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Dr. Bill and Martha Answer:
Are fluoride drops necessary for babies?

Question:
At our baby's six month checkup, her doctor prescribed fluoride drops. She said they are necessary every day until we have more fluoride in our water. This seems very unnecessary to my husband and I, as we never took them, and our teeth are fine. Are they really necessary?

 Answer:
As your baby's doctor suggested, fluoride supplements do lessen the frequency and severity of dental cavities. Fluoride becomes incorporated into the tooth enamel even before your baby's teeth erupt, making them strong and more resistant to decay. Later on this same protective effect occurs from fluoride applied topically through toothpaste or by your dentist.

Fluoride is a naturally-occurring trace mineral and, like calcium, iron and other minerals, is often found naturally in water. Unlike other minerals, it has a narrow risk-to-benefit ratio. This means that just the right amount of fluoride helps the teeth, but too much harms the teeth; thus, causing a condition called "fluorosis," which are white spots, or brownish mottling and weakening of the enamel. To be sure your infant gets just the right amount of fluoride -- not too much and not too little -- observe these recommendations.

  • Breastfeeding babies do not need fluoride supplements. Studies have shown that breastfed babies, without fluoride supplements, do not have any more cavities than fluoride-supplemented formula-feeding babies.
  • The American Academy of Pediatrics recommends that fluoride supplements not be given in infants younger than six months of age because of the concerns about fluorosis in this age group.
  • Don't use toothpaste or mouthwashes containing fluoride in children under age two, since toddlers can swallow toothpaste and get too much fluoride.
  • Once your child begins using fluoridated toothpaste, allow only a pea-sized dab a day. This will provide the recommended daily dose of fluoride without risking overdose. Don't allow your child to use the generous amounts of toothpaste they see in TV commercials.
  • Check the fluoride in your water by calling your local municipal water supply or supplier of bottled water. If the fluoride concentration in the water your child drinks is less than 0.3 parts per million, it would be wise for your child to have 0.25 milligrams of fluoride supplement daily.

Another reason why fluoride supplements are recommended is that infants traditionally do not drink a lot of water. Fluoride supplementation, if used wisely, is a good preventive dental health measure.