| Fluoride Modality | Low Caries Risk | High Caries Risk |
|---|---|---|
| Toothpaste | Starting at tooth emergence | Starting at tooth emergence |
| Fluoride varnish | Every 3-6 months starting at tooth emergence | Every 3-6 months starting at tooth emergence |
| Over-the-counter mouth rinse | Not applicable | Starting at age 6 if the child can reliably swish and spit |
| Community water fluoridation | Yes | Yes |
| Dietary fluoride supplements | Yes, if drinking water supply is not fluoridated | Yes, if drinking water supply is not fluoridated |
In May, 2014, the United States Preventive Services Task Force (USPSTF) issued new recommendations on fluoride use among primary care clinicians for children from birth through age 5 years. The Task Force found that the moderate potential benefits of fluoride varnish and fluoride supplementation outweigh the potential harm of fluorosis in children from birth through age 5 years. The American Academy of Pediatrics endorsed these recommendations.
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.
Moyer VA; US Preventive Services Task Force. Prevention of dental caries in children from birth through age 5 years: US Preventive Services Task Force recommendation statement. Pediatrics. 2014 Jun;133(6):1102-11.Â
Clark MB, Slayton RL; AAP Section on Oral Health. Fluoride use in caries prevention in the primary care setting. Pediatrics. 2014;134(3):626-33.