPD, Council on Clinical Affairs

Journal: Reference Manual/Clinical Guidelines

Year. Volume (number). Page #’s: 2007-2008. 29(7). 34.
Clinical Guidelines. 2007. 111-113.

Major topic: Fluoride Recommendations

Overview of method of research:
A systematic literature review as well as expert opinions and best current practices were used to establish this policy/guideline.

Findings:
1. AAPD encourages optimal water supply fluoridation.
2. If water supply not optimal (<0.6ppm) including other dietary ingestion of fluoride, supplements should be administered according to AAPD Guidelines (see TABLE 1. of Guidelines).
3. Dentist should educate other medical professionals about the possible effects of excess fluoride ingestion prior to enamel maturation.
4. Further research to be carried out on causes of fluorosis.
5. Prenatal fluoride supplements not advised.

Key points/Summary:
Fluoridation of community water is the cheapest and most effective way to prevent caries (55-60%).
If supplements indicated, children should chew or suck on fluoride tablets in order to optimize topical exposure.
Professionally applied topical fluoride should be administered to mod-high risk children every 3-6mo. accordingly.
Fluoridated toothpaste recommended twice daily under supervision of parent/guardian. Additional at-home therapy may be advised for high risk children (rinse or gels).
Severity of fluorosis dependant on dose, duration and timing of intake.

Assessment of Article:
Good simplification of recommendations and reminders of importance of systemic intake of fluoride. Perhaps we should be taking a closer look at our patient population and educating parents about their children’s dental development needs!