We agree with the comments of Malouff and Schutte that when a child drinks bottled water, consideration should be given to the total complement of fluoride in the drinking water, whether bottled water or tap water. As noted in our article,1 bottled water often contains minimal amounts, if any, of fluoride. Therefore, one must be cognizant of the total fluoridation level of the drinking water of the child when prescribing. Water from filtration systems, as well as water that the child drinks when in other venues (such as a different location in the school system) must be considered in the equation.
We appreciate the support of Malouff and Schutte concerning the awareness of the need to test the drinking water, regardless of the source. Given the clear effectiveness of water fluoridation and/or supplementation, it is important that supplementation be given where appropriate, but without excess.