Children and Toothpaste

Every hygienist loves to hear parents say, " My child loves to brush his teeth!" We take joy in knowing that a young one happily marches to the bathroom, takes toothbrush in hand and scrubs away the plaque, all the while singing a merry tune! A vision comes to both the parents and hygienist-this child will be cavity-free for life! The overly joyous parent then chimes in, "Yes, and he loves toothpaste so much, he eats right out of the tube" OH NO! These words are enough to make a dental professional's heart sink. The majority of toothpastes in the US contain fluoride, a naturally occurring element that can strengthen enamel both while the tooth is forming and after it is erupted into the mouth. Too much ingested fluoride can lead to fluorosis, a condition that causes the teeth to erupt with white, chalky patches, or in more severe cases, pitting and brown staining on the enamel.

The three basic sources of fluoride include:

1. Fluoridated municipal water supply. In many communities, fluoride is added to the drinking water in a one part per million ratio. (1ppm). This fluoride is most beneficial when the teeth are forming in the jaw. (systemic fluoride source) The fluoride ion is incorporated into the tooth to form a stronger structure. Fluoridated water sources can reduce decay rates 40-60%.

2. Toothpaste. Toothpaste is the main source of topical fluoride, meaning that it will strengthen teeth that it is exposed to in the mouth.(topical fluoride source) Because of its high fluoride content, approximately 1500ppm, it is NOT meant to be ingested. In my profession career, I see many cases of the white-patch fluorosis because children have been swallowing toothpaste from a young age, as well as obtaining fluoride from other sources unknowingly. Please note that fluorosis CANNOT occur after a tooth is in the mouth.

3. Diet. Trace amounts of fluoride can be found in some teas, green leafy vegetables, and processed juices and sodas.

Instructing and observing children from ages one to seven while brushing is critical in avoiding fluorosis. Toothpaste is not always necessary for the child who is not capable of "spitting out". I did not use toothpaste on my own children until after age 3, I used only water on the toothbrush. Always place a small pea-sized DAB of toothpaste on the brush for the child and instruct him not to swallow. I also like to recommend that parents brush their child's teeth until age 6 or 7, because children do miss a lot of areas, even if it looks like they are doing a thorough job.

Fluoride is a an effective cavity reducing agent, but can cause tooth abnormalities when used incorrectly. Please ask your hygienist or dentist about proper use for you and your family!

Happy flossing!