Fluoridated Toothpaste Use in Children

In order to prevent tooth de­cay in their childern, parents were advised to use toothpastes that contain fluoride with a minimum concentration of 1,000 parts per million (ppm) by researchers for the Coch­rane Oral Health Group. In a second related study, the authors suggest that concerned parents should consult their dentist to discuss the benefits and risks of fluoride use. The group’s latest re­search in­volved 79 trials on 73,000 children worldwide and ex­amined the effect of different children’s toothpastes. Tooth­pastes with fluor­ide concentrations less than 1,000 ppm were found to only be as effective as nonfluoride toothpastes at preventing tooth de­cay. Children’s toothpastes range from 100 ppm to 1,400 ppm fluoride concentration. The report suggests that brushing a child’s teeth with a toothpaste containing fluor­ide less than 12 months of age may be associated with an increased risk of de­veloping mild fluorosis. Swal­lowing large amounts of toothpaste may still cause fluo­rosis in children up to the age of 6 years when the permanent teeth are still developing, but carefully using a small amount will reduce these risks. After the age of 6 years, the teeth are fully developed, and toothpaste can be used without fear of fluorosis. Dr. Anne-Marie Glenny, an author of the review, said, “From a public health point of view, the risk of tooth decay and its consequences such as pain and extractions is greater than the small risk of fluorosis. Chil­dren would have to swallow a lot of toothpaste over a long period of time to get the severe brown mottling on the teeth, as opposed to the more typical mild white patches. For children that are considered to be at a high risk of tooth decay by their dentist, the benefit to health of preventing decay is likely to outweigh the risk of fluorosis. In such cases, careful brushing of their children’s teeth by parents with a small amount of toothpaste containing higher levels of fluoride would be beneficial. If in any doubt, we would advise parents to speak to their family dentist.” 


(Source: Cochrane Library; Uni­versity of Man­chester; accessed via MDLinx, January 2010)