This best practice provides information for practitioners regarding the use of fluoride as an aid in preventing and controlling dental caries in pediatric dental patients. These recommendations address systemic fluoride (water fluoridation, dietary fluoride supplements), topical fluoride delivery via professional application (acidulated phosphate fluoride gel or foam, sodium fluoride varnish, silver diamine fluoride), and home-use products (toothpastes, mouthrinses) as well as the associated risks of fluoride agents. The standard level for community water fluoridation (0.7 parts per million fluoride) helps balance the risk of caries and the possibility of dental fluorosis from excessive fluoride ingestion during the early years of tooth development. Specific recommendations for dietary supplementation of fluoride for children ages six months through 16 years are based on fluoride levels in the drinking water, other dietary sources of fluoride, use of a fluoridated toothpaste, and caries risk. The specific needs of each patient determine the appropriate use of systemic and topical fluoride products, whether delivered in a professional clinical or a home setting. Fluoride has proven to be an effective therapy in reducing the prevalence of dental caries in infants, children, adolescents, and persons with special needs.

Through a collaborative effort of the American Academy of Pediatric Dentistry Councils on Clinical Affairs and Scientific Affairs, this best practice was revised to offer updated information and recommendations to assist healthcare practitioners and parents in using fluoride therapy for management of caries risk in pediatric patients.