Current regulations and recommendations concerning water fluoridation, fluoride supplements, and topical fluoride...

In recent years, an increase in the prevalence of dental fluorosis, mostly of the very mild to mild category, has been seen in the United States. This paper therefore discusses the safety of dental fluoride products, primarily with respect to the risk of dental fluorosis due to chronic ingestion of these products by pre-school children. No change is indicated in the optimal fluoride level (0.7 to 1.2 ppm) for water fluoridation. A reduction in the dosage of fluoride supplements is recommended for children aged from three to six years (14.5 to 22 kg body weight) residing in communities with less than 0.7 ppm F. Physicians, pharmacists, and dentists need to be better educated in correctly prescribing fluoride supplements; such prescriptions should be based on the fluoride concentration of the domestic water supply and the child's weight/height/age. No change is recommended in the concentration of fluoride used in dentifrices and mouthrinses. The US Food and Drug Administration should require more explicit labeling of fluoride products with regard to avoidance of ingestion, use of small amounts, and need for supervised use by pre-school children. The efficacy of water fluoridation, fluoride supplements, and topical fluoride agents has been amply documented elsewhere.