Safest Ways to Use Fluoride in Your Babies and Children

Researchers say you should start fluoride with baby's first teeth
Safest Ways to Use Fluoride in Your Babies and Children (Infographic)

Contributor: Isabelita Guadiz, MD

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What is the most common chronic disease in children? It’s tooth decay. This infectious disease is caused by bacteria in your child’s mouth. As the bacteria metabolize carbohydrates, they produces acid that, over time, destroys tooth enamel and causes cavities.

The good news is that you, as a parent, can help prevent this problem.

Researchers at the American Academy of Pediatrics (AAP) say using fluoride toothpaste, even as teeth are first appearing, is key to stopping cavities from forming.

They advise parents to use fluoride toothpaste for babies. You want to use a very limited amount — just a smudge — as the first teeth come in. So, even when those first two teeth pop in on the bottom and the first two on the top, parents should start using toothpaste right on the teeth.

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Recommendations for fluoride use by age

Here’s a summary of expert advice for children of different ages:

  • For babies and toddlers, use a dab of fluorinated toothpaste the size of a grain of rice as their teeth come in.
  • Children ages 4 and 5 should use a pea-sized amount of fluorinated toothpaste. Supervise them to prevent them from swallowing toothpaste. I don’t recommend giving them water to rinse with unless you are confident they know how to rinse with it. The natural instinct can be to simply drink the water rather than spit it out.

For all children under age 6, researchers do not recommend over-the-counter fluoride rinses. If your child swallows the rinse, they could ingest higher-than-recommended levels of fluoride. (If your child isn’t really able to rinse at age 6, you can just wait until they are a little older – age 7 or 8. But at whatever age they can actually swish it around and then spit it out, that’s when you want to start.)

Work to help your kids brush their teeth for two minutes twice a day. It is a good habit that could be challenging for parents to develop in children, but it’s well worth the effort.

Fluoride varnish is also helpful for all infants and children at least once every six months, especially kids at higher risk for tooth decay because of the positioning of their teeth. When this concentrated topical fluoride preparation is brushed on teeth, it sets on contact with saliva. Ask your pediatrician or primary care provider for this service.

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Why fluoride matters

Following these recommendations is critical because early childhood tooth decay is the single greatest risk factor for cavities in your child’s permanent teeth. The researchers found that as many as 59 percent of 12- to 19-year-olds have at least one documented cavity. However, fluoride toothpaste reduces tooth decay in children by 15 to 30 percent, according to the Centers for Disease Control.

There are some risks of fluoride use, such as fluorosis, which can cause tooth discoloration. The majority of cases in the U.S. are mild and involve striations and opaque areas on the teeth. The risk for developing fluorosis mostly passes by age 8.

Help your children take care of their teeth early, and as they get older, reinforce the importance of brushing after meals. These good habits will stay with them.

Tooth decay is the most common childhood disease in the US. Prevention starts at birth.

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