Preventing Dental Caries in Kids

Dental caries prevention recommendations include fluoride supplementation and varnish

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) From the moment your child's first tooth erupts, bacteria has the ability to cause caries, or tooth decay leading to cavities. Dental caries are actually the leading chronic disease among young children in the US.

New recommendations from the US Preventive Services Task Force address what can be done to help prevent caries in kids.

The recommendations update those issued by the Task Force in 2004. The main recommendation then was to give fluoride supplements to children whose tap water was not adequately fluoridated.

The new statement adds the recommendation that children receive a fluoride varnish on their teeth when visiting their primary care doctor.

"Take your child to regular dental check-ups."

The statement, authored by Virginia A. Moyer, MD, MPH, on behalf of the US Preventive Services Task Force, provides the recommendations for preventing caries in children aged 5 and younger.

The recommendations are based on a review of available evidence on the benefits and harms of various dental interventions.

The Task Force did not find enough evidence to recommend that primary care providers, such as family doctors and pediatricians, do routine oral exams for caries in children.

No studies addressed what the possible benefits or harms of such routine oral examination screenings would be.

The benefits of fluoride supplements for children in areas with low fluoridation levels in their water were based on studies finding lower rates of caries among children who received supplementation.

Children who received supplementation saw a 32 to 72 percent reduction of decayed, missing or filled teeth compared to children who did not receive supplements or received a placebo (fake pill).

Similar evidence was found regarding children who received fluoride varnish from their primary care providers.

After two years of receiving a fluoride varnish every six months, children had an average 1 to 2.4 fewer caries than children who did not receive the varnish.

The possible risks of fluoride supplementation and fluoride varnish include a condition called fluorosis.

Fluorosis can cause cosmetic discolorations on teeth, such as small white spots with mild cases or browning in severe cases.

However, fewer than 1 percent of people experience severe fluorosis in the US, the statement noted.

The report also pointed out that dental caries occur among approximately 42 percent of children aged 2 to 11 years old.

A number of factors increase a child's risk of developing dental caries. Those factors include:

  • poor access to dental services
  • failure to brush teeth with fluoride toothpaste
  • a history of caries in a child, his/her siblings or his/her mother
  • frequent snacking
  • frequent sugar consumption
  • inappropriate bottle feeding to infants
  • low socioeconomic status
  • being an ethnic minority
  • dry mouth
  • developmental defects in a child's tooth enamel

The fluoride supplementation and fluoride varnish recommendations received a "B recommendation" from the Task Force.

All A and B recommendations are required to be covered by insurers with no patient copay as a result of the Affordable Care Act.

The statement was published May 5 in the journal Pediatrics. The US Preventive Services Task Force is an independent, voluntary body and is funded by the Agency for Healthcare Research and Quality.

Review Date: 
May 4, 2014
Last Updated:
May 5, 2014