Your next question in your risk assessment of Jessie is:

Has Jessie been receiving fluoride supplements?

Betsy states that their other healthcare provider wrote them a prescription for fluoride supplements, but that she never filled the prescription.

Your response to Betsy could be:

Yes, the use of fluoride supplements is a difficult routine to get into. However, you will need a new prescription since Jessie is now older and her requirements for fluoride have increased. (The use of fluoride supplements requires a high level of commitment from the mother or caregiver. Unfortunately, for children at high risk for developing caries, fluoride supplements may not be a viable option because of the social, economic and basic life dilemmas that face this group of children and their families.)