MS, RD, LDN
Janel holds a Master’s in Nutrition Communication from Tufts University. As the recipient of the 2010 Massachusetts Young Dietitian of the Year award, she believes in making healthy eating simple, sustainable, and delicious.
Comprehensive reviews by credible scientific and public health organizations continue to confirm the safety and oral health benefits of fluoridation, given that fluoride can slow the progression of and even prevent dental cavities and tooth decay. While fluoride is an added ingredient in most toothpastes, fluoridated drinking water is considered the most important tool in reducing the risk of tooth decay in children and adults.
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The current recommendation for fluoride in community drinking water is 0.7 milligrams per liter. If your community water supply is at the recommended dosage of fluoride, and your baby drinks the water, he likely won’t need additional fluoride.
In 2014, the AAPD and American Academy of Pediatrics changed fluoride recommendations in response to an increase in tooth decay in children under the age of 5 years. The new recommendations are to begin using a small smear (the size of a grain of rice) of tooth paste in brushing baby’s teeth as soon as they begin to come in, around 6 months. Tooth brushing should happen twice per day from this point on. Continue to use this amount of tooth paste until your child is three years old, at which point you can begin using a pea-sized dab of tooth paste.
Additional recommendations include:
Find out if your water source is fluoridated
If you pay for local water, contact your community water district or locate a customer service number on your bill and ask about the level of fluoride in your water. If you use well-water, have your water tested by your local health district or by a private lab.
Give your baby fluoridated tap water throughout the day
The best way to provide your baby with fluoride is through tap water, in addition to using a very small rice-sized amount of fluoridated tooth paste twice per day. It’s okay if your baby swallows this, as it provides only a very small amount of fluoride and is important for the health of your child’s teeth.
Note that most bottled water is not fluoridated. If it is fluoridated, it will say so on the label. To be sure, call the number on the label for more information.
If your baby is no longer exclusively breastfeeding and is ready to be drinking water, go with fluoridated tap water if available. Begin introducing a bit of fluoridated water at the age of 6 months each day. This can also double as practice for your little one to drink from a cup or sippy cup!
If you formula feed your baby, either exclusively or after the introduction of solid foods, using fluoridated water should be just fine. In some cases, the combined fluoride in the formula along with the fluoride in the water may cause mild fluorosis, which is too much fluoride causing white markings on your child’s teeth. If you are concerned, check in with your pediatrician about the combined levels of fluoride in your formula and tap water before selecting your water source.
Clean your baby or toddler’s teeth twice a day with fluoridated toothpaste
As soon as teeth begin to appear, start using a very small amount of fluoride-containing tooth paste twice per day. At the age of 3, you can increase the amount of tooth paste to a pea-size, as at this time children are able to avoid swallowing during tooth brushing and spit out the excess paste. Continue to encourage your little one to imitate you and spit, to teach good tooth brushing practices from an early age.
Give your baby or toddler a fluoride supplement only if prescribed by your pediatric dentist or physician
Fluoride supplements are prescribed for children at high risk for tooth decay and whose primary drinking water has a low fluoride concentration. To maximize the topical effect of the supplement (usually in tablet or lozenge form), have your child chew or suck the supplement for 1–2 minutes before swallowing. Supplementation may also mean more frequent topical fluoride varnish.
Community Water Fluoridation. Center for Disease Control. Date accessed 6 August 2018. Importance of Community Water Fluoridation. American Academy of Pediatric Dentistry. Date accessed 6 August 2018. American Academy of Pediatrics Supports HHS Fluoride Recommendations for Drinking Water. American Academy of Pediatric Dentistry. Date accessed 6 August 2018. Melinda B. Clark, Rebecca L. Slayton, “Fluoride Use in Caries Prevention in the Primary Care Setting.” Date accessed 6 August 2018. Guideline on Fluoride Therapy. American Academy of Pediatric Dentistry. Date accessed 6 August 2018. AAP Recommends Fluoride to Prevent Dental Caries. American Academy of Pediatrics. Date accessed 6 August 2018.