| Fluoride Modality | Low Caries Risk | High Caries Risk |
|---|---|---|
| Toothpaste | Starting at tooth emergence | Starting at tooth emergence |
| Fluoride varnish | Every 3-6 months starting at tooth emergence | Every 3-6 months starting at tooth emergence |
| Over-the-counter mouth rinse | Not applicable | Starting at age 6 if the child can reliably swish and spit |
| Community water fluoridation | Yes | Yes |
| Dietary fluoride supplements | Yes, if drinking water supply is not fluoridated | Yes, if drinking water supply is not fluoridated |
In 2014, updated in 2020, the United States Preventive Services Task Force (USPSTF) issued new recommendations on fluoride use among primary care clinicians for children from birth through age 5 years. The Task Force found that the moderate potential benefits of fluoride varnish and fluoride supplementation outweigh the potential harm of fluorosis in children from birth through age 5 years. The American Academy of Pediatrics endorses these recommendations.
Wright JT, Hanson N, Ristic H et al. Fluoride toothpaste efficacy and safety in children younger than 6 years: A systematic review. JADA. 2014. 145(2): 182-189.
Centers for Disease Control and Prevention. Recommendations for using fluoride to prevent and control dental caries in the United States. MMWR. 2001; 50 (No. RR-14).
Clark MB, Keels MA, Slayton RL.SECTION ON ORAL HEALTH. Fluoride Use in Caries Prevention in the Primary Care Setting. Pediatrics. 2020; 146 (6): e2020034637.Â
U.S. Preventive Services Task Force Recommendation Statement. Prevention of Dental Caries in Children Younger Than 5 Years: Screening and Interventions. December 07, 2021. Click hereÂ