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Dr. Paul Smolen has been practicing pediatrics for 32 years as an attending physician at Carolinas Medical Center, an Adjunct Associate Professor at the University of North Carolina School of Medicine-Chapel Hill, and a private practitioner. To learn more about Dr. Smolen, click here

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Tweaking Fluoride Recommendations Once Again (Article)

In an effort to prevent childhood and adult dental decay, dentists and public health officials recently changed their policy and began promoting the application of a small dab of fluoride toothpaste as soon as babies’ teeth erupt. Previously, experts from the American Academy of Pediatric Dentists (The AAPD) had not recommended using any fluoride toothpaste in children under two years of age for fear of causing too much fluoride to accumulate in the enamel of their teeth, a condition called fluorosis. In the AAPD’s new analysis of current data, these experts decided that the benefit of a small amount of fluoride to a baby’s teeth is safe and outweighs the very small chance that an infant will develop fluorosis. Dental experts hope that this is a step toward curing the most common chronic childhood disease, tooth decay! Currently, tooth decay is five times more common than childhood asthma, four times more prevalent than childhood obesity, and twenty times more prevalent than childhood diabetes. Alarmingly, tooth decay in children has increased by four percent in the past ten years, a direct reversal of the cavity reduction achieved in the 1980s to 1990s.

The proper use of fluoride to retard dental decay has been elusive ever since the accidental discovery of its cavity fighting potential at the turn of the 20th century. Ironically, it was the observation that natural fluoride, found in certain springs in the western US, both stained teeth in children and at the same time made their teeth resistant to decay. Since this discovery, dentists have long advocated putting a very small amount of sodium fluoride in municipal water supplies and in toothpaste. Dental decay in children has been gradually disappearing ever since, until recently.

Dentists and public health officials have decided it’s once again time to tweak the dose of fluoride for the benefit of children. In order to make the most of fluoride’s benefits without increasing the risk of fluorosis, dentists recommend that parents use only a tiny amount of fluoride toothpaste to brush their infant and toddler’s teeth twice a day. Brushing twice a day, offering your child plenty of water to drink between meals, avoiding snacks, and eliminating bottles by the end of their first year are crucial steps to avoid damaging decay. This type of proactive cavity control can prevent cavities and tooth decay that may cause other dental problems not only during childhood but later in life. So, with a simple dollop of fluoride toothpaste and a toothbrush, cavity prevention may be as easy as pie!

Written collaboratively by Keri Register and Paul Smolen M.D.

Smo Notes:

1. http://well.blogs.nytimes.com/2014/02/12/dental-group-advises-fluoride-toothpaste-before-age-2/?_php=true&_type=blogs&_php=true&_type=blogs&_php=true&_type=blogs&_r=2&sf22771120=1

2.http://www.aapd.org/assets/2/7/ECCstats.pdf

3. https://www.nidcr.nih.gov/OralHealth/Topics/Fluoride/TheStoryofFluoridation.htm

2 Responses to "Tweaking Fluoride Recommendations Once Again (Article)"

  1. Ana Propst says:

    Thanks for this!!! I’ve been wondering lately about brushing the teeth of my 6 month old! Is there a certain brand you would recommend?

    1. DocSmo says:

      Dear Ana, Thanks for the question. I really don’t have a particular brand that I prefer. The ingredients in various toothpastes are similar. Any fluoride toothpaste should do but you don’t want your child to get very much. I would take the tiniest amount of a fluoride toothpaste and rub it on your child’s erupted teeth once a day. Now that he/she is six months old, I would also offer him/her water frequently to clean her teeth. Don’t forget, when they are older, all day snacks are really bad for your child’s teeth. Avoid the constant feeding.

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