Fluoride and Children: What Parents Need to Know

Should children’s toothpaste have fluoride?

Advice to parents has changed in recent years. Whereas it was thought that fluoride worked best if given by mouth as drops or tablets, dentists now think that topical application, in toothpaste, is preferable. Most dentists today recommend supplementation only for children at high risk of decay – for example, those with decay in their milk teeth. Children who are not at particular risk should get all the fluoride they need from toothpaste.

If a child has too much fluoride when the permanent front teeth are developing – around the second birthday – it can lead to the discolouration known as fluorosis. But working out how much a child is getting can be difficult. It is the total intake – from supplements, toothpaste and the water you drink – that matters.

All water contains some fluoride (including bottled water), but you cannot tell how much unless you call your water company to ask. If you live in an area with more than 0.7 parts per million of fluoride in the drinking water, do not give your child extra fluoride.

Young children often swallow toothpaste and this can pose a problem. There is evidence of a connection between swallowing fluoride toothpaste and enamel mottling (fluorosis) in children. it has been suggested that young children may swallow up to half the paste on the brush, so children up to six who are caries-free should just use a pea-sized amount of low-fluoride toothpaste (around 500 parts per million).