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- Charlotte W. Lewis, MD, MPH*
- *Department of Pediatrics, Division of General Pediatrics, Child Health Institute and Seattle Children’s Hospital Craniofacial Center, University of Washington School of Medicine, Seattle, WA.
Author Disclosure
Dr Lewis has disclosed no financial relationships relevant to this article. This commentary does contain a discussion of an unapproved/investigative use of a commercial product/device.
- CWF:
- community water fluoridation
- ECC:
- early childhood caries
- FDA:
- Food and Drug Administration
- FPL:
- federal poverty level
- FTP:
- fluoride toothpaste
- FS:
- fluoride supplement
- FV:
- fluoride varnish
- NHANES:
- National Health and Nutrition Examination Survey
Practice Gaps
Low-income children experience more dental caries and more complications of caries, such as dental abscesses. Beginning fluoride toothpaste and fluoride varnish during the first year of life can reduce low-income children’s risk of getting dental caries.
Pediatricians and other primary care clinicians for children have an important role to play in implementing a dental caries primary prevention program for all children, which should include regular use of fluoride as the mainstay.
Fluoride toothpaste and community water fluoridation benefit both children and adults, decreasing the risk of dental caries throughout the life span.
Objectives
After completing this article, readers should be able to:
Understand the mechanism that leads to dental caries.
Understand how fluoride prevents dental decay.
Be knowledgeable of the various sources of fluoride.
Be aware of evidence to support safe use of fluoride and how to counter misinformation perpetuated by antifluoride groups.
Be able to recommend specific fluoride modalities, depending on the child’s risk for dental caries.
Introduction
Fluoride is a valuable caries prevention modality that has a large body of evidence supporting its use. Because infants, young children, and their parents typically visit the pediatric office many times before ever seeing a dentist, parents may bring questions about fluoride to their pediatricians. Moreover, health supervision visits provide unique opportunities for pediatricians to address fluoride in the context of preventive oral health. However, until recently, pediatricians typically received little training in oral health and therefore may need additional education about fluoride to answer parents’ questions, counter misinformation, and ensure appropriate use of fluoride among their patients. Given that approximately one-quarter of US children younger than 5 years have caries, it is particularly important that …
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