Fluoride varnish is an effective tool that has been proven to prevent tooth decay in both primary and permanent dentitions. Its ease of use, acceptability, and effectiveness make it an important tool in the primary prevention of dental caries in children at high risk of tooth decay. Systemic fluorides, such as community water fluoridation and fluoride dietary supplements, are also effective in reducing tooth decay. These fluorides provide topical and systemic protection because fluoride is present in saliva.
Fluoride is naturally present in all water sources, and community water fluoridation is the process of adjusting the fluoride content of fluoride-deficient water to the recommended level for optimal dental health. Studies show that water fluoridation is still effective in reducing teeth decay by 20-40%, even in the era of widespread availability of fluoride from other sources, such as toothpaste with fluoride. For those who do not live in a community with a centralized, public or private water source that can be fluoridated, fluoride is available in other forms. The Environmental Protection Agency (EPA) website for water quality reports (called Consumer Confidence Reports) provides information, as does the U.
S. Department of State Centers for Disease Control and Prevention (CDC) fluoridation website, My Water's Fluoride. The CDC website lists the fluoridation status by water system of states that have provided information. If the water source is a private well, it will be necessary to analyze it and obtain the results from a certified laboratory.
Fluoride dietary supplements are not recommended for children who live in a community with adequate levels of fluoride in the water supply. Medical and dental professionals are encouraged to work collaboratively to ensure that fluoride varnish is applied. Among the most striking results of water fluoridation is the change in public attitudes and expectations regarding dental health. In the field of primary care, fluoride varnish should be applied at least once every 6 months to all children and every 3 months to children at high risk of tooth decay, from the appearance of the first tooth to the establishment of a dental office.
A pea-sized amount of toothpaste containing 1000 to 1100 ppm of fluoride would have approximately 0.25 mg of fluoride. All children with protruding teeth can benefit from the periodic application of fluoride varnish, regardless of the fluoride levels in the water. The effectiveness of community water fluoridation in preventing dental decay has prompted its rapid adoption in cities across the United States. Communities with a disproportionate burden of tooth decay and less access than higher-income communities to dental care services and other sources of fluoride have also benefited from this public health measure. Fluoride from topical sources, such as fluoridated drinking water, is absorbed by cariogenic bacteria when they produce acid.
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