What should be the fluoride concentration in your child’s toothpaste? And how much toothpaste should one use each time?
This is the most unclear but also a relevant question every parent has or should definitely ask their pediatric dentist.
The guidelines have evolved over the years, shifting from no fluoride for the first 2 years to fluoride toothpaste as soon as the first tooth erupts (after 6 months of their birth).
But how do we adapt to these norms in India where the drinking water fluoridation is not accurate or even documented accurately?
Fluoride in excess, even in small quantities overtime, is known to affect the permanent teeth by causing white spots on them. It can affect the growing bones of the child’s body.
Thus understanding the concentration and the quantity of fluoride toothpaste to be used daily is of paramount importance.
So how can we decide on it, not arbitrarily but on the basis of an evidence based approach?
The answer to it is Caries Risk Assessment.
Especially in our country, we cannot have a blanket rule with fluoride concentrations in toothpaste. It has to be customised based on the child’s risk factors.
Caries Risk Assessment helps us identify these risk factors and we are then able to strategize on the concentrations accordingly. The Assessment is a simple questionnaire that does not take more than 2 minutes but provides crucial information on the child’s oral status.
On completion of the assessment we are able to identify the child either at Low Risk, at Moderate Risk or at High Risk for developing dental cavities.
Once that has been established, each category requires a different concentration of fluoride not only in their toothpaste but also in their varnish.
Besides the concentration, an important aspect which is frequently overlooked is the quantity of the toothpaste to be dispensed.
Being a mother, I often hear from other mothers who are not necessarily my patients how they have switched to fluoride toothpastes but are clueless of the amount to be dispensed. Quantity is, in my opinion, of greater significance than the concentration of fluoride in any form.
So once the concentration needed for the child has been determined, one should only dispense the following amount of toothpaste (not more than that)
For Children who cannot spit or are less than 3 years of age:
Not more than smear / rice grain amount of fluoridated toothpaste
For children who can spit / are more than 3 years of age, a pea sized amount:
As a simple rule, I tell all my patients to refer to the child’s pinky fingernail and dispense no more than that size ! We call it the “Pinky Rule”
As parents we are constantly trying to make the right choices for our children in every aspect of their well-being. This is an earnest effort to provide you with the right information to make “informed” decisions for their oral well-being.
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