OHRA - Toothpaste and Children

Toothpaste and Children

	Children ingest substantial amounts of toothpaste because of immature swallowing reflex.

	Early use of fluoride toothpaste may be associated with increased risk of fluorosis.

	Once permanent teeth have mineralized (around 6-8 years of age), dental fluorosis is no longer a concern.

	Parents often question when to begin using toothpaste and when to allow their child to brush independently. Caution is advised related to the use of fluoridated toothpastes by young children because they may swallow excessive amounts of toothpaste, which can lead to fluorosis. It has been found that children younger than 2 years swallow up to 60% of toothpaste that is used. Unless the child has suboptimal exposure to fluoride, fluoridated toothpastes should not be used until after the child turns 2 years old. It is noted that a pea-sized amount of fluoride-containing toothpaste contains the recommended total daily intake of fluoride for a 2-year-old child. Therefore, it is important to ensure that toothbrushing be supervised by a parent or caregiver until the child can reliably rinse and spit out excess toothpaste—usually about age 6 years. The threat of fluorosis decreases after mineralization of all permanent teeth. It is noted that usually all teeth have mineralized at around 6 years of age, the molars mineralizing at 8 years of age.

	Almost all toothpastes manufactured in the United States provide topical fluoride; however, not all natural toothpastes do. It is always a good idea to have families check the fluoride content of their toothpastes.