Fluoride Supplementation

Aka: Fluoride Supplementation, Oral Fluoride, Sodium Fluoride

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II. Indications

  1. Prevention of Dental Caries in children
    1. Use when water supply has inadequate fluoride
  2. Osteoporosis Prevention
    1. No longer recommended (previously recommended for adults at risk at 25 mg daily)

III. Precautions

  1. Narrow therapeutic index: Too high dosing effects
    1. See Fluorosis
    2. Increased Fractures from weak bone mineralization
    3. Fluorosis with mottling of dental enamel
  2. In areas with very high fluoride water concentration:
    1. Pregnant women and children should use bottled water

IV. Dosing Schedule for children for Dental Caries prevention

  1. Ages 3 months to 3 years old
    1. Local Water Fluoride <0.3 ppm: Fluoride 0.25 mg qd
    2. Local Water Fluoride 0.3-0.7 ppm: No Fluoride
    3. Local Water Fluoride >0.7 ppm: No Fluoride
  2. Ages 3 to 6 years old
    1. Local Water Fluoride <0.3 ppm: Fluoride 0.50 mg qd
    2. Local Water Fluoride 0.3-0.7 ppm: Fluoride 0.25 mg qd
    3. Local Water Fluoride >0.7 ppm: No Fluoride Supplement
  3. Ages 6 to 16 years old
    1. Local Water Fluoride <0.3 ppm: Fluoride 1.00 mg qd
    2. Local Water Fluoride 0.3-0.7 ppm: Fluoride 0.50 mg qd
    3. Local Water Fluoride >0.7 ppm: No Fluoride

V. Efficacy

  1. Prevents Dental Caries
  2. Initially thought to prevent osteoporotic Fractures if started early and in low doses
    1. Found to increase bone density 10% per year
    2. However resulting bone is not thought to be as strong, and may not confer advantage in Osteoporosis Prevention

VI. Preparations

  1. Drops: 0.125 mg, 0.25 mg and 0.5 mg per dropper
  2. Chewable tablets: 0.5 mg, 1 mg
  3. Tablets: 1 mg
  4. Multi-Vitamins (Tri-vi-flor and poly-vi-flor)
    1. Available as drops and chewable tablets
    2. Write specifically for older, generic formulation (another pharmaceutical switch to re-patent an old drug)
  5. Fluoride varnish (applied at dental visits, in addition to oral Fluoride Supplementation as needed)
    1. Fluoride varnish is also applied to teeth at each pediatric dental visits after Tooth Eruption (6 months)
    2. See Oral Health in Children
    3. Sievers (2016) Am Fam Physician 93(9):743-4 [PubMed]

VII. References

  1. Pak (1995) Ann Intern Med 123:401-8 [PubMed]

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Related Studies

Cost: Medications

Sodium Fluoride . (on 6/18/2017 at Walmart.com)
Sodium Fluoride .25mg chewable (120ct bottle) #1 bottle for $4.00 $4.00 each
sodium fluoride (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
SODIUM FLUORIDE 0.5 MG/ML DROP Generic $0.12 per ml
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

Ontology: Sodium Fluoride (C0037508)

Definition (NCI) An inorganic salt of fluoride used topically or in municipal water fluoridation systems to prevent dental caries. Fluoride appears to bind to calcium ions in the hydroxyapatite of surface tooth enamel, preventing corrosion of tooth enamel by acids. This agent may also inhibit acid production by commensal oral bacteria. (NCI04)
Definition (MSH) A source of inorganic fluoride which is used topically to prevent dental caries.
Definition (PDQ) An inorganic salt of fluoride used topically or in municipal water fluoridation systems to prevent dental caries. Fluoride appears to bind to calcium ions in the hydroxyapatite of surface tooth enamel, preventing corrosion of tooth enamel by acids. This agent may also inhibit acid production by commensal oral bacteria. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39598&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39598&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C832" NCI Thesaurus)
Concepts Biomedical or Dental Material (T122) , Inorganic Chemical (T197)
MSH D012969
SnomedCT 6910009, 329199009
HL7 NAF
English Fluoride, Sodium, Sodium Fluoride, Sodium fluoride (NaF), sodium fluoride preparations, sodium fluoride preparations (medication), sodium fluoride (medication), dental preparations sodium fluoride preparations, fluoride (as sodium fluoride), NaF, SODIUM FLUORIDE, Sodium Fluoride [Chemical/Ingredient], sodium fluoride, Fluorides, Sodium, Sodium Fluorides, fluoride sodium, Fluoride, sodium, Sodium Fluoride (NaF), Sodium fluoride, Sodium fluoride (substance), Sodium fluoride product (product), Sodium fluoride product, Sodium fluoride product (substance), FLUORIDE (AS SODIUM FLUORIDE), FLUORIDE (AS SODIUM), Fluoride Sodium
French Fluorure de sodium
Swedish Natriumfluorid
Spanish fluoruro de sodio, producto, fluoruro de sodio (producto), producto con fluoruro de sodio (producto), producto con fluoruro de sodio, fluoruro de sodio (sustancia), fluoruro de sodio, fluoruro de sodio, producto (producto), Fluoruro de Sodio
Czech fluorid sodný
Finnish Natriumfluoridi
Russian NATRIIA FTORID, NATRII FTORISTYI, НАТРИЙ ФТОРИСТЫЙ, НАТРИЯ ФТОРИД
Japanese フッ化ナトリウム, ふっ化ナトリウム, 弗化ナトリウム
Polish Fluorek sodowy
Norwegian Natriumfluorid
German Natriumfluorid
Italian Floruro di sodio
Portuguese Fluoreto de Sódio
Derived from the NIH UMLS (Unified Medical Language System)

Related Topics in Minerals and Other Inorganic Chemicals

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