Since Betsy lives in a community that is not receiving the benefits of water fluoridation and she relates to you that her family drinks tap water, you recommend to her that her baby will need to receive a prescription for fluoride supplements.

Fluoride in water and fluoride supplements are considered to be long-term caries preventive mechanisms by making fluoride available systemically while the tooth is forming, specifically when the enamel is forming. When the fluoride levels in the drinking water fall below 0.6 ppm, the prescribing of a fluoride supplement should be considered. According to the American Academy of Pediatric Dentistry, before fluoride supplements are prescribed, it is essential to know the fluoride concentration of the patient's drinking water. Review of all sources of drinking water (i.e. home, day care) is essential in determining the patient's response to fluoride.

Fluoride in drinking water that is concentrated at a level between 0.7 and 1.2 ppm will offer the maximum reduction in dental caries with the minimal amount of mottled enamel, or fluorosis. When the water consumed by the child falls between this range, a supplement is not to be prescribed.

According to the American Academy of Pediatric Dentistry, significant cariostatic benefits can be achieved by the use of fluoride-containing preparations such as toothpastes, gels and rinses, especially in areas without water fluoridation. Topical fluoride-containing products must be used with caution in young children in order to prevent ingestion of excessive amounts of fluoride.