New dental guidelines may limit how much toothpaste children use

Dentists often apply prescription-strength fluoride treatments directly on the teeth. Fluoride helps prevent cavities, primarily through a process called re-mineralization.

UNC pediatric dentist Dr. Tim Wright says new ADA guidelines place new limits on the amount of fluoride toothpaste, starting when the first tooth emerges.

“The current recommendation is a ‘smear’ till the age of 3 and a ‘pea-sized’ amount after that,” Wright said.

Toothpaste ads typically suggest more than that to cover the entire brush. Younger children often swallow toothpaste rather than spitting it out. That could increase the risk of fluorosis, which can cause mild discoloration or streaking in the teeth.

But not getting enough fluoride can lead to more cavities, so Wright recommends drinking fluoridated water and often recommends over-the-counter fluoride mouth rinses. It's only part of the strategy to fight decay.

“It's just a matter of getting those therapies to the right people at the right ages and at the right time to prevent caries in all children,” Wright said.

City water systems include fluoride, but well water systems vary in the amount of naturally occurring fluoride. Bottled water typically doesn’t contain fluoride unless it is listed on the bottle.