Pediatricians and other primary care doctors should apply fluoride varnish to infants’ teeth soon after they erupt, according to new cavity-fighting guidelines.
The recommendations come from the U.S. Preventive Services Task Force (USPSTF), a government-backed panel.
“Only one in four preschool children is seeing a dentist, but most see a primary care clinician,” Dr. Michael LeFevre told Reuters Health. “Primary care clinicians can play an important complementary role in helping dentists keep children’s teeth healthy.”
A family physician from the University of Missouri School of Medicine in Columbia, LeFevre chairs the USPSTF.
The panel declined to state how often doctors should apply fluoride varnish to infants’ teeth, saying research is inconclusive.
Pediatric dentist Dr. Mary Hayes welcomed the help from pediatricians, family doctors and nurse practitioners.
“It’s a good thing that dentistry and medicine are working hand in hand trying to attack decay in kids’ mouths,” she told Reuters Health. Hayes is an American Dental Association spokeswoman and was not involved with the new recommendations.
In addition to applying fluoride varnish to all baby teeth, the task force continues to urge doctors to prescribe oral fluoride supplements to infants who have not had fluoride added to their drinking water. Supplements come in daily doses of drops, tablets or lozenges.
In an effort to prevent tooth decay, fluoride was first added to the water supply in Grand Rapids, Michigan, in 1945. Since then, communities throughout the U.S. have debated whether to add the naturally occurring mineral to public water systems.
About two-thirds of Americans currently drink water from fluoridated community systems, according to the Centers for Disease Control and Prevention.
The task force last updated its recommendations on prevention of tooth decay in preschool-aged children 10 years ago.
In 2004, it said primary care doctors should prescribe oral fluoride to babies whose water had not been fluoridated starting at six months old.
Evidence at the time showed the benefit of reducing the risk of dental cavities with fluoride outweighed possible harms, including fluorosis, a condition that discolors teeth and can pit the enamel.
LeFevre and Hayes both said the task force thoroughly examined fluoride risks in formulating the new recommendations. But Dr. Philippe Grandjean, from the Harvard School of Public Health in Boston, told Reuters Health in an email that the panel appears not to have considered brain-related risks from fluoride exposure.
In 2012, Grandjean found that 26 of 27 studies on intelligence tests in fluoride-exposed children showed an IQ deficit linked to increased fluoride.