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Fluoride for Children: Parent FAQs

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Fluoride helps prevent tooth decay and makes your child's teeth stronger. Fluoride can be found in drinking water, toothpaste, mouth rinses and medical treatments such as fluoride varnish.

Here are some common questions you may have about how fluoride helps keep your child's teeth healthy.

Why do children need fluoride?

Fluoride is a natural mineral that can slow or stop cavities from forming.

We all have bacteria in our mouth that combines with sugars from food and drinks to make acid. The acid harms the outer layer of the tooth, called the enamel. Fluoride protects teeth from being damaged by the acid and helps rebuild tooth enamel.

That is why many communities add fluoride to the tap water. Children should drink plenty of water and brush with toothpaste that has fluoride in it.

Is fluoridated water safe for my children?

Yes. The American Academy of Pediatrics (AAP), the American Dental Association and the Centers for Disease Control and Prevention agree that water fluoridation is safe and works to prevent tooth decay. Community water fluoridation has been shown to reduce tooth decay by 25%.

When should my child start using fluoride toothpaste?

The AAP recommends using a smear or grain-of-rice–sized amount of fluoride toothpaste twice a day when the first tooth appears and until age 3 years. A pea-sized amount of fluoride toothpaste can be used once they turn 3.

What if we live in a community where the water is not fluoridated? What can we do?

Check with your local water utility agency to find out if your water has fluoride in it. If it does not have fluoride or you have well water, ask your pediatrician or dentist if your child is at high risk for cavities. The doctor may recommend you buy fluoridated water or give you a prescription for fluoride drops or tablets for your child.

Should my child get fluoride varnish?

Yes. Fluoride varnish is used to help prevent or slow down tooth decay. Your pediatrician or dentist can apply the varnish starting after your baby gets their first tooth. (Try to make your baby's first dental appointment after the first tooth appears.)

The varnish is painted on the top and sides of each tooth and hardens quickly. Then, it is brushed off by parents at home after 4 to 12 hours. It is recommended that children have varnish applied 2 to 4 times per year until they are 5 years old.

What should I know about fluoride if I am breastfeeding or using infant formula?

When they are younger than 6 months old, breastfed babies and babies fed infant formula do not need fluoride supplements or formula mixed with water than is fluoridated. It is safe to use fluoridated water to mix the formula if your baby is younger than 6 months old, but there is a small risk of "fluorosis." (See more details, below.) Ask your pediatrician or dentist if you need more advice.

If you prefer not to use fluoridated water with formula before your baby's first tooth emerges, you can:

  • Use bottled or purified water that has no fluoride to mix with the formula.

  • Use ready-to-feed formula that does not need water to be added.

What is dental fluorosis, and will fluoridated water mixed with infant formula increase the risk?

Fluorosis usually appears as very faint white streaks on the teeth. Often it is only noticeable by a dental expert during an exam. Mild fluorosis is not painful and does not affect the function or health of the teeth.

Although using fluoridated water to prepare infant formula might increase the risk of dental fluorosis, most cases are mild.

Once your child's adult teeth come in (usually around age 8), the risk of developing fluorosis is over.

More Information

Last Updated
American Academy of Pediatrics (Copyright @ 2024)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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