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Infants' Fluoride Ingestion from Water, Supplements and Dentifrice
Concerns about dental fluorosis and the paucity of detailed fluoride intake data prompted this longitidinal study of fluoride intake in infants from birth to 9 months of age. On average, water fluoride greatly exceeded that from dietary fluoride supplements and dentifrice contributed substantial proportions of fluoride intake among children using them. Some children has estimated fluoride intake from water, supplements and dentrifice that exceeded the recommended "optimal" intake (a level that has yet to be determined scientifically). Practitioners should estimate fluoride ingestion from all of these sources if considering systematic fluoride supplementation.
Steven M. Levy, D.D.S., M.P.H;
... More recently, concerns have been raised about the increased prevalence and severity of dental fluorisis in the United States due to the widespread ingestion of fluoride from a variety of sources. Local and regional studies in the United States and Canada have found the prevalence of mostly mild dental fluorosis to range from 20% to 80%. In an effort to help people achieve the "optimal" intake of ingested fluoride to balance dental caries prevention and dental fluorosis, the recommended dietary fluoride supplementation dosage recently has been reduced in both the United States and Canada. ...
(Authors note: The optimum level of fluoride intake has never been determined scientifically and has been used only in general terms. Levy and Guha-Chowdhury addressed the limations of current knowledge of "optimal" fluoride intake levels.)