Appropriate Fluoride Exposure in Toddlers
Children age 18 months to 36 months are most susceptible to cosmetically objectionable fluorosis of their developing permanent dentition. As always, the risk-benefit ratio must be weighed.
Photo Credit: kate_sept2004 / E+
The risk of fluorosis for a toddler vs the benefits of a topical fluoride application to prevent the early lesions from progressing to cavitated lesions and possibly causing pain must be considered.
Photo Credit: Hailshadow / iStock / Getty Images Plus
Recommendations from the ADA
In 2013, the American Dental Association (ADA) Council on Scientific Affairs published evidence-based clinical recommendations regarding professionally applied and prescription-strength home-use topical fluoride agents for caries prevention.
Photo Credit: BanksPhotos / iStock / Getty Images Plus
The recommendations include two types of professionally applied fluorides: 5% neutral sodium fluoride (NaF) varnish and 1.23% acidulated phosphate fluoride (APF) gel. However, for children younger than 6, only the 5% NaF varnish is recommended. This is due to the risk of adverse effects (particularly nausea and vomiting) associated with swallowing excess amounts of fluoride gel.
Photo Credit: TAK / iStock / Getty Images Plus
Varnish Vs Gel
Even though 5% NaF varnish contains a much higher concentration of fluoride (22,000 ppm) compared with the APF gel (9,000 ppm)—overall, less fluoride is used for a full-mouth application. This is because the varnish is painted on the teeth in a thin layer. In addition, evidence suggests that 5% NaF varnish can arrest active pit and fissure caries in primary teeth.