Fluoride Supplementation

1. Indications
   1. Prevention of Dental Caries in children
      1. Use when water supply has inadequate fluoride
   2. Osteoporosis Prevention
2. Precautions
   1. Narrow therapeutic index: Too high dosing effects
      1. See Fluorosis
      2. Increased Fractures from weak bone mineralization
      3. Fluorosis with mottling of dental enamel
   2. In areas with very high fluoride water concentration:
      1. Pregnant women and children should use bottled water
3. Dosing Schedule for children for Dental Caries prevention
   1. Ages 3 months to 3 years old
      1. Local Water Fluoride <0.3 ppm: Fluoride 0.25 mg qd
      2. Local Water Fluoride 0.3-0.7 ppm: No Fluoride
      3. Local Water Fluoride >0.7 ppm: No Fluoride
   2. Ages 3 to 6 years old
      1. Local Water Fluoride <0.3 ppm: Fluoride 0.50 mg qd
      2. Local Water Fluoride 0.3-0.7 ppm: Fluoride 0.25 mg qd
      3. Local Water Fluoride >0.7 ppm: No Fluoride Supplement
   3. Ages 6 to 16 years old
      1. Local Water Fluoride <0.3 ppm: Fluoride 1.00 mg qd
      2. Local Water Fluoride 0.3-0.7 ppm: Fluoride 0.50 mg qd
      3. Local Water Fluoride >0.7 ppm: No Fluoride
4. Dosing in adults for Osteoporosis Prevention
   1. Fluoride (Long acting) 25 mg PO bid
5. Efficacy
   1. Prevents Dental Caries
   2. Prevents Osteoporotic Fractures
      1. If started early and in low doses
   3. References
      1. Pak (1995) Ann Intern Med 123:401-8