Dental Care - Pediatrics
(including Fluoride recommendations)
As of 2011, I have changed official recommendations about fluoride for babies and
children.
In the past, based on official recommendations, I informed parents about the potential
benefits of oral fluoride drops, leaving the decision about whether or not to prescribe
them up to the parents in light of contraversies about fluoride supplementation.
Now, based on newer research and changing official recommendations from
professional organizations, I am NOT generally in support of oral fluoride drop
prescription.
Current research trends show that the most effective mechanism is the remineralizing
action caused by the exposure of tooth surfaces to frequent, low concentration sources
of fluoride such as fluoridated toothpaste.1
This basically means that exposing the teeth to fluoride is what really counts, not
swallowing it (and resulting in systemic absorption, which can have negative side
effects, like fluorosis).
Therefore my recommendations are:
1. for babies aged 6 months to 3 years old, I recommend 1 small smear of fluoride
toothpaste rubbed on the teeth 2-3 times daily (a "smear" is the size of an uncooked
grain of rice).
2. for children 3-6 years old, I recommend 1/2 pea-sized amount 2-3 times daily
3. for children 6 years and older, I recommend 1/2 to 1 pea-sized amount 2-3 times
daily.
And, when available, it could still be advisable to use the most "natural" option; Tom's of
Maine, for example or another fluoride toothpaste.
A local pediatrician colleague, Dr. Joel Amundson, has some interesting thoughts on
the subject that he's deliberated on as well; here's the link to his discussion on the
subject: http://www.drjoelsclinic.com/learn/Fluoride.html
References:
1. “Fluoride facts: What pediatricians need to know about fluoride agents for children,
including supplementation.” Rebecca L. Slayton. AAP News 2010;31;30.
-Shay Hosseinion, M.D.
January 10, 2012