B. Fluoride
Fluorides are safe and effective for caries control and prevention. Fluoride can be applied professionally or by the patient under supervision. Although more than half the U.S. population has access to fluoridated community water, an increasing number of families consume processed water with unknown fluoride content. The cariostatic mechanisms of fluoride include increased resistance to demineralization, enhanced remineralization, and inhibition of bacterial colonization of dental plaque. Fluoride affects the dentin and enamel of both erupted and unerupter affects the dentin and enamel of both erupted and unerupted teeth. Systemic effects are achieved by oral ingestion from sources such as fluoridated drinking water or fluoride supplements. Fluoridated toothpaste and mouth rinses deliver topical benefits. Table 16-1 shows the current AAP and AAPD recommendations
For dietary fluoride supplementation in children drinking fluoride deficient water. The patient true exposure to fluoride must be judiciously evaluated defore supplements are prescribed to avoid dental fluorosis. Because children younger than 6 years of age cannot expectorate reliably, the use of fluoridated toothpaste must be monitored by their parents and the recommendation to use only a pea-sized amount of toothpaste should be followed. Higher risk individuals with orthodontic appliances, reduced salivary function, or gastroesophageal reflux disease, or those who are unable to clean their teeth properly, are at dietary risk, have mothers or siblings with caries, or have active caries should be considered for additional topical fluoride therapy to supplement oral hygiene measures.