Philippine Pediatric Dental Society Inc. Flouride Guidelines

Posted by admin | November 11, 2011

The Philippine Pediatric Dental Society Inc. formed a Special Committee on Fluoride made up of the Society's Past Presidents for the purpose of coming up with recommendations to guide interested parties on the use of fluoride-containing products. A series of workshops were held starting February 2010 and culminating in the presentation, deliberation and approval of the members of the Society of these evidence-based guidelines simultaneous with the August 17, 2011 seminar held at the St. Lukes Medical Center Global City. All points stated in the Fluoride Guidelines were based on various articles and researches which went under the Cochrane Review and were in close consultation with known experts in the field of fluoride and Preventive Dentistry.

Fluoride Vehicle	6 months to 2 years	2 to 6 years	6 years and above
Water fluoridation	0.5 – 1ppm	0.5 – 1ppm	0.5 – 1ppm
Fluoride toothpaste frequency concentration amount	Twice a day 1000ppm smear	Twice a day 1000ppm smear	Twice a day 1500ppm 10 mm and above
Fluoride mouthrinse frequency time amount	none	When able to spit Daily for 1 minute 10 ml	Daily For 1 minute 10 ml
Fluoride Supplements	Caries risk assessment	Caries risk assessment	1 mg
Fluoride Gel	-	-	2-4x a year
Fluoride Varnish	2-4x a year	2-4x a year	2-4x a year

Fluoride Recommendations

1. The use of community water fluoridation is effective in preventing dental caries with an optimum water fluoridation concentration within the range 0.5-1.0 mg/Liter.
2. From the time a tooth erupts, the teeth should be cleaned by an adult.
3. Teeth should be cleaned or brushed twice a day or more frequently with a fluoride toothpaste containing at least 1000ppm fluoride or 1mg/g fluoride for 2 minutes.
4. Toothpaste should be used under the supervision of an adult, dispensing a smear, pea size or 1 cm amount depending on the age.
5. Spitting out and not swallowing and not rinsing should be encouraged.
6. As an adjunct fluoride vehicle for children with moderate/high risk for caries, daily or weekly mouthrinses must be used regularly.
7. Mouth rinses should be used for children who are able to spit out properly.
8. After brushing or at a time when toothpaste is not used, swish (10 ml amount) for 1 minute and spit out.
9. Prescribing Fluoride supplements are done after an assessment of all sources of fluoride and caries risk assessment.
10. Fluoride supplements may be given to children 6 years and older and who have a moderate to high risk for developing caries.
11. Fluoride gels and foams are effective in the prevention of caries and may be used for children who have moderate or high risk of developing caries.
12. Fluoride gels and foams may be applied every 3 to 6 months depending on caries risk assessment using appropriate volume and armamentarium.
13. Fluoride varnishes are very effective in prevention of caries and may be used for children who have moderate or high risk of developing caries.
14. Fluoride varnishes may be applied every 3 to 6 months or as often as necessary to prevent or arrest caries.