Should I Use Fluoridated Toothpaste for My Child?

Parents should use a tiny smear of fluoride toothpaste to brush baby teeth twice daily as soon as they erupt, instead of waiting until kids are older, according to new guidelines.

That advice overturns the A.D.A.'s decades-old recommendation to begin using a pea-size amount at 24 months. Once children are 3 to 6 years old, then the sum should be increased to a pea-size dollop, the updated guidelines say.

The dental group advises getting a jump start on prevention, to fight with the rising variety of cavities in the very youthful. Nevertheless, they emphasize only the most tiny amount should be utilized to minimize the chance of mild discoloration, white spots or streaking of the teeth, a condition called fluorosis that ingesting fluoride toothpaste at a youthful age causes. "We want to minimize the level of fluoride consumption to decrease the chance of fluorosis while concurrently adding a preventative tool for kids 2 and under that we haven't recommended formerly," said Dr.

Jonathan Shenkin, a spokesman for the A.D.A. and a pediatric dentist in Augusta, Me. Just a tiny quantity of toothpaste should be smeared on the brush since some children are likely to ingest a few of the fluoride, he said.

The change comes after a systematic review of 17 studies published in The Journal of the American Dental Association this month. It reasoned that scientific evidence, though restricted in kids under age 6 and more robust in older children, demonstrated that fluoride toothpaste is powerful in controlling tooth decay, and that "the proper number" should be used "by all children irrespective of age."

An early start is crucial, Dr. Shenkin said, because children with dental decay are at greater risk of developing cavities as adults. "By beginning earlier, we can efficiently reduce an eternity of ailment for a lot of kids."

Dr. Man Wai Ng, the dentist in chief at Boston Children's Hospital, applauded the new recommendation and said, "It's a wonderful matter for parents to know: 'Use a tiny quantity of fluoride, and brush two times a day to counter the effects of regular snacking.'"

The new A.D.A. guidelines stress that kids should spit out toothpaste after they're able, but not having the ability to spit does not preclude using a rice-grain-size little of fluoride toothpaste.

Dr. Shenkin has had some 5-year old patients "still not using a fluoride toothpaste because parents don't think they can spit it out yet." The goal will be to have parents monitor the amount and to assist in brushing. Children typically cannot correctly until they will have the dexterity brush.

The American Academy of Pediatric Dentistry, another trade group, has long recommended using just a smear of fluoride toothpaste for children younger than 2 who are at an increased risk for cavities, including people who go to bed with a bottle at night or have a family history of cavities. The best predictor is a history of cavities.

Some dentists already counsel parents of kids under 2, particularly those at high risk, to brush with fluoride.

Current labels advise parents of children under 2 to consult a dentist or physician.

It is unclear when and if the labels will change, or what is going to happen to fluoride-free training toothpastes, which currently are marketed as "safe if consumed."

By doing so, "the people will be less bemused."