Fluoride

     Fluoride is important for helping to prevent dental caries. Fluoride is available in city water supplies, some bottled water, over the counter fluoride rinses, treatments at the dentist office, and prescription drops and dissolvable tabs. Too little fluoride in your system and the teeth are prone to tooth decay. Too much fluoride and your teeth (and bones!) will become speckled or permanently stained with a discoloration.
     The need to supplement with fluoride is based on wanting to protect the teeth from both tooth decay (caries) and too much fluoride. Over the 18 years I have been a pediatrician, the recommendation has changed in trying to make sure we find the right balance. These are the current recommendations as of now for daily adequate intake:
0-6 months: 0.0 1mg/day AND additional supplementation is not recommended at this time
7-12 month: 0.5 mg/day
1-3 years: 0.7 mg/day
4-8 years: 1 mg/day
9-13 years: 2 mg/day
14-18 years: 3mg/day

The recommended daily fluoride dose of supplement, if needed, is adjusted in proportion to the fluoride content of drinking water.
Fluoride content of water  ==> Daily dose of oral fluoride (mg)
<0.3 ppm
Birth-6 months ==> 0
6 mo-35 mo ==> 0.25 mg
3-6 yr ==> 0.5 mg
6-16 yr ==> 1 mg
0.3-0.6 ppm
Birth-3 yr ==> 0
3-6 yr ==> 0.25 mg
6-18 yr ==> 0.5 mg
>0.6 ppm
All ages ==> 0

Commonly prescribed forms of fluoride include the following:
Luride(r) Drops (0.5mg/ml -- comes in 50ml. bottle)
Luride Lozi-Tab (0.25, 0.5, and 1mg -- comes in a bottle with 120 tabs)

     If you have well water, it is important to check the fluoride content of the well water before supplementing. There are families with wells that happen to contain a high amount of fluoride and supplementing these kids will just stain their teeth. For families with no fluoride in their well [we have well water at our home and we found it has no fluoride], we can discuss when you are in the office if your child needs a fluoride supplement. For families who do not drink tap or well water and primarily get water from bottled water, we can discuss at their check-up whether your child needs a fluoride supplement.