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The Case for Reducing the Current Council on Dental Therapeutics Fluoride Supplementation Schedule
Author(s) -
Newbrun Ernest
Publication year - 1999
Publication title -
journal of public health dentistry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.64
H-Index - 63
eISSN - 1752-7325
pISSN - 0022-4006
DOI - 10.1111/j.1752-7325.1999.tb03280.x
Subject(s) - medicine , schedule , dental fluorosis , fluoride , limiting , medical prescription , dentistry , pediatrics , family medicine , environmental health , pharmacology , mechanical engineering , inorganic chemistry , chemistry , computer science , engineering , operating system
The milder forms of dental fluorosis have increased in prevalence since the original epidemiologic surveys of the 1930s. Most studies of fluorosis have identified the use of supplements as a major risk factor. Fluorosis could be prevented, in part, by stopping the improper prescription of fluoride supplements in optimally fluoridated areas and by lowering the dosage currently recommended by the Council on Dental Therapeutics supplemental fluoride schedule. At a 1991 workshop at the University of North Carolina, five alternatives to the present ADA Council on Dental Therapeutics schedule were suggested; however, no consensus on dosage was reached. Recently, the Federation Dentaire International adopted a dosage schedule of 0.25 mg F from birth to 3 years of age, 0.5 mg F from 3 to 5 years, and 1 mg F thereafter. At a 1992 Canadian workshop it was proposed that supplements should not be started until age 3, should be given only to those “at high risk” of caries, and only 0.25 mg F should be prescribed from 3 to 5 years of age. Similarly, in some European countries supplements are not recommended until 3 years, at which time 0.5 mg F is prescribed, but only “for children at risk.” Australia is considering a dosage schedule starting with 0.25 mg Fat 6 months, again only for those “particularly at risk of caries.” Serious problems exist in limiting fluoride supplementation only to high‐caries‐risk children because they are not easily identifiable at a young age. Ideally, a dosage schedule should be based on body surface area or weight rather than simply age, and supplements should be in the form of lozenges for children over 2 years of age. A reduced fluoride supplement dosage schedule is proposed.