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Fluoride chemoprevention supplement and fluoride varnish

Dental caries (cavity) is an infectious disease in which acid produced by bacteria dissolves tooth enamel. If not halted, this process will continue through the tooth and into the pulp, resulting in pain and tooth loss. This activity can further progress to local infections, systemic infection, and, in rare cases, death.

Who is at risk

Your child’s pediatrician will generally ask questions about:

  • Personal and family oral health history
    • Developmental defects of the tooth enamel
    • Dry mouth
    • History of previous caries
    • Cavities in parents or brothers and sisters
  • Dietary habits
    • Frequent sugar exposure
    • Inappropriate bottle feeding
    • Frequent snacking
  • Fluoride exposure
    • Primary water supply has low fluoride
  • Oral hygiene practices
    • Poor oral hygiene
    • Lack of access to dental care
    • Preventive measures, such as using fluoride-containing toothpastes


The first symptom may be a cavity.

What you can do

  • Use of fluoride toothpaste should begin with the eruption of the first tooth.
  • Eat and drink foods that contain fluoride such as potatoes, tea, shellfish, and grapes.
  • Talk to your child’s pediatrician about how much fluoride is the right amount.

Preventive service at no cost

Children From Birth Through Age 5 Years

The USPSTF recommends that primary care clinicians prescribe oral fluoride supplementation starting at age 6 months for children whose water supply is deficient in fluoride.

Children From Birth Through Age 5 Years

The USPSTF recommends that primary care clinicians apply fluoride varnish to the primary teeth of all infants and children starting at the age of primary tooth eruption.

Why the service is important

All children with erupted teeth can potentially benefit from the periodic application of fluoride varnish, regardless of the levels of fluoride in their water.

The American Dental Association (ADA) recommendations on the dosage of and age at which to start dietary fluoride supplementation take into account the amount of fluoride in the child's water source.

What the service is

Many primary care providers already prescribe oral fluoride supplementation to patients with low levels of fluoride in their water. Fluoride varnish does not require specialized equipment or personnel and can be applied quickly.

Application of fluoride varnish is most commonly performed at the time of a well-child visit. Teeth are dried with a 2-inch gauze square, and the varnish is then painted onto all surfaces of the teeth with a brush provided with the varnish. Children are instructed to eat soft foods and not to brush their teeth on the evening after the varnish application to maximize the contact time of the varnish to the tooth. The following day, they should resume brushing twice daily with fluoridated toothpaste.


Your child’s pediatrician may recommend taking him/her to the dentist more frequently than the recommended checkups.

Dietary fluoride supplements should be considered for children living in communities in which the community water is not fluoridated or who drink well water that does not contain fluoride.

My Water’s Fluoride

Additional tips

  • Take your child to the dentist with their first tooth.
  • Take your child to the dentist every six months for a checkup.
  • Fluoride can be hazardous at high does, so be sure to supervise young children brushing teeth.