Fluoride is the safest and best way to prevent tooth decay. Fluoride is obtained from a variety of sources, including community fluoridated water, fluoride toothpaste, fluoride varnish, and fluoride supplements.

Fluoride supplements are recommended for children ages 6 months to 16 years who are determined to be at high risk for dental caries (tooth decay) and whose primary source of drinking water does not contain the right amount of fluoride that is naturally found in water. Unlike dietary supplements, fluoride supplements can't be purchased over the counter. Fluoride supplements require a prescription from a dentist, physician, or nurse practitioner. Fluoride supplements come in tablets, drops, or lozenges. Parents should give the supplement to the child each day for it to work best to prevent tooth decay.

This Brush Up on Oral Health tip sheet provides information about fluoride supplements and the role of Head Start staff in promoting them.

Determining a Child's Need for Fluoride Supplements

The dentist, physician, or nurse practitioner will consider all sources of fluoride that a child receives (for example, fluoridated water, fluoride toothpaste, fluoride varnish, multi-vitamin containing fluoride) to determine if a child needs a fluoride supplement.

Below are simple questions that the child's dentist, physician, or nurse practitioner will consider to determine if the child should take fluoride supplements.

• Is the family's primary source of drinking water fluoridated? Many towns and cities add fluoride to their water supplies. If a family's water supply comes from a well, it will need to be tested to determine whether the right amount of fluoride is in the water. The public health department can advise families on how to have their home well water tested. Test results can be reviewed by the child's dentist, physician, or nurse practitioner to determine if fluoride supplements are needed.
• What is the child's primary source of drinking water? Some parents choose to give their child bottled water instead of tap water. Bottled water is an extra expense; in addition, most brands do not contain the right amount of fluoride to prevent tooth decay. Bottled water companies are not required to list fluoride on product labels unless the fluoride content is within set limits. If the bottled water label does not provide information about fluoride content, the bottled water company can be contacted and asked to provide this information.

Role of Head Start Staff in Promoting Fluoride Supplements

• Determine if children's primary drinking water supply is fluoridated as part of the program's community assessment. This can be determined by checking My Water's Fluoride or by contacting the state oral health program or local health department. If children's primary drinking water supply is not fluoridated, the Head Start Health Services Advisory Committee can promote the importance of water fluoridation within the community where the program is located.
• If a child's dentist, physician, or nurse practitioner prescribes fluoride supplements, Head Start staff should note this information in the child's health record. Head Start staff should also check with the parents from time to time to see how things are going and help address any problems, as needed. Some common problems include getting the prescription filled; getting the child to take the supplement daily; or asking the dentist, physician, or nurse practitioner for a prescription refill.

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Last Updated: November 9, 2022