[The Nutrition Commission of the Austrian Society of Pediatrics and Adolescent Medicine. Prevention of caries].

Effective preventive programs must be instituted early in the life of a child. The pediatrician plays an important role in preventive oral health care, because most children do not visit a dentist before 3 years of age. Fluoride therapy decreases the caries vulnerability of the tooth, oral hygiene measures are important to remove bacterial plaque, and dietary modifications reduce the number of carbohydrate exposures per day. Community water fluoridation is proposed in Austrian cities, because it continues to be the most cost-effective caries prevention measure available. As long as the population does not have access to optimally fluoridated water, dietary fluoride supplementation offers an effective alternative. The recommended dosage of fluoride supplements for children depends on the amount of fluoride present in their drinking water and on the child's age. Liquid fluoride supplements and chewable tablets are proposed for children between 0.5 and 3 years and children between 3 and 13 years, respectively. Home use topical fluorides and professionally applied topical fluorides are useful beyond 3 years of age. Teaching of oral hygiene measures should be continued in kindergarten and school. The 3-6 year-old children require parental assistance to achieve effective plaque removal. Semiannual dental visits should begin at the age of three and continue throughout childhood and adolescence. As far as the diet is concerned, the frequency of exposure to sugar appears to be the most important factor in the development of dental caries. It now appears that most sugars are nearly equally cariogenic in a pure form.