What should children's toothpaste be like?

There are many varieties of children's toothpaste on the market. But when it comes to choosing one for our children, what should we take into account to make sure we make the right choice?

Doubts about toothbrushes and toothpastes are frequent in paediatric dentistry practices.
Doubts about toothbrushes and toothpastes are frequent in paediatric dentistry practices.

Amount of fluorine

The amount of fluoride in a toothpaste is specified in parts per million (ppm). Most children's toothpastes contain approximately 500 ppm, while the amount in adult toothpastes is usually around 1450 ppm, although the dentist may suggest a higher concentration depending on the patient's risk of caries.

Children's toothpaste should have adequate proportions of fluoride, to control intake, and detergents, to control foaming.
Children's toothpaste should have adequate proportions of fluoride, to control intake, and detergents, to control foaming.

The reduced fluoride dosage in children's toothpastes is related to the underdeveloped swallowing reflex, which causes part of the toothpaste to be swallowed, increasing the risk of fluorosis (excess fluoride intake that is stored in bones and teeth), so this possibility is avoided.

Does a low dose of fluoride protect against tooth decay?

This depends on the caries risk of the patient in question, which will be determined by the Paediatric DentistThe family's diet, hygiene and oral health status (especially that of the parents), among others, will be assessed.

Recent studies, such as the Cochrane Oral Health Group Systematic Review have shown that toothpaste with a fluoride content of less than 1000ppm has no caries protective effect. Given that children's toothpastes have approximately 500ppm, how can we improve the dental health of our children's teeth and gums?

To answer this question, we must remember that caries is a multifactorial disease, dependent on many factors, including oral hygiene. Thus, a good brushing with fluoride-free or low quantity toothpastemay be correct if all other factors influencing caries (sugar consumption, oral health of the family, etc.) are under control and if the risk of caries is low.

If, on the other hand, the risk of caries is high, it is necessary to use a toothpaste with at least 1000 ppm, even in the case of very young children. We recommend a check-up with your Paediatric Dentist from the eruption of the first tooth, to assess the risk of caries and receive advice on oral health prevention.

How much paste should they use?

From 0 to 2 years:

–        In patients with low caries risk, Usar pasta con 1000 ppm en cantidad “raspada”.

–        If the risk of caries is highuse a very small amount (stain the toothbrush) of toothpaste with 1000 ppm fluoride in its composition.

Remember that they can brush without toothpaste if they have a low risk of caries.
Remember that they can brush without toothpaste if they have a low risk of caries.

From 2 years old:

- All children should use fluoride toothpaste (1000-1450ppm)), in minimal quantity (stain the brush or put the amount similar to the size of a pea) at least twice a day. Keep in mind that the dry brush produces less foam and therefore, they swallow less paste if they do not know how to spit.

A pea-sized amount is sufficient for children and adults.
A pea-sized amount is sufficient for children and adults.

When should they brush on their own, and when should they be helped by their parents?

Brushing should be done by parents until the age of 3. Thereafter, brushing should be assisted (done by the children but supervised by the parents) until the child is at least 8 years old.

From the age of eight they can brush on their own, without supervision.
From the age of eight they can brush on their own, without supervision.

Conclusions

In this way, we can suggest the following elements to keep our children's teeth in perfect condition throughout their lives:

1. Seeing a paediatric dentist during the first year of lifeto assess the risk of caries and to receive oral hygiene instructions.

2. If the caries risk is lowdo not use paste until two years of age (until the patient learns to spit).

If the rhe risk of caries is medium or highuse toothpaste with at least 1000 ppm fluoride, very little, at least twice a day.

4 The brushing should be carried out by parents until the age of 3 years, and thereafter supervised until at least 8 years of age.

Dr. Clara Serna Muñoz

Degree in Dentistry

Master's Degree in Paediatric Dentistry

 San Rafael Hospital in Madrid