Fluoride is the only known mineral that effectively makes the teeth more resistant to cavities (caries), fortifies tooth enamel, and inhibits bacterial formation. "Fluoride toothpaste" simply put is any toothpaste that contains fluoride (Crest, Colgate, etc.). It is safe and effective against cavities for all ages as long as it is used as recommended. This article only focuses on fluoride for topical and not ingested means.
When to First Start Using Fluoride Toothpaste?
When the first tooth is visible. "Starter toothpastes" help the infant get used to the idea of brushing teeth but usually have no added benefit.
How Much Toothpaste Do I Use?
From the first tooth erupting to the end of 2-years old, use a smear only of toothpaste on the brush and the parent should brush the child's teeth. This age group cannot spit effectively so toothpaste needs to be strictly minimal to avoid ingesting.
From 3-6-years old, the child can have a pea-sized amount but it is still recommended that the adult continue brushing the child's teeth. 40% of all 3-6-year olds use too much toothpaste mostly because they're brushing without supervision and thus more vulnerable to fluorosis--see below.
Is There a Difference in Fluoride Between Kid's and Adult Toothpaste?
No. Children and adult toothpastes have the same amount of fluoride in each. The only differences are that kid's toothpastes have cooler flavors and characters on the packaging.
What Age Can Kids First Start Brushing On Their Own?
Ideally when your child is taught in school how to write in cursive handwriting. This is when they have the appropriate manual dexterity. Since most schools stopped teaching cursive that may mean a lot of adult children still need their teeth brushed by their parents...or aim for 3rd grade (age 8) when children can effectively brush their own teeth.
When Should Children Start Using Mouthwash That Has Fluoride?
Mouthwash does not need to be started until the child reaches age 6--kindergarten years. This is mainly because of their inability to effectively rinse and spit before that age. Chronic swallowing could potentially lead to fluorosis. We highly recommend ACT mouthwash for your child not only because of a welcoming taste but the fluoride content is optimal.
How Much Fluoride Should My Kid Have: The Science
The ADA recommends 2,000 ppm of non-ingested fluoride per day to effectively protect your teeth, and everyone with teeth from infants to adults should brush at least 2-minutes at a time. ADA-approved fluoride toothpastes (nearly all marketed toothpastes in the USA) contain about 1,000 ppm of fluoride. Mouthwash contains at most about 250 ppm. Though there is substantially less fluoride in mouthwash, it definitely helps compensate for poor brushing habits since 6 out of 10 kids brush their teeth much less than 2 minutes at a time. Fluoride mouthwash is even more important if you do not live in a community where fluoride is not added to the drinking water.
Product | Fluoride PPM (Parts per million) |
ADA Recommended fluoride/day | 2,000 |
Nearly all fluoride toothpastes | 1,000 |
Mouthrinse (ie ACT) | 225 |
Community Drinking water with fluoride | 0.7 |
Consequences of too much fluoride: Fluorosis
Fluorosis is when a child swallows too much fluoride during the tooth developing years between 0-7 years old with the largest risk being ages 0-3. Effects are striations and/or discolorations on adult teeth only. For example, if a child swallows too much toothpaste between 15-30 months of life then their two adult front teeth will be permanently discolored when they come in around age 7. Once teeth are done developing under the gums by age 8 the adult teeth cannot get fluorosis and after that age it matters not in regards to affecting the teeth development if your child decides to smother his or her toothbrush with toothpaste.
Fluorosis risk is drastically reduced when following the recommended daily amounts of fluoride toothpaste. We cannot find any research that quantifies how much toothpaste swallowed over time would lead to fluorosis; however, the onus falls on parents to prevent fluorosis since they really should be brushing their younger children's teeth, monitoring how much toothpaste is used, and making sure the child spits out the residual toothpaste and mouthwash.