Fluoride is a naturally occurring substance present in some foods and is also present in natural bodies of water like streams, ponds and lakes. Given its innate enamel-strengthening properties, fluoride is a supplementary ingredient in many oral healthcare products, particularly toothpaste.
An overload of fluoride could cause a condition called dental fluorosis, which actually alters the appearance and color of tooth enamel. Plus, fluoride ingested in large amounts could lead to dangerous toxicity. For these reasons, parents are right to be concerned about babies (with teeth growing in) and toddlers using fluoride toothpaste.
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Because of this, warning labels are required by the U.S. Food and Drug Administration (FDA) for all fluoride products (mainly toothpaste) for any child under 6 years old. The labels warn against giving any child under 6 fluoride toothpaste and to avoid swallowing more than is necessary for brushing.
Using fluoride toothpaste can serve as a preventive measure to reduce the risk of cavities forming. Just remember to use a small smear of toothpaste until age 3, and then a pea-sized amount from ages 3 to 6.
Most baby toothpastes are designed to be safe when swallowed. Keep in mind that you might see conflicting information, with some experts still recommending that parents avoid toothpaste with fluoride for infants and toddlers.
So, what should you prioritize as you shop for baby toothpaste? It depends on whether you want to follow AAP or ADA recommendations. If you do, then toothpaste with fluoride is going to be a priority.
The ADA acceptance program makes fluoride toothpastes easier to find. While most of the brands on our list carry fluoride toothpastes for tooth health, for those concerned about fluoride, we focused on their fluoride-free products.
If your little one loves the taste of bananas, this pick from Radius is a great choice. The coconut banana-flavored toothpaste is U.S. Department of Agriculture (USDA) certified organic, and the company is Leaping Bunny certified for their commitment to avoid use of animal testing for their products.
This two-pack of organic toothpaste is a great way to stay stocked up on oral care supplies. This toothpaste is vegan-friendly, gluten-free, SLS-free, and is certified cruelty-free as well. Note that this is another fluoride-free option.
The safe-to-swallow toothpaste comes in two different flavors: banana and raspberry. This pick has xylitol and calendula, which the brand claims have been added to help reduce the risk of cavities while also soothing gums and fighting tooth decay.
Similar to cost to value, think about whether you want to buy a dental kit or a single or multipack set of toothpaste. Kits can be great because they contain both the toothpaste and a child-safe toothbrush. But dental kits are usually more expensive. The ADA recommends changing toothbrushes every 3 to 4 months.
Keep in mind that most babies and toddlers dislike the strong mint flavors typically found in adult toothpaste. So, using a baby-friendly and safe-if-swallowed toothpaste with a mild flavor might be a better option to introduce and encourage a love of brushing their teeth.
From age one, or when their first tooth erupts, brushing with no toothpaste is perfectly acceptable, and prevents baby bottle tooth decay. Kids should never go to sleep with a bottle, and parents should try to prevent pacifiers or bottles from becoming a prolonged habit.
From ages 2-5, a pea-sized amount of fluoride-free, kid-safe toothpaste is recommended. Your child will need help brushing and you should remind them to spit out the toothpaste. Guide your child on proper brushing techniques to prevent cavities at a young age. As mentioned previously, your child can switch to a fluoride toothpaste once they're able to spit after brushing.
Children younger than 3 years should use a smear of fluoridated toothpaste about the size of a grain of rice. Once children are 3 years or older, they can use a pea-sized drop of fluoridated toothpaste. Children should be assisted by or supervised by an adult and should be instructed to spit the excess toothpaste out after brushing.1
The American Dental Association recommends brushing teeth twice a day for two minutes using a fluoride toothpaste. Brushing for two minutes has been shown to achieve clinically significant plaque removal3 and use of a toothpaste containing fluoride enhances fluoride concentration levels in biofilm fluid and saliva, and is associated with decreased risk of caries and remineralization of teeth.4
Toothpaste is a paste or gel dentifrice used with a toothbrush to clean and maintain the aesthetics and health of teeth. Toothpaste is used to promote oral hygiene: it is an abrasive that aids in removing dental plaque and food from the teeth, assists in suppressing halitosis, and delivers active ingredients (most commonly fluoride) to help prevent tooth decay (dental caries) and gum disease (gingivitis).[1] Owing to differences in composition and fluoride content, not all toothpastes are equally effective in maintaining oral health. The decline of tooth decay during the 20th century has been attributed to the introduction and regular use of fluoride-containing toothpastes worldwide.[2][3] Large amounts of swallowed toothpaste can be toxic.[4] Common colors for toothpaste include white (sometimes with colored stripes or green tint) and blue.
Toothpastes are generally useful to maintain dental health. Toothpastes containing fluoride are effective at preventing tooth decay.[2][5][6] Toothpastes may also help to control and remove plaque build-up, promoting healthy gums. A 2016 systematic review indicated that using toothpaste when brushing the teeth does not necessarily impact the level of plaque removal.[7] However, the active ingredients in toothpastes are able to prevent dental diseases with regular use.[8]
Abrasives constitute 8-20% of a typical toothpaste.[8] These insoluble particles are designed to help remove plaque from the teeth.[9] The removal of plaque inhibits the accumulation of tartar (calculus) helping to minimize the risk of gum disease.[10] Representative abrasives include particles of aluminum hydroxide (Al(OH)3), calcium carbonate (CaCO3), magnesium carbonate(MgCo3), sodium bicarbonate, various calcium hydrogen phosphates, various silicas and zeolites, and hydroxyapatite (Ca5(PO4)3OH).
The abrasive effect of toothpaste is indicated by its RDA value. Toothpastes with RDA values above 250 are potentially damaging to the surfaces of teeth. The American National Standards Institute and American Dental Association considers toothpastes with an RDA below 250 to be safe and effective for a lifetime of use.[12]
Fluoride in various forms is the most popular and effective active ingredient in toothpaste to prevent cavities.[9] Fluoride is present in small amounts in plants, animals, and some natural water sources. The additional fluoride in toothpaste has beneficial effects on the formation of dental enamel and bones. Sodium fluoride (NaF) is the most common source of fluoride, but stannous fluoride (SnF2), and sodium monofluorophosphate (Na2PO3F) are also used.[9] At similar fluoride concentrations, toothpastes containing stannous fluoride have been shown to be more effective than toothpastes containing sodium fluoride for reducing the incidence of dental caries and dental erosion,[13][14][15][16][17] as well as reducing gingivitis.[18][19][20][21][22] Some stannous fluoride-containing toothpastes also contain ingredients that allow for better stain and calculus removal.[23] A systematic review revealed stabilised stannous fluoride-containing toothpastes had a positive effect on the reduction of plaque, gingivitis and staining, with a significant reduction in calculus and halitosis compared to other toothpastes.[24] Furthermore, numerous clinical trials have shown gluconate chelated stannous fluoride toothpastes possess superior protection against dental erosion and dentine hypersensitivity compared to other fluoride-containing and fluoride-free toothpastes.[25]
Much of the toothpaste sold in the United States has 1,000 to 1,100 parts per million fluoride. In European countries, such as the UK or Greece, the fluoride content is often higher; a sodium fluoride content of 0.312% w/w (1,450 ppm fluoride) or stannous fluoride content of 0.454% w/w (1,100 ppm fluoride) is common. All of these concentrations are likely to prevent tooth decay, according to a 2019 Cochrane review.[6] Concentrations below 1,000 ppm are not likely to be preventive, and the preventive effect increases with concentration.[6] Clinical trials support the use of high fluoride (5,000 ppm fluoride) dentifrices, for prevention of root caries in elderly adults by reducing the amount of plaque accumulated, decreasing the number of mutans streptococci and lactobacilli and possibly promoting calcium fluoride deposits to a higher degree than after the use of traditional fluoride containing dentifrices.[6]
Many, although not all, toothpastes contain sodium lauryl sulfate (SLS) or related surfactants (detergents). SLS is found in many other personal care products as well, such as shampoo, and is mainly a foaming agent, which enables uniform distribution of toothpaste, improving its cleansing power.[11]
Triclosan, an antibacterial agent, is a common toothpaste ingredient in the United Kingdom. Triclosan or zinc chloride prevent gingivitis and, according to the American Dental Association, helps reduce tartar and bad breath.[1][26] A 2006 review of clinical research concluded there was evidence for the effectiveness of 0.30% triclosan in reducing plaque and gingivitis.[27] Another Cochrane review in 2013 has found that triclosan achieved a 22% reduction in plaque, and in gingivitis, a 48% reduction in bleeding gums. However, there was insufficient evidence to show a difference in fighting periodontitis and there was no evidence either of any harmful effects associated with the use of triclosan toothpastes for more than 3 years. The evidence relating to plaque and gingivitis was considered to be of moderate quality while for periodontitis was low quality.[28] Recently, triclosan has been removed as an ingredient from well-known toothpaste formulations. This may be attributed to concerns about adverse effects associated with triclosan exposure. Triclosan use in cosmetics has been positively correlated with triclosan levels in human tissues, plasma and breast milk, and is considered to have potential neurotoxic effects.[29] Long-term studies are needed to substantiate these concerns. 2ff7e9595c
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