Dietary Fluoride Supplementation

Dietary fluoride supplementation by prescription for children at high caries risk who do not have access to optimally fluoridated water is recommended by the American Academy of Pediatric Dentistry and the Centers for Disease Control and Prevention.

In 2014, the USPSTF recommended primary care clinicians prescribe oral fluoride supplementation starting at age 6 months for children whose water supply is deficient in fluoride, not based on risk assessment. The American Academy of Pediatrics also recommends fluoride supplements age 6 months to 16 years of age for children whose water supply is deficient in fluoride, not based on risk assessment.

Dietary Fluoride Supplementation Doses for Children

Appropriate dosing is shown in the table above.


  • If the fluoride content of the main water used for cooking and drinking cannot be determined, then supplemental fluoride should NOT be prescribed.
  • In optimally fluoridated communities where children drink bottled water, supplements should NOT be prescribed due to halo effect.
  • Supplementation is not recommended for breast feeding infants or formula fed infants until age six months.
  • All prescriptions for fluoride should specify a sugar-free preparation


Adair S, Graham F, et al. Evidence-Based Clinical Recommendations on the Prescription of Dietary Fluoride Supplements for Caries Prevention. A Report of the American Dental Association Council on Scientific Affairs. JADA. December 2010 vol. 141(12): 1480-1489.

Recommendations for using fluoride to prevent and control dental caries in the United States. Centers for Disease Control and Prevention. MMWR Recomm Rep 2001;50(RR-14):1-42. View site here.

Wright JT, Hanson N, Ristic H et al. Fluoride toothpaste efficacy and safety in children younger than 6 years: A systematic review. JADA. 2014. 145(2): 182-189.

Clark MB, Keels MA, Slayton RL; AAP Section on Oral Health. Fluoride use in caries prevention in the primary care setting. SECTION ON ORAL HEALTH. Pediatrics. 2020; 146 (6).

U.S. Preventive Services Task Force Recommendation Statement. Prevention of Dental Caries in Children from Birth Through Age 5 Years. May 2014. View site here.