TL;DR summary:Smiling child

If your water is below the ideal amount of fluoride in water (0.7 ppm), talk to your dentist or doctor about fluoride supplements for kids.  Fluoride supplements are not as good of a source of fluoride as fluoridated water is, but when fluoride in water is too low to prevent cavities, supplements do provide some of the systemic fluoride that wellness experts recommend for kids’ developing teeth.  Be careful to not mix fluoride supplements (drops, tablets) with fluoridated water.  Fluoride supplements are not for kids who are drinking fluoridated water.

Smiling child who only needs fluoride supplements if no fluoridated water

If you live in a city or area that does not fluoridate, or if you otherwise have water that is substantially lower than the recommended 0.7 ppm, then the experts in kids’ health and wellness recommend talking to your pediatrician or dentist about a fluoride supplement.  Fluoride supplements are an alternative way to get the systemic fluoride that forms strong fluorapatite in kids’ developing teeth – which we discussed in our article Fluoridated water has just a little fluoride.  However, supplements aren’t as good as fluoridated water.  They do make up some of the difference, and get some of that systematic benefit in, but they don’t quite do the job that fluoridated water does with its reliable systemic and topical benefits.

Options for supplements include fluoride drops, typically given to babies and toddlers, and fluoride tablets, typically for older kids.  Sometimes fluoride comes as part of multivitamin drops as well.  Drops and tablets may provide some topical benefit in addition to the systemic benefit – especially if parents put the drops in water for little ones to drink over part of the day, or if children chew the tablets before swallowing.  But supplements are regarded as mostly providing a systemic benefit where kids teeth are strengthened from the inside out as they are developing under the gumline.

It is particularly important to be aware that fluoride supplements – drops and tablets – are NOT for kids who drink fluoridated water, nor are they for kids who have a water source that is above the recommended level for fluoridated water.  (See this article of ours to help you figure out if your water is fluoridated or above the recommended level for fluoridation.)

Just to be extra extra clear that we’re on the same page … If you’ve got fluoridated tap water, then the science says drink fluoridated water and brush twice a day with the right amount of fluoride toothpaste for your age. If you don’t have fluoridated water and your water is low in fluoride, then science says to talk to your dentist or doctor about a fluoride supplement for your kids to make up for the lack of fluoridated water (and still brush twice a day with the amount of fluoride toothpaste recommended for your age). It’s either fluoride from water + fluoride toothpaste … or fluoride supplement + fluoride toothpaste … not all three.

Basic options for routine sources of fluoride - fluoride supplements vs fluoridated water Basic options for routine sources of fluoride - fluoride supplements vs fluoridated water

If you think your family needs fluoride supplements, talk to your kids’ dentist or doctor.  They’ll be able to assess your water source, answer more questions, and if they determine you don’t have the right amount of fluoride in your water source and a supplement is needed, they can get you all set up with drops, tablets, or other options.