May 2019

Fluoride toothpaste: are kids using too much?

The Centers for Disease Control (CDC) and American Dental Association (ADA) recently warned that kids might be using too much fluoride toothpaste. Does this mean kids should avoid toothpastes containing fluoride? 

Definitely not. Fluoride is obtained through two main sources: toothpaste and drinking water. Using a fluoride toothpaste is a very important part of preventing dental caries. The problem is, some children might be applying far too much toothpaste to their toothbrush, and as a result, swallowing far too much fluoride. Findings from a recent survey suggest that 38% of kids 3 to 6 years-old are using too much toothpaste. If regularly swallowed, this can cause fluorosis, or discoloration on permanent teeth.

While these findings are important, this does NOT mean children should stop using fluoride toothpastes, or brush less than twice per day. Proper toothpaste application is important – children under 6 should use no more than a pea-sized amount at a time just in case they do swallow some. Parents should also help their kids brush to limit the amount that is swallowed. Fluoride toothpastes most often contain fluoride as stannous or sodium salts. Stannous fluoride might cause tooth staining. So, if you’re worried about staining, look for products containing sodium fluoride instead.

Parents might also ask about fluoride in drinking water. Tell them that the FDA recently proposed lowering the fluoride concentration level standard in bottled water to 0.7 milligrams per liter - down from 0.8-1.7 milligrams per liter. Despite some critics saying this is not low enough, both the ADA and American Academy of Pediatrics stand by the benefits of water fluoridation and support the proposed new level as an appropriate balance between preventing tooth decay and limiting the risk for fluorosis. About 75% of communities already have fluoride in their tap water at 0.7 milligrams per liter. Its effect on dental caries prevention is considered one of the biggest public health successes of the past century. 

For more details, check out our recently updated monograph.

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