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The American Dental Association is now recommending fluoride toothpaste be used on children’s teeth as soon as they emerge.

New recommendations for pediatric oral healthcare

Friday, March 28th, 2014
Issue 13, Volume 18.

INLAND EMPIRE – Dental decay is the most common chronic childhood disease. More than 16 million children in the United States alone suffer from untreated tooth decay, according to the U.S. Centers for Disease Control and Prevention. As more and more children develop cavities, new advice is being offered to those who care for young children’s emerging and established teeth.

The American Dental Association’s Council on Scientific Affairs has updated its dental care guidelines for caregivers. While it was once recommended to use water only or a non-fluoride toothpaste to clean teeth of the very young, the CSA now recommends the use of fluoride toothpaste even for young children, saying parents and other caregivers should brush their kids’ teeth with fluoride toothpaste as soon as the first tooth comes in.

"Approximately 25 percent of children have or had cavities before entering kindergarten, so it’s important to provide guidance to caregivers on the appropriate use of fluoride toothpaste to help prevent their children from developing cavities," said CSA chair Edmond L. Truelove, D.D.S.

The CSA recommends that caregivers use a smear of fluoride toothpaste (or an amount about Advertisement
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the size of a grain of rice) for children younger than three years old and a pea-size amount of fluoride toothpaste for children between the ages of three and six years old. The updated guidelines are intended to provide children with the full benefit of cavity protection while limiting their risk of developing fluorosis, which is a mild discoloration of teeth usually appearing as faint lines.

The CSA found that using just a "smear" of toothpaste for children younger than three years old and a pea-size amount for children between the ages of three and six helps to prevent cavities and is less likely to cause fluorosis. Children should spit out toothpaste as soon as they are old enough to do so.

Caregivers also are urged to take their children to the dentist when the first tooth erupts or no later than a child’s first birthday. Semiannual or annual visits thereafter should be the norm, or as directed by a dentist.

Oral healthcare is important for people of all ages, including very young children with cavities. Learn more about preventative oral care by visiting



Comment Profile ImageNo need for added fluoride
Comment #1 | Wednesday, Apr 2, 2014 at 9:03 am
There is no evidence that decay-prone toddlers are fluoride-deficient. The CDC reports up to 60% of adolescents were fluoride overdosed when their teeth were forming and are afflicted with dental fluorosis - white spotted, yellow, brown and/or pitted teeth.

This new recommendation to feed babies a rice-sized amount of fluoridated toothpaste is foolhardy at least and health-damaging at worst.

Many government, health and dental groups warn against routinely mixing fluoridated water with infant formula because it ups the risk of dental fluorosis with no benefit. See:

So it really makes little sense to feed babies a rice-sized amount of fluoridated toothpaste that invariably will get swallowed and add to their body burden of fluoride and make them more susceptible to dental fluorosis.

Also, babies risk fluorosis from unlabeled fluoride in infant foods, say Indiana University researchers in General Dentistry (March/April 2014)

Detectable fluoride levels, found in all 360 samples tested, is due to pesticides, fertilizers, soil, groundwater and/or fluoridated water used in processing, the researchers report.

Foods containing mechanically de-boned chicken and turkey were highest in fluoride because fluoride-saturated bone dust gets into the finished product.

The researchers measured .26 mg/fluoride in chicken baby food which is 65% of a 7-month-old’s recommended daily fluoride intake, they say.

“Consuming greater than 1 serving/day of the high fluoride concentration products in this study would cause children of the target age to exceed the recommended daily fluoride intake,” they write. Average 7-month-old’s shouldn't ingest more than 0.4 mg of fluoride daily, they advise

Often ignored is the American Dental Association’s (ADA) advice that fluoride therapy and prescribing be based upon children’s total fluoride intake. "Caries-free children in fluoridated areas are not likely to benefit from topical fluorides," according to NYS DofH dentist J. Kumar.

“…a person’s greatest susceptibility to fluorosis occurs within the first 2 years of life, as a result, fluoride intake from all sources should be monitored closely during this critical period,” the researchers caution.

This information rarely reaches the public.


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