Fluoride Supplementation

Prevention of Dental Caries in children
1. Use when water supply has inadequate fluoride
Osteoporosis Prevention
1. No longer recommended (previously recommended for adults at risk at 25 mg daily)

Narrow Therapeutic Index: Too high dosing effects
1. See Fluorosis
2. Increased Fractures from weak bone mineralization
3. Fluorosis with mottling of dental enamel
In areas with very high fluoride water concentration:
1. Pregnant women and children should use bottled water

Ages 3 months to 3 years old
1. Local Water Fluoride <0.3 ppm: Fluoride 0.25 mg qd
2. Local Water Fluoride 0.3-0.7 ppm: No Fluoride
3. Local Water Fluoride >0.7 ppm: No Fluoride
Ages 3 to 6 years old
1. Local Water Fluoride <0.3 ppm: Fluoride 0.50 mg qd
2. Local Water Fluoride 0.3-0.7 ppm: Fluoride 0.25 mg qd
3. Local Water Fluoride >0.7 ppm: No Fluoride Supplement
Ages 6 to 16 years old
1. Local Water Fluoride <0.3 ppm: Fluoride 1.00 mg qd
2. Local Water Fluoride 0.3-0.7 ppm: Fluoride 0.50 mg qd
3. Local Water Fluoride >0.7 ppm: No Fluoride

Prevents Dental Caries
Initially thought to prevent osteoporotic Fractures if started early and in low doses
1. Found to increase bone density 10% per year
2. However resulting bone is not thought to be as strong, and may not confer advantage in Osteoporosis Prevention

Drops: 0.125 mg, 0.25 mg and 0.5 mg per dropper
Chewable tablets: 0.5 mg, 1 mg
Tablets: 1 mg
Multi-Vitamins (Tri-vi-flor and poly-vi-flor)
1. Available as drops and chewable tablets
2. Write specifically for older, generic formulation (another pharmaceutical switch to re-patent an old drug)
Fluoride varnish (applied at dental visits, in addition to oral Fluoride Supplementation as needed)
1. Fluoride varnish is also applied to teeth at each pediatric dental visits after Tooth Eruption (6 months)
2. See Oral Health in Children
3. Sievers (2016) Am Fam Physician 93(9):743-4 [PubMed]