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Principle #1: Approach with confidence: Make fluoride the default, not a debate

Make Prevention theDefault

Position fluoride as standard preventive care, rather than a controversial topic for debate. Framing the conversation around protection and routine health behaviour reduces unnecessary hesitation and normalizes daily use.

Core Behaviour

  • Lead with a clear, matter-of-fact recommendation
  • Use presumptive, but everyday, routine language
  • State the recommendation first
  • Speak as you would about any standard preventive habit (e.g., brushing, seatbelts)
  • Move naturally into demonstration or instruction
  • Use inclusive language (“we use”, “we recommend”)
  • Avoid opening the conversation with opinion-based or permission-seeking questions

QuickTalking Tips

 Presumptive language means starting from the assumption that recommended preventive care will be used, in the same way as other routine health measures. It does not mean being forceful, dismissive, or ignoring.

A Simple Rule of Thumb: If you are asking permission before giving the recommendation, the language is not presumptive.

DOThis

(Presumptive Framing)

Present fluoride as standard care, for example:

  • “We use fluoride toothpaste twice a day to help prevent cavities.”
  • “At this age, we brush with fluoride toothpaste.”
  • “For children, fluoride toothpaste is part of routine prevention.”
  • “I’ll show you the right amount of fluoride toothpaste for your child.”
  • “This is how we protect teeth before cavities start.”

These statements:

  • Assume acceptance unless concerns are raised
  • Sound the same as advice about brushing or flossing
  • Move naturally into demonstration or instruction.

AVOIDThis

(Participatory or optional framing)

These examples turn prevention into a decision point before any concern exists:

  • “What do you think about fluoride?”
  • “Would you like to use fluoride toothpaste?”
  • “Some parents choose fluoride, some don’t.”
  • “It’s up to you whether you want fluoride.”
  • “Do you have any concerns about fluoride?” (before recommending it)

These phrases unintentionally:

  • Signal that fluoride is controversial
  • Suggest uncertainty about safety or value
  • Invite debate where it may not be needed

Standard Chairside Language

“To help prevent cavities, we use fluoride toothpaste twice a day. I’ll show you the right amount for your child’s age.”

“At this age, brushing twice daily with fluoride toothpaste is part of routine prevention.”

“This is the standard way we protect children’s teeth before cavities start.”
  • Physically demonstrate the correct toothpaste amount (smear or pea-sized)
  • Show the toothpaste on the brush rather than describing it verbally

This reinforces routine use and shifts focus from abstract risk to practical care.

General Delivery Tips

  • Use a calm, confident tone
  • Deliver the recommendation early in the visit
  • Maintain eye level and relaxed posture
  • Do not over-explain unless questions are asked

Starting with a routine recommendation:

  • Normalises fluoride as everyday preventive care
  • Prevents the conversation from becoming adversarial
  • Reduces the influence of external misinformation
  • Preserves trust by demonstrating professional confidence

Evidence Base

Research in paediatrics shows that beginning preventive discussions with a presumptive recommendation (presenting the intervention as routine care) is associated with higher acceptance than framing it as an open debate.

Framing fluoride as routine prevents the conversation from being positioned as controversial from the outset.

Key Evidence

 

Other Principles

The Fluoriders campaign is an initiative of the International Association of Paediatric Dentistry (IAPD) designed to promote good oral hygiene habits in children.

The Fluoriders initiative is supported by an educational grant from Colgate’s Bright Smiles, Bright Futures® programme. All educational content is developed independently by IAPD.