In the draft recommendation, the USPSTF concluded with "moderate certainty that there is a moderate net benefit of preventing future dental caries with fluoride varnish application in all children younger than age 5 years."
Similarly, it said with "moderate certainty that there is a moderate net benefit of preventing future dental caries with oral fluoride supplementation at recommended doses in children older than age 6 months whose water supply is deficient in fluoride."
The task force gave both fluoride practices a "B" grade, meaning that clinicians should offer or provide the services. However, only 4% of pediatricians report regularly applying fluoride varnish, the USPSTF noted in the draft recommendation.
"All children with erupted teeth can potentially benefit from the periodic application of fluoride varnish, regardless of the levels of fluoride in their water," the USPSTF wrote in the draft recommendation. "Although the evidence to support fluoride varnish is drawn from higher-risk populations, the provision of fluoride varnish to all children is reasonable since the prevalence of risk factors is high in the U.S. population."
The USPSTF also reviewed the evidence on conducting caries screening in primary care settings but found insufficient evidence to grade the practice. That said, providing dental caries screening in primary care settings is "noninvasive and not likely to cause serious harms," the task force noted.
The new draft recommendation statement is an update to the USPSTF's 2014 recommendations on the same topic. Like in 2014, the task force came up with the recommendations after conducting a systematic review and limited the scope to interventions provided by primary care physicians to children under the age of 5.
The draft recommendation statement is not yet final, and clinicians can comment on the document through June 7, 2021. After taking the comments into consideration, the USPSTF will publish its final recommendation statement.
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