optimal fluoride levels in drinking water supplies. When fluoridation of drinking water is impossible, effective systemic fluoridation can be achieved through the intake of daily fluoride supplements. Before supplements are prescribed, it is essential to review dietary sources of fluoride (eg, all drinking water sources, consumed beverages, prepared food, toothpaste) to determine the patient’s true exposure to fluoride. Fluoride content of ready-to-use infant formulas in the US and Canada ranges from 0.1 to 0.3 mg/L, which provides only a modest source of fluoride. The more important issue, however, is the fluoride content of concentrated or powdered formula when reconstituted with fluoridated water. Considering the potential for mild fluorosis, caution is advised for infants consuming formula that is reconstituted with optimally-fluoridated water. As the Environmental Protection Agency/Department of Health and Human Services’ recommendation for optimizing community water supplies to 0.7 ppm F is instituted, fluorosis due to reconstituting infant formula with fluoridated water will be less of an issue.