Keeping an eye on your child’s oral health is always a good idea — and it’s especially important here in Washoe County, where the water supply does not contain the fluoride necessary for healthy teeth.

“Many years ago, it was discovered that fluoride strengthens the enamel on our teeth,” said Trudy Larson, MD, dean of the School of Community Health Sciences at the University of Nevada, Reno, and professor of pediatrics at the University of Nevada, Reno, School of Medicine. “Subsequently, it was discovered it also diminishes breakdown of enamel and inhibits those naturally occurring bacteria in our mouth that contribute to tooth decay.”

Based on these findings, the proactive fluoridation of water began. The goal was to help prevent tooth decay across all segments of the population — and it worked. According to the Centers for Disease Control and Prevention (CDC), drinking fluoridated water reduces cavities in children and adults by about 25 percent. In fact, the CDC named the fluoridation of community water one of the 10 great public health achievements of the 20th century.

“Today, about 210 million Americans benefit from fluoridation,” said Max Coppes, MD, PhD, physician-in-chief at Renown Children’s Hospital and professor and Nell J. Redfield Chair of Pediatrics at the University of Nevada, Reno, School of Medicine. “Unfortunately, in our state, only children and families in Clark County benefit from fluoridation because state law mandates fluoridation in counties with more than 700,000 residents. For counties with fewer residents, fluoridation is optional.

Washoe County residents voted against community water fluoridation, so it’s up to parents to take the extra steps necessary to make sure their kids get enough fluoride to protect and strengthen their teeth.

“It is typically recommended to start giving fluoride at 6 months of age, when teeth are developing,” said Jeremy Bearfield, MD, PhD, a family medicine physician with Northern Nevada Medical Group. “It is often recommended through age 16, as this is the peak time of permanent teeth development, although adults benefit from fluoride as well.”

In communities without fluoridated water, many pediatricians prescribe fluoride drops for infants around 6 months of age. Once your child starts getting teeth, the American Dental Association (ADA) recommends brushing them twice a day with a soft toothbrush and a smear of fluoride toothpaste the size of a grain of rice. For children ages 3 to 6, the ADA recommends a pea-sized dollop. Once your little one is brushing with this larger amount, spitting and rinsing need to be part of the routine, too.

“Until 6 years old, you want to supervise your child’s brushing to make sure they spit out and don’t swallow the toothpaste. Even at age 6 and older, parents should double check to make sure kids are brushing properly,” Coppes said. “After age 6, talk to your doctor about whether they need a fluoride mouth rinse.”

As far as when to see a dentist for the first time, the American Academy of Pediatric Dentistry uses the slogan “first visit by first birthday.”

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