In a systematic review, where 214 studies were analyzed,McDonagh et al, observed a decrease in the number of caries-affected teeth and an increase in dental fluoro- sis, depending on the fluoride intake. They also stated that the prevalence of dental fluorosis indicates that children are ingesting other sources of fluoride besides drinking water. In areas where drinking water is obtained directly from deep wells, dental fluorosis is often endemic and in many cases, the deeper the wells, the higher the fluoride concentration in drinking water In order to prevent fluorosis, the pediatric dentist has to instruct parents about the fluoride content in the drinking water and when it is not known, look for this information in the local water supply service. If child drinks well water or bottled water, the pediatric dentist may assist parents or caregivers in getting an analysis of its fluoride content, and afterwards decide together whether the child needs a fluoride supplement or not. Dentists also should educate parents about diet, such as children's formula, food or sodas that need water to be manufactured and can indirectly participate in the development of dental fluorosis. Therefore, parents should also limit the amount of fluoride in bottled beverages.