Download or read book The Effectiveness of Silver Diamine Fluoride when Used to Arrest Caries in Children and Associated Oral Health related Quality of Life written by Rena Sihra and published by . This book was released on 2019 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Objective: To investigate the efficacy of silver diamine fluoride (SDF) with 5% fluoride varnish (FV) in treating cavitated caries in young children and to explore the association between SDF treatment and oral health-related quality of life (OHRQoL). Methods: Children with active dentinal caries lesions (ICDAS 5 or 6) in primary teeth underwent treatment with 38% SDF and 5% FV at baseline and 4 months later. Treated lesions were assessed 4 and 8 months after baseline to determine arrest. Participants were deemed Completely Successful (CS) if all treated lesions were arrested and Incompletely Successful (IS) if at least one lesion was not arrested. The early childhood oral health impact scale (ECOHIS) questionnaire was completed at second and third visits. Statistical analyses included descriptive and bivariate methods. A P value ≤ 0.05 was significant. Results: Forty children with 239 caries lesions were enrolled; mean age 40.2 +/- 14.9 months and 45% male. Lesion arrest rates after one and two applications of SDF were 74.1% and 96.2%, respectively. Children who reportedly brushed twice daily were more likely to be in the CS group compared to those who brushed less (p=0.006). Participants in the CS group had a significantly lower mean baseline dmft score than those in the IS group (p= 0.048). No significant difference in OHRQoL was observed between CS and IS groups. Conclusions: SDF with 5% FV is an effective approach to the management of ECC; more than one application is recommended along with regular follow-up of patients and twice daily brushing. OHRQoL was not found to be affected by the level of success of SDF treatment.
Download or read book Effect of Silver Diamine Fluoride on Oral Microflora Growth and Oral Health related Quality of Life of Preschool Children with Early Childhood Caries written by Sara Rahman and published by . This book was released on 2018 with total page 106 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Silver Diamine Fluoride and Oral Health related Quality of Life written by Nazafarin Javdan and published by . This book was released on 2017 with total page 26 pages. Available in PDF, EPUB and Kindle. Book excerpt: Purpose: The purpose of this study was to study the association between Silver Diamine Fluoride (SDF) and Oral Health-Related Quality of Life as assessed by "The Early Childhood Oral Health Impact Scale" questionnaire. Methods: Parents of healthy children (ASA I and II) ages 1-5 with early childhood caries with reversible pulpitis who had application of SDF filled out a questionnaire at baseline and again after one month. The questionnaire was designed to evaluate the child's behavior, physical abilities, pain, temperament, and how well the child gets along with others. Results: Wilcoxon Signed Rank Test was used to determine if responses to various ECOHIS items and the total scores were different between the two time points. Conclusion: Children with dental caries who had application of SDF reported less dental pain, less eating problems, higher quality of sleep and overall higher quality of life at one-month follow up compared with the baseline.
Download or read book Effectiveness of Silver Diamine Fluoride Solution in Arresting Early Childhood Caries written by Ho-Tak Marcus Fung and published by Open Dissertation Press. This book was released on 2017-01-27 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation, "Effectiveness of Silver Diamine Fluoride Solution in Arresting Early Childhood Caries" by Ho-tak, Marcus, Fung, 馮浩德, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Early childhood caries (ECC) is the most prevalent oral disease of children worldwide. Epidemiological studies reported that most of the ECC are left untreated. While young children may not be co-operative enough for conventional restorative treatments, silver diamine fluoride (SDF) can be topically applied on tooth surfaces as a cariostatic agent. Previous clinical trials have confirmed that annual application of 38% SDF is effective in arresting dentin caries in preschool children. However, information about the effectiveness of SDF with different combinations of concentration and frequency is still lacking. This information is important for the optimal application of SDF in the future public health programs for caries control. This prospective randomized controlled trial aimed to investigate and compare the effectiveness of 12% and 38% SDF when applied annually or biannually in arresting dentin caries of primary teeth of preschool children for 30 months. The two null hypotheses tested were firstly, there is no difference in effectiveness when SDF is applied at 12% or 38% in arresting dentin caries of preschool children; and secondly, there is no difference in effectiveness when SDF is applied annually or biannually in arresting dentin caries of preschool children. A total of 888 healthy and cooperative K1 children aged 3-4 years with at least one dentin caries surface were recruited and randomized into four treatment groups: Group 1 received annual applications of 12% SDF, Group 2 received biannual applications of 12% SDF, Group 3 received annual applications of 38% SDF, and Group 4 received biannual applications of 38% SDF. Group 3 was assigned as the positive control group. Primary outcome was soft dentin caries surface at baseline that became arrested at the follow-up examinations. Clinical examinations were conducted at the kindergartens every 6 months by the same trained examiner. Parental questionnaires were used to collect the children's demographic information, oral hygiene related habits, parental satisfaction with children's dental appearance and dental health at baseline, 18- and 30-month examinations. Adverse effects after treatments including increment of non-vital teeth, complaint about tooth or gingival discomfort, gingival discoloration, and black staining over arrested surfaces were also recorded. A total of 798 children with 3,268 caries surfaces were examined at 30-month follow-up. The dropout rates of the four groups were similar. The respective proportions of arrested surfaces in Group 1 to Group 4 were 48.7%, 54.0%, 60.6%, and 66.9%, respectively (p To conclude, SDF is more effective in arresting dentin caries in primary teeth of preschool children at 38% than 12%, and when applied biannually than annually. Clinical significant improvement in effectiveness can be achieved by increasing its concentration. DOI: 10.5353/th_b5435643 Subjects: Denta
Download or read book Oral health of Australian children written by Loc G. Do and published by University of Adelaide Press. This book was released on 2016-11-01 with total page 369 pages. Available in PDF, EPUB and Kindle. Book excerpt: This collaborative work provides a detailed snapshot of child oral health in Australia. In doing so, it describes the levels of dental caries and its components, dental fluorosis and other oral health conditions and how they vary by social characteristics. It also describes protective factors such as toothbrushing, the use of fluoridated toothpastes and making dental visits. The 2012–14 National Child Oral Health Study (NCOHS) was a cross-sectional study of the child population aged 5 to 14 years in Australia. A total of 24,664 children from 841 participating schools completed the study. The study sample was selected in a complex multistage, stratified sampling design. Sophisticated weighting procedure was employed to adjust for variations in probabilities of selection and response rates. Therefore, this report presents estimates as representative of child oral health in Australia. Information was collected via a parental questionnaire and a detailed dental examination by trained dental professionals.
Download or read book Effectiveness of Silver Diamine Fluoride and Sodium Fluoride Varnish in Arresting Dentine Caries written by Chun-Hung Chu and published by . This book was released on 2017-01-27 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation, "Effectiveness of Silver Diamine Fluoride and Sodium Fluoride Varnish in Arresting Dentine Caries" by Chun-hung, Chu, 朱振雄, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Abstract of thesis entitled Effectiveness of silver diamine fluoride and sodium fluoride varnish in arresting dentine caries submitted by Chu Chun Hung for the degree of Doctor of Philosophy at the University of Hong Kong in May 2004 Introduction: Caries prevalence in young children in China is high and most of the decayed teeth are left untreated. Conventional dental treatments are either not available or are unaffordable in many rural areas. Innovative approaches are needed to improve this situation. Aim: This prospective clinical trial investigated the effectiveness of topical fluoride applications in arresting dentine caries. The first null hypothesis to be tested was that there were no differences in the effectiveness of applying a 38% silver diamine fluoride (SDF) solution (44,800 ppm F), a 5% sodium fluoride (NaF) varnish (22,600 ppm F) and water in arresting dentine caries. The second null hypothesis was that caries removal prior to fluoride application had no impact on its effectiveness in arresting dentine caries. Methods: A total of 375 Chinese kindergarten children, aged 3-5 years with carious upper anterior teeth were divided into five groups. Children in the first and second groups received annual applications of SDF. NaF was applied every three months onto the lesions of children in the third and fourth groups. For children in the first and third groups, soft carious tissues were removed with hand instruments prior to fluoride application at the baseline examination. The fifth group of children received annual applications of water. Follow-up examinations were performed every six months. The children's parents completed a questionnaire to assess parental satisfaction with the appearance of the upper anterior teeth of their child before treatment and again at 24 months after treatment. Results: A total of 308 children were followed for 30 months. The respective mean numbers of arrested caries tooth surfaces in the five groups of children were 2.5, 2.8, 1.5, 1.5 and 1.3 (pDOI: 10.5353/th_b3016250 Subjects: Dental caries - Prevention Dental caries in children Fluorides - Therapeutic use Sodium fluoride - Therapeutic use
Download or read book Silver Diamine Fluoride written by Karthika D and published by Clever Fox Publishing. This book was released on with total page 74 pages. Available in PDF, EPUB and Kindle. Book excerpt: Dental caries specifically ECC, remains a remarkable issue in certain parts of society, particularly those with low socioeconomic status and with scarce health care services. Techniques that promote less discomfort, such as the application of silver diamine fluoride, should be preferred and considered. Treatment of the disease is needed as children with an active caries lesion in their primary dentition can also present with caries lesions in their permanent dentition. By arresting and preventing the progression of caries, SDF offers an intervening care path for young children for whom traditional restorative treatment is not instantly available nor unacceptable by the children. This book on SDF highlights the properties of SDF and clinical recommendations on its use, safety for clinicians, the pros and cons of SDF solution in the clinical use of young children.
Download or read book Effects of Silver Diamine Fluoride on Oral Bacteriome and Mycobiome written by Mayura Manerkar and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction: Silver diamine fluoride (SDF) is a simple and non-invasive agent to arrest caries in children. The purpose of this study is to investigate changes to the oral bacteriome and mycobiome in young children treated with SDF Methods: Plaque samples were collected from 45 children with early childhood caries (ECC). Frequency regimens of SDF were two applications 4 months apart (4M), two applications 6 months apart (6M), and two applications 1 month apart (1M). DNA was extracted and sent to Genome Quebec Innovation Center for library preparation and paired-end Illumina MiSeq PE300 sequencing of the V4 region of bacterial 16S rRNA and fungal ITS1 rRNA genes. Sequencing data was analyzed using QIIME2 2018.11. Results: A total of 195 carious lesions in 44 children were treated at baseline and followed over two subsequent study visits. The overall arrest rates were 77.69% at Visit 2 and 93.61% at Visit 3 respectively. Arrest rates were higher for all lesions after two applications of SDF. The alpha diversity and beta diversity analysis showed no significant differences in the supragingival bacteriome and mycobiome for all three regimens. Taxonomic assignment showed that Streptococcus, Corynebacterium and Actinomyces were the most abundant genera for Bacteria and Candida, Blumeria, and Malassezia were the most abundant genera for Fungi. Streptococcus mutans and Veillonella dispar both showed a decrease in relative abundance, but these changes were a trend and not found to be statistically significant. Candida albicans was highly abundant in all groups regardless of number of visits or regimens. The differential abundance analysis showed significant changes in both bacterial and fungal species, particularly Lactobacillus spp., Bifidobacterium spp. and Candida spp. Our study found a vast diversity of fungal species and differential abundance analysis suggested that SDF treatment may have an effect on the abundance of specific fungi. Conclusion: SDF was an effective modality for arresting dental caries with higher arrest rates for all lesions after two applications of SDF. Further studies with a larger sample size are needed to confirm whether the presence or absence of various bacterial and fungal species are the result of SDF application at various frequencies.
Download or read book Silver Fluoride and Caries Management written by Raman Bedi and published by Frontiers Media SA. This book was released on 2024-09-13 with total page 62 pages. Available in PDF, EPUB and Kindle. Book excerpt: The World Health Organization (WHO) have classified the dental caries epidemic as a global public health priority. A global action plan has been published, and by 2030, each country needs to reduce the dental caries burden and implement a universal health care strategy. Public and private oral health care expenditure has reached an estimated 387 billion US dollars, and its distribution is unequal, with most costs occurring in high-income settings. Dental caries is estimated to impact 3.5 billion people and is more significant than any other Non-communicable disease. The majority of dental cavities are untreated. In 2021, the WHO Essential Medicine Committee included, for the first time, silver diamine fluoride (SDF) as a critical medicine. SDF was listed as a caries arresting product. Silver fluoride product has recently been introduced to the dental market and initial evidence is that it is also as effective in arresting caries.
Download or read book Caries Excavation Evolution of Treating Cavitated Carious Lesions written by F. Schwendicke and published by Karger Medical and Scientific Publishers. This book was released on 2018-09-13 with total page 190 pages. Available in PDF, EPUB and Kindle. Book excerpt: Currently there is no reason, in most cases of cavitated caries lesions, to remove affected tissue. This book presents evidence-based research on the topic and provides assessments of diagnostic devices. It offers new insights into how a dentine carious cavity can be managed by either tissue removal or restoration. Methods for preserving dental tissue are presented and ample evidence highlights the need to seal with a quality restorative material. An update on how to conduct a randomized clinical trial is followed by a chapter on agreed upon terminology for supporting improved communication among oral health professionals around the world. This is a must-read for general practitioners, restorative specialists, dental students, and oral hygienists/therapists.
Download or read book Silver Diamine Fluoride for the Prevention and Arresting of Dental Caries Or Hypersensitivity written by Shirley S. T. Yeung and published by . This book was released on 2017 with total page 27 pages. Available in PDF, EPUB and Kindle. Book excerpt: The purpose of this report is to review the clinical and cost-effectiveness of silver diamine fluoride for the prevention and arrest of dental caries or hypersensitivity, as well as the guidelines for its use.
Download or read book Effectiveness of Silver Diamine Fluoride Solution in Arresting Early Childhood Caries written by 馮浩德 and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Dental Caries written by and published by BoD – Books on Demand. This book was released on 2018-09-19 with total page 178 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides information to the readers starting with the history of oral hygiene manners, and modern oral hygiene practices. It continues with the prevalence and etiology of caries and remedy of caries through natural sources. Etiology of secondary caries in prosthetic restorations and the relationship between orthodontic treatment and caries is addressed. An update of early childhood caries is presented. The use of visual-tactile method, radiography and fluorescence in caries detection is given. The book finishes with methods used for the prevention of white spot lesions and management of caries.
Download or read book Early Childhood Oral Health written by Joel H. Berg and published by John Wiley & Sons. This book was released on 2015-10-26 with total page 344 pages. Available in PDF, EPUB and Kindle. Book excerpt: Dental caries has been called a “silent epidemic” and is the most prevalent chronic disease affecting children. Though much has been written on the science and practice of managing this disease, publications are diverse in their loci, preventing easy access to the reader. Early Childhood Oral Health coalesces all the important information related to this topic in a comprehensive reference for students, academics, and practitioners. This second edition expands the scope of the first and puts an additional focus on interprofessional and global efforts that are necessary to manage the growing disease crisis and screening and risk assessment efforts that have expanded with the boom of new technologies. With updated references and incorporating the latest research, chapters address the biology and epidemiology of caries, the clinical management of early childhood caries, risk assessment, and early diagnosis. Other topics include public health approaches to managing caries worldwide, implementation of new caries prevention programs, fluoride regimens, and community programs, and family oral health education. Brand new are four chapters on the medical management of early childhood caries, considerations for children with special needs, interprofessional education and practice, and how the newest policy issues and the Affordable Care Act affect dental care. A must-read for pediatric dentists, cariologists, public health dentists, and students in these fields, Early Childhood Oral Health is also relevant for pediatricians and pediatric nursing specialists worldwide.
Download or read book Root Caries From Prevalence to Therapy written by M. Rocha de Olivera Carrilho and published by Karger Medical and Scientific Publishers. This book was released on 2017-10-19 with total page 150 pages. Available in PDF, EPUB and Kindle. Book excerpt: Case reports and clinical trials conducted in various countries show, more and more frequently, a positive correlation between the presence of original teeth and prevalence of root caries in older age. Because this is a global trend, it is likely that the predicted increase in the worldwide elderly population may soon cause a significant increase in the number of people requiring effective means of preventing and treating root surface caries. In response to this development, a team of outstanding contributors has reviewed the most important aspects of root caries. This new volume presents their findings along with discussions of how to deal with this health issue that progressively affects the oral health balance. The chapters in this book are divided in four core parts: Epidemiology, Biological Determinants, Lesion Assessment and Features and Preventive and Operative Therapies. The collection of state-of-the-art articles provides a broad overview and will serve as a reference for clinicians as well as scientists and, hopefully, will encourage new research.
Download or read book A Randomized Clinical Trial on Arresting Dentin Caries in Preschool Children by Topical Fluorides written by Duangporn Duangthip and published by . This book was released on 2017-01-26 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation, "A Randomized Clinical Trial on Arresting Dentin Caries in Preschool Children by Topical Fluorides" by Duangporn, Duangthip, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Introduction: Silver diammine fluoride (SDF) has been found to be effective in preventing and arresting dental caries in children. The annual or semi-annual application of SDF may not be practical in migratory populations or effective high caries risk patients. So far, no data are available about the effectiveness of intensive fluoride treatment in arresting dental caries in primary teeth. Objectives: This study aimed to compare the effectiveness of three topical fluoride application protocols in arresting dentin caries in primary teeth of preschool children. Methods: Children aged 3-4 years who had at least one active dental caries lesion were clinically examined by a trained examiner. The visible plaque index (VPI), the dmfs index, extent of carious lesion (ICDAS codes 3-6), color of lesion and presence of plaque on lesion were recorded. After examination, the study children were randomly allocated into three intervention groups: Group 1 - annual application of 30% SDF solution; Group 2 - three applications of 30% SDF solution at weekly intervals; and Group 3 - three applications of 5% sodium fluoride (NaF) varnish at weekly intervals. Information about the children's background, and oral health related behaviors was collected by a parental questionnaire. The masked examiner carried out follow-up examinations every 6 months. For cavitated dentin lesions (ICDAS code 5 or 6 at baseline), lesions with smooth and hard surfaces were classified as arrested caries. For established carious lesions (ICDAS 3 or 4 at baseline), caries arrest was recorded if they did not progress to cavitated dentin carious lesion. Results: A total of 371 children with 2526 tooth surfaces with active caries lesions received treatment at baseline. After 24 months, 316 children (85%) remained in the study. Of the children remaining, 61% had received only the assigned fluoride treatments provided in the study, while 39% of them had received dental treatments from other dentists. For cavitated dentin lesions, the caries arrest rates among the children receiving only the assigned fluoride treatment were 37%, 35% and 27% for Groups 1, 2 and 3, respectively (p=0.04), while for the children receiving other dental treatments, no significant differences in caries arrest rates between the three groups were observed. The results of multi-level survival analysis showed that the arrest times of dentin caries in both SDF groups were significantly shorter than those of the NaF varnish group. For established carious lesions, the caries arrest rates were 50%, 48% and 54% in Groups 1, 2 and 3, respectively. No statistically significant differences were found among three groups. Presence of plaque on lesion, tooth type, tooth surface and extent of the caries lesion had significant effects on caries arrest rates. Conclusions: For cavitated dentin carious lesions, application of SDF solution, either 3 weekly applications at baseline or annual application, can arrest active dentin caries in primary teeth faster than 3 weekly applications of NaF varnish at baseline. However, for established carious lesions, the three fluoride application protocols are equally efficient in controlling established carious lesions. Subjects: Fluorides - Therapeutic use Dental caries in children - Treatment
Download or read book Screening and Interventions to Prevent Dental Caries in Children Younger Than Age Five Years written by Roger Chou and published by . This book was released on 2021 with total page 111 pages. Available in PDF, EPUB and Kindle. Book excerpt: BACKGROUND: In 2014, the U.S. Preventive Services Task Force (USPSTF) found insufficient evidence to assess the benefits and harms of screening for dental caries, but recommended that primary care clinicians prescribe oral fluoride supplementation to preschool children starting at age 6 months whose primary water source is deficient in fluoride and apply fluoride varnish to the primary teeth of all infants and children starting at the age of primary tooth eruption. PURPOSE: To systematically review the current evidence on primary care screening for and prevention of dental caries in children younger than 5 years old. DATA SOURCES: We searched the Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (through April, 2021), and MEDLINE (2013 to April, 2021); with surveillance through July 23, 2021, and manually reviewed reference lists. STUDY SELECTION: Randomized controlled trials (RCTs) and controlled observational studies on benefits and harms of screening versus no screening and referral to dental care from primary care versus no referral; studies on the diagnostic accuracy of oral examination and risk assessment by primary care clinicians; RCTs on benefits and harms of oral health education and preventive interventions; and systematic reviews on risk of fluorosis associated with early childhood ingestion of dietary fluoride supplements. DATA EXTRACTION: One investigator abstracted data and a second investigator checked data abstraction for accuracy. Two investigators independently assessed study quality using methods developed by the USPSTF. DATA SYNTHESIS (RESULTS): Thirty-three studies (reported in 36 publications) were included in this update (19 RCTs, four non-randomized trials, nine observational studies, and one systematic review [19 studies]). Seventeen studies were newly identified as part of this update and 16 studies (including the systematic review) were carried forward from the previous review. No randomized trial or observational study compared clinical outcomes between children younger than 5 years of age screened and not screened by primary care clinicians for dental caries. One good-quality cohort study (n=258) found primary care pediatrician examination following 2 hours of training associated with a sensitivity of 0.76 (95% confidence interval [CI], 0.55 to 0.91) for identifying a child with one or more cavities and 0.63 (95% CI, 0.42 to 0.81) for identifying children younger than 36 months of age in need of a dental referral, compared with a pediatric dentist evaluation. One study (n=697) found a novel risk assessment tool administered by home visitor nurses associated with suboptimal accuracy for predicting future caries in children 1 year of age. The prior USPSTF review found oral fluoride supplementation associated with reduced caries incidence versus no supplementation in children younger than 5 years of age in settings with inadequate water fluoridation, though only one trial was randomized; we identified no new trials. The prior USPSTF review included a systematic review of observational studies which found an association between early childhood ingestion of systemic fluoride and enamel fluorosis. Topical fluoride (all trials except for one evaluated varnish) associated with decreased caries increment (13 trials in updated meta-analysis, N=5733, mean difference in decayed, missing, and filled teeth or surfaces −0.94, 95% CI, −1.74 to −0.34) and decreased likelihood of incident caries (12 trials, N=8177, RR 0.80, 95% CI, 0.66 to 0.95; absolute risk difference −7%, 95% CI, −12% to −2%) versus placebo or no varnish, with no increase in risk of fluorosis or other adverse events. Almost all trials of topical fluoride were conducted in higher risk populations or settings. Evidence on other preventive interventions was limited (xylitol) or unavailable (silver diamine fluoride). Evidence on educational or counseling interventions is very sparse and no studies directly evaluated the effectiveness of primary care referral to a dentist versus no referral. LIMITATIONS: Only English-language articles were included. Graphical methods were not used to assess for publication bias, due to diversity in populations, settings, and outcomes, and substantial statistical heterogeneity. Statistical heterogeneity was present in pooled analyses of fluoride varnish and not explained by stratification on a variety of factors. Studies conducted in resource-poor settings may be of limited applicability to screening in the United States. Most studies had methodological limitations. CONCLUSIONS: Dietary fluoride supplementation and fluoride varnish appear to be effective at preventing caries outcomes in higher risk children younger than 5 years of age. Dietary fluoride supplementation in early childhood is associated with risk of enamel fluorosis, which is usually not severe. More research is needed to understand the accuracy of oral health examination and caries risk assessment by primary care clinicians, primary care referral for dental care, and effective parental and caregiver/guardian educational and counseling interventions.
