Some commonly used brand names are:

In the U.S.—

In Canada—

• Vitamin replenisher–dental caries prophylactic --Vitamins and Fluoride

This medicine is a combination of vitamins and fluoride. Vitamins are used when the daily diet does not include enough of the vitamins needed for good health.

Fluoride has been found to be helpful in reducing the number of cavities in the teeth. It is usually present naturally in drinking water. However, some areas of the country do not have a high enough level of fluoride in the water. To make up for this, extra fluorides may be added to the diet. Some children may require both dietary fluorides and fluoride treatments by the dentist. Use of a fluoride toothpaste or rinse may be helpful, as well.

Taking fluorides does not replace good dental habits. These include eating a good diet, brushing and flossing teeth frequently, and having regular dental checkups.

This medicine is available only with your medical doctor's or dentist's prescription, in the following dosage forms:

Oral
• Oral solution (U.S. and Canada)
• Chewable Tablets (U.S. and Canada)

In deciding to use a dietary supplement, the risks of taking the dietary supplement must be weighed against the good it will do. This is a decision you and your medical doctor or dentist will make. For multiple vitamins and fluoride, the following should be considered:

Allergies—Tell your medical doctor or dentist if you have ever had any unusual or allergic reactions to fluoride. Also, tell your medical doctor, dentist, and pharmacist if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Fluoride occurs naturally in water and has not been shown to cause problems in infants of mothers who drank fluoridated water or took recommended doses of supplements.

Breast-feeding—Small amounts of fluoride pass into breast milk; however, problems have not been documented with normal intake.

Children—Doses of fluoride that are too large or are taken for a long time may cause bone problems and teeth discoloration in children.

Older adults—This dietary supplement has not been shown to cause different side effects or problems in older people than it does in younger adults.

Other medicines—Medicines or other dietary supplements

Although certain medicines or dietary supplements should not be used together at all, in other cases they may be used together even if an interaction might occur. In these cases, your medical doctor or dentist may want to change the dose, or other precautions may be necessary. When you are taking multiple vitamins and fluoride it is especially important that your medical doctor or dentist, and pharmacist know if you are taking any of the following:

• Anticoagulants, coumarin- or indandione-derivative (blood thinners)—Use with vitamin K (in the multiple vitamins and fluoride preparations) may prevent the anticoagulant from working properly

• Iron supplements—Use with vitamin E (in the multiple vitamins and fluoride preparation) may prevent the iron supplement from working properly

• Vitamin D and related compounds—Use with vitamin D (in the multiple vitamins and fluoride preparations) may cause high blood levels of vitamin D, which may increase the chance of side effects

• Dental fluorosis (teeth discoloration)—Fluorides may make this condition worse

Take this dietary supplement only as directed by your medical doctor or dentist. Do not take more of it and do not take it more often than ordered. Taking too much fluoride and some vitamins (especially vitamins A and D) over a period of time may cause unwanted effects.

Do not take multiple vitamins and fluoride products at the same time as taking foods that contain calcium. It is best to space them 1 to 2 hours apart, to get the full benefit from the medicine.

For patients taking the chewable tablet form of this dietary supplement:

• Tablets should be chewed or crushed before they are swallowed.
• This dietary supplement works best if it is taken at bedtime, after the teeth have been thoroughly brushed.

For patients taking the oral liquid form of this dietary supplement:

• This dietary supplement is to be taken by mouth even though it comes in a dropper bottle. The amount to be taken is to be measured with the specially marked dropper.
• Always store this dietary supplement in the original plastic container. It has been designed to give you the correct dose. Also, fluoride will interact with glass and should not be stored in glass containers.
• This dietary supplement may be dropped directly into the mouth or mixed with cereal, fruit juice, or other food.

Missed dose—

If you miss a dose of this dietary supplement, take it as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

To store this dietary supplement:

• Keep this dietary supplement out of the reach of children, since overdose is especially dangerous in children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the dietary supplement to break down.
• Protect the oral solution from freezing.
• Do not keep outdated dietary supplements or those no longer needed. Be sure that any discarded dietary supplement is out of the reach of children.

The level of fluoride present in the water is different in different parts of the country. If you move to another area, check with a medical doctor or dentist in the new area as soon as possible to see if this medicine is still needed or if the dose needs to be changed. Also, check with your medical doctor or dentist if you change infant feeding habits (e.g., breast-feeding to infant formula), drinking water (e.g., city water to nonfluoridated bottled water), or filtering systems (e.g., tap water to filtered tap water).

Inform your medical doctor or dentist as soon as possible if you notice white, brown, or black spots on the teeth. These are signs of too much fluoride.

Along with its needed effects, a dietary supplement may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

When the correct amount of this dietary supplement is used, side effects usually are rare. However, taking an overdose of fluoride may cause serious problems.

Stop taking this dietary supplement and check with your medical doctor immediately if any of the following side effects occur, as they may be signs of severe fluoride overdose:

• Black, tarry stools;  bloody vomit;  diarrhea;  drowsiness;  faintness;  increased watering of mouth;  nausea or vomiting;  shallow breathing ;  stomach cramps or pain;  tremors;  unusual excitement;  watery eyes;  weakness 

Check with your medical doctor or dentist as soon as possible if the following side effects occur, as some may be early signs of possible chronic fluoride overdose:

• Pain and aching of bones;  skin rash ;  sores in the mouth and on the lips;  stiffness;  white, brown, or black discoloration of teeth 

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your medical doctor or dentist.