For generations, fluoridated drinking water helped protect most American children. Recently, skepticism about fluoridation has grown and some places, including Utah and Florida, have stopped adding fluoride to public water. Dental groups such as the American Academy of Pediatrics, the American Dental Association and the American Academy of Pediatric Dentistry still strongly recommend fluoridated water. Cheen Loo, chair of pediatric dentistry at Tufts, says it is concerning that two states banned fluoride and that about one-third of Americans did not have access to fluoridated water even before those actions.
Dentists explain that fluoride replenishes minerals removed by acids and mouth bacteria, which helps enamel resist decay. Alternatives include fluoridated toothpaste (safe and effective when used in the right amount), fluoride rinses for older children, and topical fluoride varnishes applied at dental visits about every six months. At the Tufts pediatric clinic, dentists see more tooth decay in children from towns without fluoridated water; Loo often recommends fluoride toothpaste and sometimes a supplemental rinse or prescription-strength toothpaste.
Parents should supervise brushing because young children often miss back teeth and lack dexterity. Flossing usually requires adult help until a child can tie shoelaces. Over-the-counter fluoride rinses are not recommended for children under 6 because they may swallow them. Ingestible fluoride supplements should be used with care; in October the FDA recommended that such products not be given to children under 3 or to those not at high risk of tooth decay. Many pediatric dentists now prefer professional topical varnish, which lasts for several months.
Difficult words
- fluoride — a chemical that prevents tooth decay
- skepticism — doubt or lack of trust in something
- replenish — to replace something that was lostreplenishes
- enamel — hard outer layer of a tooth
- topical — applied to a specific surface or area
- varnish — a protective coating applied to a surfacevarnishes
- dexterity — skill in using hands or small movements
- supplement — something added to improve health or treatmentsupplements
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- Do you think your local public water has fluoride? How would that change your child's dental care?
- Would you choose fluoride toothpaste, a supplemental rinse, or professional varnish for a child? Why?
- What can parents do at home to help prevent tooth decay in young children?
Related articles
Toxic cosmetics sold in Latin American street markets
Informal markets in Latin America sell cosmetics often without labels or health checks. Studies found toxic metals in many cheap products; authorities seized counterfeit goods and experts warn of health risks, especially for children.
Gagandeep Kang on Vaccines, Surveillance and Child Health in India
Gagandeep Kang, a leading expert on enteric diseases, urges India to prepare tools to prevent viral outbreaks. She helped develop indigenous rotavirus vaccines, built surveillance networks and now works at the Gates Foundation.
Citizen science could help monitor health and the SDGs
A systematic review in Frontiers in Public Health finds citizen science can support monitoring many health and well‑being indicators in the UN Sustainable Development Goals and the WHO Triple Billion Targets. Authors are from IIASA and WHO.
Study finds Abbott-Bioline malaria test gives many false negatives
A study on the Thailand–Myanmar border found the Abbott-Bioline rapid malaria test missed many infections. Researchers call it “not fit for purpose”; WHO and the manufacturer are reviewing the test and further studies are under way.