Fluoride has been a cornerstone in caries prevention for decades. However, evolving evidence and changes in public health exposure have reshaped clinical recommendations.
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Dental Article 🔽 Fluoride in Pediatric Dentistry: Dosage, Frequency, and Current Controversies ... Key aspects include topical vs. systemic fluoride, caries-preventive effectiveness, and a special update on recent FDA considerations (2025) related to systemic fluoride supplements.Fluoride tablets, once widely prescribed to children, are now indicated only in specific circumstances. Understanding updated guidance is essential for safe and effective pediatric dental care.
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✅ What Are Fluoride Tablets?
Fluoride tablets are systemic fluoride supplements intended to be ingested daily. They were historically prescribed to children living in areas without optimally fluoridated water to enhance enamel resistance to caries.
Systemic fluoride differs from topical fluoride, as its primary benefit occurs during tooth development rather than after eruption.
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Current recommendations reflect:
▪️ Widespread availability of fluoridated toothpaste
▪️ Increased access to professionally applied topical fluorides
▪️ Greater awareness of dental fluorosis risk
As a result, routine fluoride supplementation is no longer universally recommended for children.
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Dental Article 🔽 Latest FDA Guidelines (2025) on Fluoride Use in Children: What Dentists Need to Know ... The Food and Drug Administration (FDA) released in 2025 a set of critical regulatory changes affecting fluoride use in children. These updates address long-standing concerns surrounding unapproved systemic fluoride products, raising new questions for pediatric dental practice.✅ When Are Fluoride Tablets Still Indicated?
According to current international guidelines, fluoride tablets may be considered when all of the following conditions apply:
▪️ The child lives in a non-fluoridated area
▪️ Drinking water fluoride concentration is below optimal levels
▪️ The child presents a high caries risk
▪️ Other topical fluoride measures are insufficient
Risk-based assessment is mandatory before prescribing fluoride tablets.
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While effective in selected cases, fluoride tablets carry potential drawbacks:
▪️ Increased risk of dental fluorosis, especially in children under 6
▪️ Difficulty controlling total fluoride intake
▪️ Dependence on long-term compliance
Excessive systemic fluoride intake during enamel formation remains a major concern.
💬 Discussion
The decline in fluoride tablet prescriptions reflects a shift toward topical fluoride strategies, which provide direct anticaries benefits with a lower systemic risk. Evidence consistently shows that fluoridated toothpaste and varnishes are highly effective, reducing the need for systemic supplementation in most populations.
Fluoride tablets should no longer be considered a first-line preventive measure, but rather a targeted intervention for specific high-risk children.
📊 Comparative Table: Fluoride Tablets in Pediatric Dentistry
| Aspect | Advantages | Limitations |
|---|---|---|
| Systemic fluoride delivery | Provides fluoride during tooth development | Higher risk of dental fluorosis |
| Indication scope | Useful in non-fluoridated communities | Not recommended for routine use |
| Caries prevention | Effective in high-risk children when properly prescribed | Less effective than topical fluoride after eruption |
| Patient compliance | Simple oral administration | Requires daily long-term adherence |
Fluoride tablets are no longer routinely recommended for children. Updated guidelines emphasize a risk-based, individualized approach, prioritizing topical fluoride therapies. Systemic supplementation should be reserved for children with limited fluoride exposure and elevated caries risk.
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▪️ Assess total fluoride exposure before prescribing supplements
▪️ Prioritize fluoridated toothpaste and professional topical applications
▪️ Avoid fluoride tablets in children under 6 unless clearly indicated
▪️ Educate parents about fluorosis risk and correct fluoride use
📚 References
✔ American Academy of Pediatric Dentistry. (2023). Fluoride therapy. Pediatric Dentistry, 45(6), 262–268.
✔ World Health Organization. (2022). Guidelines on fluoride in drinking-water. WHO Press.
✔ European Academy of Paediatric Dentistry. (2019). Best clinical practice guidance for the use of fluoride in children. European Archives of Paediatric Dentistry, 20(6), 507–516. https://doi.org/10.1007/s40368-019-00464-2
✔ Wright, J. T., et al. (2014). Evidence-based clinical recommendations on the use of fluoride toothpaste for young children. Journal of the American Dental Association, 145(2), 190–201. https://doi.org/10.14219/jada.2013.47
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