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Kids, Use Fluoride with Care

The fluoridation of public water supplies has played a major role in reducing U.S. tooth decay. But for children — particularly infants — too much fluoride can be too much of a good thing.

Too much fluoride during the formation of teeth inside the gums can cause enamel fluorosis, a cosmetic condition resulting in visible white lines or stripes on the teeth. It doesn’t affect the structure or overall health of the teeth, but it can be a cosmetic concern.

To prevent enamel fluorosis, the American Dental Association (ADA) recommends you consider:

  • Breast-feeding

  • Using ready-to-feed formula rather than formula mixed with water containing fluoride

  • Using powdered or liquid concentrate infant formula that can be mixed with water that contains little or no fluoride. Examples include water labeled purified, demineralized, deionized, distilled, or everse osmosis–filtered.

Once your child’s teeth emerge from the gums, there is no danger of fluorosis. However, the last of your child’s permanent teeth might not emerge until about age 12. That’s why the ADA has additional recommendations for the use of dental products containing fluoride.

For children younger than age 2:

  • After each feeding, wipe the baby’s gums. Begin brushing your child’s teeth with a child-sized toothbrush when your child’s first tooth erupts. Clean and message gums in areas that remain toothless. Do not use fluoride toothpaste until your child is age 2 unless you are advised to do so by a dentist or another health professional.

For kids ages 2 through 5:

  • Place only a pea-sized dab of fluoride toothpaste on your child’s toothbrush.

  • Supervise your child while he or she brushes his or her teeth. Make sure your child spits out, rather than swallows, the toothpaste.

  • Avoid fluoride mouth rinse unless recommended by your child's dentist. Many kids younger than age 6 have not fully developed their swallowing reflex and may accidentally swallow the rinse.

“Interim Guidance on Fluoride Intake for Infants and Young Children.” American Dental Association, November 8, 2006. www.fairbanksalaska.us/wp-content/uploads/2011/07/20061108ADA-Interim-Guidance-Fluoride-Intake.pdf Accessed 2013.

“Fluoride and Infant Formula: Frequently Asked Questions.” American Dental Association. www.ada.org/4052.aspx Accessed 2013.

“Tooth Eruption: The Permanent Teeth.” Journal of the American Dental Association. January 2006, vol. 137, p. 127. www.ada.org/sections/scienceAndResearch/pdfs/patient_58.pdf Accessed 2013.

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