Systemic Fluoride
Guidelines
- All children at high caries risk should receive fluoride through systemic water fluoridation or dietary supplements.
- Children who drink optimally fluoridated water should NOT receive supplements.
- Optimal water fluoridation level is 0.7 ppm.
Steps to Take Before Considering Prescribing Supplements
Determine the source of your patient's water, which may be:
- Fluoridated city water
- Nonfluoridated city water
- Bottled water (variable fluoride levels)
- Well water (variable fluoride levels)
Determine the fluoride content:
- Public water supply: Contact local health departments or water company for fluoride levels.
- Well water: Test the well water for fluoride level. Local health departments can perform test or provide resources
for water testing.
Additional factors affecting fluoride content:
- Water filters:
- Most filters are charcoal based and do not remove fluoride.
- Only reverse osmosis water filters (very costly to install) remove fluoride.
- Bottled water:
- If companies add fluoride, this must be listed on the bottle.
- The fluoride content of most bottled water is unknown as that water source may or may not contain naturally occurring fluoride.
References
Federal Registrar: View site here (accessed March 18, 2014).
Rozier RG, Steven Adair S, Graham S, Lafolla T. et al. Evidence-Based Clinical Recommendations on the Prescription of Dietary Fluoride Supplements for Caries Prevention. Journal of the American Dental Association. 2010; 141 (12): 1480-1489.