Several previous studies using food consumption tables or diet records have estimated that children aged 1 to 12 years resident in fluoridated (1 ppm) areas receive, on average, between 0.05 and 0.07 mg fluoride/kg body weight from foods and drinks alone. In this study, the duplicate-diet approach, which is a more accurate method of determining nutrient intake, was used to determine if levels of fluoride intake from foods and drinks are similar to those estimated from food consumption tables or diet records. Duplicate portions of all foods and drinks consumed over 24 hours by 66 children aged 3 to 4 years resident in fluoridated and low-fluoride areas of New Zealand were collected on three separate days over a period of 12 months and analyzed for fluoride. Fluoride intake from the use and ingestion of toothpastes and fluoride supplements was also determined for each child. It was hypothesized that the total amount of fluoride received by children in low-fluoride areas from diet, toothpastes, and fluoride supplements was similar to that received by children in fluoridated areas from diet and toothpastes. The mean fluoride intake from foods and drinks alone in the low-fluoride areas was 0.008 +/- 0.003 mg/kg body weight (0.15 +/- 0.06 mg/day; n = 34) and in the fluoridated areas was 0.019 +/- 0.009 mg/kg body weight (0.36 +/- 0.17 mg/day; n = 32). The mean fluoride intake from foods and drinks and toothpastes in the low-fluoride areas was 0.027 +/- 0.012 mg/kg body weight (0.49 +/- 0.25 mg/day) and in the fluoridated areas was 0.036 +/- 0.015 mg/kg body weight (0.68 +/- 0.27 mg/day). Fluoride intake from diet alone did not exceed 0.04 mg/kg body weight (0.74 mg/day), and fluoride intake from diet and toothpaste did not exceed 0.07 mg/kg body weight (1.31 mg/day). The results suggest that levels of fluoride intake from foods and drinks alone as estimated by the duplicate-diet approach are much lower than previously estimated from food consumption tables or diet records. It was calculated that if all children in the low-fluoride areas were to take currently recommended dosages of fluoride tablets, which have been based on dietary surveys and diet records, then the total fluoride intake of some children in the low-fluoride areas would exceed that of their counterparts in the fluoridated areas. The results suggest that currently recommended dosages of fluoride tablets need to be further reduced if dental fluorosis in children is to be avoided.

The prevalence of dental caries continues to increase, and novel strategies to reverse this trend appear necessary. The probiotic Streptococcus salivarius strain M18 offers the potential to confer oral health benefits as it produces bacteriocins targeting the important cariogenic species Streptococcus mutans, as well as the enzymes dextranase and urease, which could help reduce dental plaque accumulation and acidification, respectively. In a randomized double-blind, placebocontrolled study of 100 dental caries-active children, treatment with M18 was administered for 3 months and the participants were assessed for changes to their plaque score and gingival and soft-tissue health and to their salivary levels of S. salivarius, S. mutans, lactobacilli, b-haemolytic streptococci and Candida species. At treatment end, the plaque scores were significantly (P50.05) lower for children in the M18-treated group, especially in subjects having high initial plaque scores. The absence of any significant adverse events supported the safety of the probiotic treatment. Cell-culture analyses of sequential saliva samples showed no differences between the probiotic and placebo groups in counts of the specifically enumerated oral microorganisms, with the exception of the subgroup of the M18-treated children who appeared to have been colonized most effectively with M18. This subgroup exhibited reduced S. mutans counts, indicating that the anti-caries activity of M18 probiotic treatments may be enhanced if the efficiency of colonization is increased. It was concluded that S. salivarius M18 can provide oral health benefits when taken regularly.

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Treating young children with high disease experience in a single session under GA results in immediate improvement in oral health and aspects of their QoL for both the children and their families.