HICKSVILLE, N.Y., May 24 /PRNewswire/ -- To avoid permanent tooth discoloration, the Canadian Dental Association advises against fluoride supplement use for children before their permanent teeth have erupted, at about 6 or 7 years old.

There is "...weak scientific evidence supporting the effectiveness of fluoride supplements." This was reported at a Canadian Consensus Conference on the Appropriate Use of Fluoride Supplements. "The use of fluoride supplements before the eruption of the first permanent tooth is generally not recommended," says recently released CDA fluoride supplement guidelines and announced world-wide on the internet-based dental-public-health listserv, a forum for government and academic public health dentists and other fluoride policy makers.\\\\\\\\\\\\\\\\

"Studies show that tooth decay is declining in both fluoridated and non- fluoridated areas while dental fluorosis (white spotted, yellow or brown stained and sometimes crumbly teeth) is increasing, more so in fluoridatedareas," says lawyer Paul Beeber, President of the New York State Coalition Opposed to Fluoridation. "Furthermore, fluoride poses harmful systemic damage as well as dental damage," says Beeber.

"New research shows that swallowed fluoride carries little, if any, benefit," says Canada's leading fluoride authority, dentist Hardy Limeback, head of the Department of Preventive Dentistry, University of Toronto, and past-president of the Canadian Association for Dental Research. "Fluoride's enamel strengthening effects are primarily topical, or when fluoride touches the outside of the tooth," says Limeback. "Fluoride's adverse effects occur upon ingestion. Fluoride gets into every cell of the body and can especially damage the bones and teeth."

"Half of all ingested fluoride remains in the skeletal system and accumulates with age," says Limeback. "Studies have linked fluoridation to hip fractures and high levels of naturally-occurring water fluoride to crippling skeletal fluorosis, a bone deforming arthritic-type disease endemic to India," says Limeback.

A study in progress by Limeback shows that residents of fluoridated Toronto have double the fluoride in their hip bones than residents of non- fluoridated Montreal. "Worse, we discovered that fluoride is actually altering the basic architecture of human bones," says Limeback. Ironically, "Here in Toronto we've been fluoridating for 36 years. Yet Vancouver, which has never fluoridated, has a cavity rate lower than Toronto's," says Limeback.

"Current fluoridation studies show that the benefit of fluoride added to water is minuscule but it has increased dental fluorosis. We are now spending more money treating dental fluorosis than we would spend treating new decay if water fluoridation halted," says Limeback.

Children have become over-saturated with fluoride from food and beverages made in fluoridated cities, from the overuse or misuse of a growing number of fluoridated dental products, from fluoride containing pesticide residues in food, from industrial fluoride air emissions and from some fluoride-containing medicines, anesthetics and other products. Fluoride is also inhaled via ocean mist (ocean water and fish contain 1.4 ppm fluoride) and through showers and humidifiers using fluoridated water. Fluoride is found naturally in some foods like tea.

"The safety of long-term fluoride ingestion has not been proven," says Limeback. "The notion that systemic fluorides are needed in non-fluoridated areas is an outdated one that should be abandoned altogether." says Limeback. The American Dental Association (ADA) still recommends fluoride supplements for children from 6 months to 16 years old in non or low- fluoridated communities. "The ADA is clinging to outmoded ideas," says Beeber. "And they are trailing behind the CDA by failing to protect our children."

"Fluoride supplements and water fluoridation must stop immediately," says Beeber.

Text of CDA Resolution:

Canadian Dental Association

Considerations re: Fluoride Supplementation

The Canadian Dental Association supports the appropriate use of fluorides in the prevention of dental caries as one of the most successful preventive health measures in the history of health care. The availability of fluorides from a variety of sources, however, is a current reality which the practising dentist needs to take into account in dealing with patients. This is particularly true of children under the age of six, where exposure to more fluoride than is required simply to prevent dental caries can cause dental fluorosis. There is no evidence of any health problems being created by such exposure, but it is prudent to attempt to limit exposure to the optimal levels required for continuing dental caries protection. Current levels of fluoride intake from all sources are difficult to establish for any given area, but the dentist should consider general intake to the extent possible in recommending fluoride supplementation.

The following suggestions are consistent with these principles:

1. Fluoride supplements are only required for high dental caries risk patients and may be unnecessary if the patient is receiving adequate fluoride from other sources.

2. Before prescribing fluoride supplements, a thorough clinical examination, dental caries risk assessment and informed consent with patients/caregivers are required.

3. The Canadian Consensus Conference on the Appropriate Use of Fluoride Supplements for the Prevention of Dental Caries in Children, held in November 1997 suggested that high caries risk individuals or groups may include those who do not brush their teeth (or have them brushed) with a fluoridated dentifrice twice a day or those who are assessed as susceptible to high caries activity because of community or family history, etc.

4. The estimation of fluoride exposure from all sources should include use of fluoridated dentifrice and all home and child care water sources. Dentists should be aware of the average fluoride exposure in their area. The possible impact of fluoride reducing factors within the home such as the use of unfluoridated bottled water of some reverse osmosis devices should be taken into account.

5. Lozenges or chewable tablets are the preferred forms of fluoride supplementation. Drops may be required for individual patients with special needs.

6. The use of fluoride supplements before the eruption of the first permanent tooth is generally not recommended. When, on an individual basis, the benefit of supplemental fluoride outweighs the risk of dental fluorosis, practitioners may elect to use these supplements at appropriate dosages on younger children. In doing so, the total daily fluoride intake from all sources should not exceed 0.05-0.07 mg F / kg body weight in order to minimize the risk of dental fluorosis.

7. Following the eruption of the first permanent tooth and the associated decrease in the risk of dental fluorosis at this stage of development, fluoride supplements in the form of lozenges or chewable tablets may be used to deliver an intra-oral fluoride dose. A lozenge or chewable tablet containing 1 mg fluoride delivers the same amount of fluoride intra-orally as brushing with an average load (1 gm) of a 1000 ppm fluoride dentifrice.

Approved by Resolution 2000.06

Canadian Dental Association Board of Governors

March, 2000