This series of fact sheets is based on the work of the U.S. Preventive Services Task Force (USPSTF). The USPSTF systematically reviews the evidence of effectiveness of a wide range of clinical preventive services—including screening, counseling, and chemoprevention (the use of medication to prevent diseases)—to develop recommendations for preventive care in the primary care setting.
This fact sheet presents highlights of USPSTF recommendations on this topic and should not be used to make treatment or policy decisions.
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The U.S. Preventive Services Task Force (USPSTF) recommends that primary care clinicians prescribe oral fluoride supplementation at currently recommended doses to preschool children older than 6 months if their primary water source is deficient in fluoride. The USPSTF concludes the evidence is insufficient to recommend for or against the routine risk assessment of preschool children by primary care clinicians for the prevention of dental disease.
It is important for primary care clinicians to be aware of the fluoride level in their patients' primary water supply to ensure appropriate supplementation with minimal risk for fluorosis. Current dosage recommendations based on the water supply in communities across the country are available online at www.ada.org.
Because few preschool-aged children ever visit a dentist, primary care clinicians often are the only health professionals young children visit. Clinicians, therefore, have a unique opportunity to prevent dental caries in this population.
| Primary care clinicians should be aware of the fluoride level in their patients' primary water supply. |
Oral fluoride supplementation, available by prescription, is recommended for preschool children with fluoride-deficient water supplies. Professionally applied topical fluoride varnishes are adjuncts to this oral supplementation; these topical varnishes are approved to prevent dental caries in young children. Their advantages over other topical fluoride agents, such as mouth-rinse and gel, include ease of use, patient acceptance, and reduced potential for toxicity.
Dental fluorosis, typically very mild, is the most common potential harm of either oral fluoride supplementation or the use of fluoride toothpaste in children younger than 2 years in the United States.
For more information, contact the following organizations:
American Dental Association®
www.ada.org
Centers for Disease Control and Prevention
www.cdc.gov
healthfinder®
www.healthfinder.gov
Members of the USPSTF represent the fields of family medicine, gerontology, obstetrics-gynecology, pediatrics, nursing, prevention research, and psychology. Members of the USPSTF when its recommendation on this topic was finalized:
Alfred O. Berg, M.D., M.P.H., Chair
Janet D. Allan, Ph.D., R.N., C.S., Vice-chair
Paul S. Frame, M.D.
Charles J. Homer, M.D., M.P.H.
Mark S. Johnson, M.D., M.P.H.
Jonathan D. Klein, M.D., M.P.H.
Tracy A. Lieu, M.D., M.P.H.
C. Tracy Orleans, Ph.D.
Jeffrey F. Peipert, M.D., M.P.H.
Nola J. Pender, Ph.D., R.N.
Albert L. Siu, M.D., M.S.P.H.
Steven M. Teutsch, M.D., M.P.H.
Carolyn Westhoff, M.D., M.Sc.
Steven H. Woolf, M.D., M.P.H.
For a list of current Task Force members, go to www.ahrq.gov/clinic/uspstfab.htm
AHRQ Publication No. APPIP04-0006
Current as of April 2004
Internet Citation:
Preventing Dental Caries in Preschool Children. What's New from the USPSTF? AHRQ Publication No. APPIP04-0006, April 2004. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/3rduspstf/dental/dentchwh.htm
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