Jones and Berg1 argued strongly in AJDC that dentists and pediatricians should consider local water supply fluoride levels in deciding whether to prescribe supplemental fluoride for a child. We agree with this suggestion, but we would like to point out that poor decisions may result unless the health care providers also consider whether the child is drinking bottled water and whether the child is drinking water that has passed through a home filtration unit.
Millions of American families drink bottled water, some of which may not have fluoride, and millions more have carbon-based or distilled water treatment systems in their homes, both of which tend to remove tooth-protecting fluoride along with pollutants such as chloroform.2,3
For health care providers, the best decision path for prescribing fluoride supplements would include determining whether the child is drinking (1) nonfluoride-supplemented bottled water or (2) tap water that has inadequate levels of
Malouff J, Schutte N. Assessing Fluoride Intake. Arch Pediatr Adolesc Med. 1994;148(7):768. doi:10.1001/archpedi.1994.02170070106024