The Committee on Nutrition of the American Academy of Pediatrics (AAP) last issued a statement in 1986 on the topic of fluoride supplementation for children. The recommendations made at that time have recently been reassessed because of what appears to be an increased incidence of dental fluorosis in children living in the United States. Dental fluorosis appears during tooth formation and is caused by excessive fluoride ingestion, which leads to enamel protein retention, hypomineralization of the dental enamel and dentin, and disruption of crystal formation. The effect is cosmetic only, ranging from barely perceptible white striations or specks to confluent areas of pitting or brownish-gray staining. Teeth affected by fluorosis appear to continue to be resistant to dental caries.
