Smiles For Tomorrow
Topical Fluoride

Course Author(s): American Academy of Pediatric Dentistry

Topical Fluoride

The use of topical fluorides may result in a significant reduction in caries. Topical application of fluoride is available via:

  • Professionally-applied topical fluoride treatment
  • Over-the-counter rinses for home use
  • Prescription rinses and gels for home application
  • Fluoride-containing toothpastes

Over-the-counter fluoride mouthrinses are not recommended for preschool aged children. Fluoride mouthrinses or brush-on gels may be recommended for school-aged children with active caries or at high risk for caries. Indicators of increased caries risk include:

  • orthodontic/prosthodontic appliances
  • reduced salivary function
  • inability to clean teeth properly
  • dietary risks
  • siblings with caries
  • high oral levels of cariogenic bacteria

Over-the-counter rinses are designed for daily use. Higher concentration fluoride prescription rinses and gels are designed for weekly use.

Using small amounts of fluoride on a routine basis can help prevent tooth decay. Too much fluoride could cause fluorosis of developing enamel. Fluorosis usually is mild, with tiny white specks or streaks that often are unnoticeable. Development of fluorosis depends on the amount, duration and timing of excessive fluoride intake. Products containing fluoride should be stored out of the reach of young children.

Toothpaste can be used as a means to deliver fluoride to the tooth surface. The use of a fluoridated toothpaste should always be supervised in this age group. For those under two years old, a smear of fluoridated toothpaste is recommended by the American Academy of Pediatric Dentistry. A very small amount of fluoridated toothpaste, equal to the size of a pea, should be wiped onto the toothbrush by the caretaker for children over aged 2 to 5. Caution should be taken to prevent the swallowing of toothpaste during critical periods of enamel formation.

Toothpaste can be used as a means to deliver fluoride to the tooth surface. The use of a fluoridated toothpaste should always be supervised in this age group. For those under three years old, a smear or rice size amount of fluoridated toothpaste twice a day is recommended by the American Academy of Pediatric Dentistry and American Dental Association.12 A very small amount of fluoridated toothpaste, equal to the size of a pea, should be wiped onto the toothbrush by the caretaker for children over aged 3 to 6 years of age twice a day.12 Caution should be taken to prevent the swallowing of toothpaste during critical periods of enamel formation.

Fluoride products should be kept in childproof storage areas. This includes not only supplements but toothpastes, fluoride rinses, and gels.