Practice Guideline Endorsement

Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States

The American Academy of Pediatrics endorses and accepts as its policy the Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States.

This policy was published in August 2001.

Abstract: Widespread use of fluoride has been a major factor in the decline in the prevalence and severity of dental caries (i.e., tooth decay) in the United States and other economically developed countries. When used appropriately, fluoride is both safe and effective in preventing and controlling dental caries. All U.S. residents are likely exposed to some degree to fluoride, which is available from multiple sources. Both health-care professionals and the public have sought guidance on selecting the best way to provide and receive fluoride. During the late 1990s, CDC convened a work group to develop recommendations for using fluoride to prevent and control dental caries in the United States. This report includes these recommendations, as well as a) critical analysis of the scientific evidence regarding the efficacy and effectiveness of fluoride modalitities in preventing and controlling dental caries, b) ordinal grading of the quality of the evidence, and c) assessment of the strength of each recommendation.

Because frequent exposure to small amounts of fluoride each day will best reduce the risk for dental caries in all age groups, the work group recommends that all persons drink water with an optimal fluoride concentration and brush their teeth twice daily with fluoride toothpaste. For persons at high risk for dental caries, additional fluoride measures might be needed. Measured use of fluoride modalitities is particularly appropriate during the time of anterior tooth enamel development (i.e., age < 6 years).

The recommendations in this report guide dental and other health-care providers, public health officials, policy makers, and the public in the use of fluoride to achieve maximum protection against dental caries while using resources efficiently and reducing the likelihood of enamel fluorosis. The recommendations address public health and professional practice, self-care, consumer product industries and health agencies, and further research. Adoption of these recommendations could further reduce dental caries in the United States and save public and private resources.

This Morbidity and Mortality Weekly Report (MMWR) report was published by the Centers for Disease Control and Prevention (Centers for Disease Control and Prevention. Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States. MMWR Morb Mortal Wkly Rep. 2001;50). The PDF file can be viewed and downloaded from the Centers for Disease Control and Prevention (CDC) Web site at http://www.cdc.gov/mmwr/PDF/RR/RR5014.pdf.

The recommendations in this statement do not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.

Return to AAP Policy Statements