Parents Use Too Much Fluoride for Young Children: Study

One toothpaste was overdosed by a factor of 5.9 while the second was overdosed by a factor of 7.2.

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Many parents are using too much fluoride for young children without fully understanding the potential risks, a new study reports.

The study, published in BDJ Open, looked at how big a dollop of fluoride toothpaste parents put on their infants’ or toddlers’ toothbrushes and noticed it was up to 7.2 times more than the suggested “grain of rice-size amount.”

According to the German study, fluoride toothpaste dosage depends on a user’s age. For children 6 years and younger, the recommended amount of toothpaste is pea-sized. Children are also to brush their teeth under adult supervision to minimize swallowing. For infants and toddlers, the dosing amount is reduced to the size of a grain of rice.

The study asked 61 parents of children in five different daycares in Germany to perform a simple task: put toothpaste on their child’s toothbrush. Professional dentists then performed dosing five times in a row at the recommended rice-grain size. These were then used as a reference for the study.

The parents used two different toothpastes with similar densities in the study. The research team observed that one toothpaste was overdosed by a factor of 5.9, and the second was overdosed by a factor of 7.2.

“This is in line with other studies with older children who should use a pea-size amount of toothpaste but overdosed,” the researchers wrote, adding that their study “questions the recommended size of a grain of rice-size amount of fluoride toothpaste since the practical implementation seems to be not likely under real-life conditions.”

What Is Fluoride?

Fluoride is pretty common in everyday consumption. According to the National Institutes of Health (NIH), most people in the United States consume fluoride through foods that naturally contain fluoride or fluoridated tap water.

The NIH claims that fluoride is a critical component of good oral health. Adequate fluoride intake protects teeth from the bacteria and plaque that cause cavities and other oral hygiene issues. Bacteria feed on leftover sugary foods and drinks in the mouth and release acid. This acid eventually erodes the teeth’s protective layer of enamel, setting them up for cavities or further tooth decay. The naturally occurring mineral is believed by many health authorities to work by repairing the damage these bacteria cause to teeth through a process called remineralization. The American Dental Association calls fluoride “nature’s cavity fighter.”

Is There Such a Thing as Too Much Fluoride?

However, too much fluoride can do more harm than good. Dental fluorosis can occur when children consume too much fluoride over a long period, especially when their teeth are still developing. Characterized by mottled teeth, streaks, spots, or pits on the surface of the teeth, dental fluorosis usually results when young children take fluoride supplements or swallow fluoride toothpaste too often.

According to the study, nearly 40 percent of parents were unaware of the risks of using fluoride, such as dental fluorosis.

Dental fluorosis can be treated, though it isn’t a medical condition. Typical treatment options include teeth whitening.

However, the topic of fluoride is controversial, and some say fluoride affects more than just the surfaces of teeth. For example, some research has shown that fluoride can affect the brain. One study reported that children’s IQ scores decreased after prolonged fluoride use, and another indicated that behavioral and neurological disorders appeared. Additional research concluded that artificial fluoride causes 20 to 30 excess cancer deaths for every 100,000 people, though opponents have criticized this figure.

The researchers of the BDJ Open study recommended that to avoid potential negative effects, parents switch to fluoride-free toothpaste for children under the age of 3. Suggested alternatives include toothpastes made of calcium phosphates or hydroxyapatites.

“Since some fluoride sources ... cannot be avoided by parents, at least they can switch to a fluoride-free toothpaste for the oral care for their infants and toddlers,” they wrote. “There are safe and efficient alternatives to fluoride toothpastes ... which can also be dosed in higher amounts.”