Fluoride – The Good and The Bad

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With a topic so hotly debated, it’s difficult to find unbiased information about fluoride, when it’s appropriate, and how it should be used. According to the American Acadamy of Pediatrics (AAP) fluoride should be prescribed as soon as teeth emerge.

A new report, released just 3 days ago by the AAP, lays out specific recommendations for children at each stage of development. This is the first time that the AAP has endorsed these guidelines through their own publications.

It is important to note that fluoride provides both risks AND benefits for its users. Pediatricians must be aware of both in order to provide the best possible care for the patients they treat.

Dental caries has long been known as the most widespread disease among children in the United States. It is also known to be widely preventable. Correct usage of fluoride provides the possibility of stopping the disease in its tracks.

A few of the risks that one should be aware of are fluoride poisoning and failure of tooth to mineralize properly. Fluoride poisoning has become much more common as fluoride becomes more widely available in the United States. Most of these cases are very mild, and include symptoms of slight striations in the teeth, or slightly opaque areas.

More severe cases can include pitting in the teeth, and weaker tooth structure over all, but these cases are quite rare in the US. By the time a child reaches age 8, the risk for fluoride poisoning (fluorosis) drops dramatically.

Among other recommendations in the report, the AAP suggested the following:

  • Supervision for small children using fluoride
  • Prescriptions should not exceed a 4 month period
  • Fluoride toothpaste is recommended for all children at the time of tooth eruption
  • Toothpaste should be no bigger than a grain of rice up to age 3, and no bigger than a pea after age 3
  • Fluoride varnish should be applied every 3-6 months starting at tooth eruption
  • Over-the-counter fluoride product should not be used by children under 6 years of age

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