The American Academy of Pediatrics (AAP) has issued a statement urging pediatricians to prescribe fluoride as soon as their patients’ first teeth erupt. Published in the Aug. 25 online journal Pediatrics, the clinical report concluded that fluoride is an effective way to prevent cavities in children.
According to an AAP news release, tooth decay is the most common chronic disease in the U.S. Called a “silent disease” by report authors, it affects a disproportionate number of poor, young and minority populations. Because cavities are largely preventable, the AAP has incorporated guidelines established by the Centers for Disease Control and Prevention in 2001 into its own publications.
The AAP now recommends the use of fluoridated toothpaste for all children as soon as their first teeth begin to emerge. For children 3 years old and younger, a smear – the size of a grain of rice – should be applied to the toothbrush. After the age of 3, a peanut-sized amount of toothpaste can be used. To avoid using more than the recommended amount, the group urges parents to supervise and assist with brushing and to dispense toothpaste for children.
In addition, the AAP recommends that a fluoride varnish be applied by a doctor or dentist every 3 to 6 months, starting when teeth begin to erupt. However, because of the risk of swallowing higher-than-recommended levels of fluoride, over-the-counter fluoride rinses are not recommended for children younger than 6 years.
Report authors Melinda B. Clark, MD, a pediatrician at Albany Medical Children’s Hospital in New York, and Rebecca L. Slayton, DDS, PhD, the director of the Center for Pediatric Dentistry in Seattle, Wash., cautioned there are risks associated with fluoride. The most common, fluorosis, is a cosmetic condition that causes striations and pitting on the teeth.
Fluoride can also be toxic if consumed in very large quantities. Because fluoride is available in many sources, including food and tap water, the authors recommended that pediatricians and dentists prescribe no more than a 4-month supply at a time.