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*CHILDREN'S TEETH*

• Fluoride is safe and necessary, but only at appropriate levels.
  
• Fluoride works two ways: systemically, meaning it strengthens teeth internally, under the gums in the jawbone. Externally, fluoride strengthens tooth enamel on the surface of the teeth. Children between 6 months and age 16 should take in fluoride every day.
  
• Water fluoridation is the safest and most cost-effective way to prevent tooth decay.
  
• Two of the most common sources of fluoride are tap water and fluoridated toothpaste. Fluoride occurs naturally in some water, but in most major municipalities it is added to the water to help prevent tooth decay.
  
• As more parents turn to bottled water for drinking and food preparation, pediatric dentists are concerned about whether children will get enough fluoride. Most bottled water brands do not contain the level of fluoride recommended by the AAPD, American Dental Association, American Academy of Pediatrics, American Medical Association, US Public Health Service, and the World Health Organization.
  
• Pediatric dentists recommend that children who regularly drink bottled water, well water, or unfluoridated tap water get fluoride in some other way. Fluoride vitamins, drops, and tablets are good examples of fluoride supplements.
  
• Most bottled water brands process water by distilled- or reverse-osmosis systems that remove fluoride along with contaminants. Some types of bottled water add fluoride to the final product and are safe for children of all ages.
  
• If you want to keep fluoride in your tap water, try using a charcoal- or carbon-activated filtration pitcher (such as Brita) that offers better-tasting water without removing fluoride.
  
• As important as fluoride is, it only works when used at the appropriate levels. Too much fluoride can cause a harmless discoloration of the teeth known as enamel fluorosis.
  
• Most cases of enamel fluorosis result from children taking fluoride supplements when their drinking water is optimally fluoridated. If there is enough fluoride in the child’s primary source of drinking water, pediatric dentists will seldom prescribe supplements.
  
• It is impossible to know how much fluoride is in a child’s primary source of drinking water without having it tested. Ask your pediatric dentist to test the fluoride level of your bottled water, tap water, or well water BEFORE supplements are prescribed.
  
• Pediatric dentists recommend scheduling a child’s first dental visit when the first tooth appears or no later than the first birthday to determine risk factors and evaluate fluoride needs before the child’s permanent teeth come in.
  
• Regardless of whether or not their water is fluoridated, children need to brush with a pea-sized amount of fluoridated toothpaste two times a day: after breakfast and before bed. Parents need to supervise children’s toothbrushing until age 8, when most children have the manual dexterity to accomplish this task independently.
  
• Parents, be more cautious using toothpaste with children under age 2. They are not able to spit the toothpaste out after brushing and tend to swallow it. Too much fluoride taken internally between age 2-4 can lead to enamel fluorosis, or discoloration of the teeth.
  

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