When should a child start using toothpaste?

Parents know that taking care of small children is a full-time job - and along with diaper changes, bath time, and medical checkups, parents also need to take care of their children's teeth.

Birth to 18 months: no toothpaste required

Start cleaning your child's teeth as soon as the teeth begin to come in - but you don't need toothpaste at first. For babies younger than 18 months, the best way to clean your child's teeth is with a wet cloth or gauze - without toothpaste. Gently rub your child's teeth and gums with a cloth over your fingertip - this, along with nursing and/or drinking water, is all the oral hygiene that your child needs at the infant stage. Once your child has more of a "full set" of teeth, you can use a small, soft toothbrush to brush your child's teeth with water.

When to start toothpaste? 18 months

In general, children should not use toothpaste until they are at least 18 months old - and when you do start using toothpaste, make sure it is a safe "children's toothpaste" made especially for young ones. Young children have different dental needs than grown-ups - and children's toothpaste is made for this purpose.

What to look for in a children's toothpaste:

-Safe to swallow: Most young children tend to swallow while brushing, rather than spitting out the toothpaste - so make sure that your children's toothpaste is formulated with this in mind.

- Use only a pea-sized amount: Don't use too much toothpaste - just squeeze a small, pea-size (or smaller) amount onto the toothbrush. Your child doesn't need much toothpaste to be effective, and you don't want your child to swallow too much toothpaste.

- Consider low-fluoride children's toothpaste: Fluoride is an important element of keeping teeth healthy and strong, but too much fluoride can be harmful for young children. Talk to your dentist if you have concerns about fluoride in your child's toothpaste - several varieties of children's toothpaste have lower amounts of fluoride or are fluoride-free.

- Fun flavors: Try some different flavors of toothpaste and see what your child likes. Some children - especially at the toddler stage - are very picky about flavors and might be reluctant to use a certain flavor of toothpaste. So be prepared to buy a few different varieties of children's toothpaste and see which one is your child's favorite.

Remember: brushing your child's teeth is part of parenting, and you need to start at a young age. By taking the time each day - before bedtime and in the morning - to clean your child's teeth with a specially-formulated children's toothpaste, you will be helping to create a lifetime of healthy dental habits and happy smiles.

Should I use Fluoride?

Some people have concerns about fluoride - either in their toothpaste or in their drinking water. Let me do what I can to help relieve you of those concerns. Fluoride is a naturally-occurring chemical compound that is used in dental care as a way to prevent tooth decay. Most toothpastes contain fluoride, and many visits to the dentist will include a fluoride treatment. In addition to its use in dental products, many communities across the U.S. adjust the fluoride levels of their drinking water supplies as a way to bolster the oral health of the public.

The American Dental Association (ADA) stands in favor of using fluoride as an essential component of public health and as a way to reduce the harm caused by tooth decay. Simply put: fluoride results in fewer cavities and lower long-term dental care costs.Is fluoride safe?The American Dental Association (ADA) has been a big supporter of fluoride in drinking water (and fluoride in toothpaste and other dental care products) for many years. Several decades of peer-reviewed scientific research has demonstrated that fluoride is one of the most essential components of improving the oral health of Americans during the past 50 years. Simply put, as best as we can tell from the available, credible scientific research, fluoride is safe and is beneficial - the improvements in the health of our teeth far outweigh any risks of using fluoride.

What about people who say that fluoride is dangerous?

During the past 60 years, fluoride has proven to be a big success in reducing tooth decay and cavities, and dentists are big fans of fluoride. In recent years, some activist groups have been making some claims about the supposed health risks of fluoride and objecting to the use of fluoride in drinking water. Many of these fluoride opponents are using suspect research or scare tactics, or are just opposed to chemicals as a matter of principle - and many of the fluoride opponents' arguments are based on myths and misconceptions. Is fluoride "unnatural?"Isn't it a chemical? Fluoride is a chemical, but it is naturally occurring. There are small amounts of fluoride that occur naturally in drinking water, food, and many other substances that people live with every day. There's nothing "unnatural" about fluoride.

In fact, some communities have to actually reduce the level of fluoride in their drinking water in order to reach the optimal level to improve dental health - often, when a community fluoridates its water, there's no "adding" of fluoride at all.Should children use fluoride? Parents of small children should be careful not to let their children use too much fluoride - when young children swallow too much fluoride, it can cause dental fluorosis, a type of tooth discoloration. (This is one of the reasons why we teach kids not to swallow their toothpaste.) Use a specially-formulated children's toothpaste that has a lower amount of fluoride. According to the ADA, fluoride in drinking water has not been proven to be the cause of fluorosis - as there are a number of possible causes. Fluorosis occurs in rare cases and usually only results in minor complications - and again, the consensus among dental health professionals is that the benefits of fluoride far outweigh these rare complications.

Where can I get more information? The American Dental Association has a detailed article called Fluoridation Facts with all of the relevant research, questions and answers about fluoride and dental health. This is a great resource if you have any concerns about fluoride and want to learn more - it's a fair, evenhanded look at the issues and the facts.

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