TimesLeader.com

November 4, 2008

Fluoride supplement recall causes local pharmacy shortage

SUE GANNIS Times Leader Correspondent

If you are a parent attempting to stave off your child’s cavities using fluoride supplements, you may have noticed that filling these prescriptions has been a little challenging lately. Many area pharmacies have experienced shortages or no supply of fluoride tablets and multi-vitamins with fluoride for anywhere from two weeks to sometimes five months, as the Medicine Shoppe in Nanticoke has been experiencing. These supplements are only available by prescription.

The shortage problem stems from a recent recall of multi-vitamin/fluoride supplements. A recall notice was sent to retail outlets (dental offices and pharmacies, for example) for the Poly-Vitamin Fluoride tablets by the Actavis Group.

According to the directive, the recall was due to the product being “out of specification results for assay at the stability time point.” Because this manufacturer recalled its product, it resulted in a shortage in the market when other manufacturers were unable to increase production.

These prescription fluoride supplements are known as systemic fluorides because they are ingested and absorbed by the body to strengthen the enamel of the permanent teeth that are forming. This process makes the teeth stronger and more resistant to cavities and tooth decay.

These fluoride supplements are produced in three different strengths and prescribed by pediatricians and pediatric dentists based on the child’s age. They are not prescribed for every child, however. If you live in an area where the water is fluorinated, fluoride supplements are not necessary.

Although there are some manufacturers of bottled fluorinated water, Dr. Richard Brown from the Children’s Dental Center in Kingston does not recommend using it as an alternative to the supplements “…because it is not known how much fluoride is in the water,” he explained.

Excessive fluoride could cause a complication called fluorosis. It is characterized by yellowing of teeth, white spots or pitting of the tooth’s enamel. In severe cases, teeth may have black or brown spots and/or cracks or pits in the teeth.

Topical fluoride products such as fluoride rinses and toothpaste will also help prevent decay in your child’s existing teeth.

“It never hurts to brush more often and use fluoride rinse,” assured Dr. Brown, “but that’s not going to help the forming teeth.” Systemic fluoride benefits the formation of teeth because fluoride is easily absorbed by the body. Fluoride works in conjunction with other minerals—calcium, magnesium, zinc and phosphorus — to help form and maintain teeth. Calcium has long been recommended for healthy teeth, but it is digested at a slower rate by the body than fluoride.

So what’s a concerned parent to do? Don’t panic. Some pharmacies are already receiving stock of the fluoride supplements. Even though the orders are being shipped slowly, local pharmacists expect the shortage to be short-lived. Most of the pharmacies have been told by their wholesalers that they should start shipping again this month. However, different wholesalers supply different pharmacies, so deliveries will vary.

Tony Dougalas from the Medicine Shoppe said he has a supply of fluoride tablets in stock, but he has been unable to order more because they have been backordered.

If you have any questions about fluoride supplements or the recall, talk to your pediatrician, pediatric dentist or pharmacist, or call Actavis Group directly at 800-432-8534.

If you are experiencing a fluoride shortage, an increase in calcium consumption through natural sources such as dairy products or plant sources like tofu, kale, spinach or other green leafy vegetables might aid your child, although no pediatrician or dentist has required such measures.

But surely, few children will object to eating a bowl of ice cream even if you tell them the calcium content will help their developing teeth. Just make sure they brush their existing teeth when they are finished eating.