Should children use fluoride toothpaste?

Fluoride is naturally occurring in rocks, water, and soil. When it comes into contact with teeth, it is absorbed into the surface of the tooth making it more resistant to decay or acid erosion.

Fluoride has been used in toothpastes for several decades and there are many studies showing its effectiveness in reducing tooth decay with concentrations above 1000ppm (parts per million).  Some children’s pastes available in New Zealand contain less than 1000ppm so should be avoided. Adult toothpastes usually contain between 1000-1450ppm but are often not well tolerated by children because of the stronger flavour.

When fluoride is ingested at a young age while the teeth are still developing under the gum, then it will also be built into the forming tooth. At small amounts, such as found in fluoridated water supplies, this will make the teeth stronger, but if too much is swallowed at this time then visible spots on the teeth can form. This is called fluorosis and can range from mild white specks through to more obvious brown marks. This is why care must be taken to make sure children, particularly those under 6, are not swallowing too much toothpaste. If very large amounts of fluoride are swallowed it can be toxic and emergency care should be sought immediately.

Key messages for brushing children’s teeth.

  • Brush your child’s teeth twice a day with a fluoride toothpaste as soon as they are visible in the mouth.
  • Reduction of dental caries by fluoride toothpaste is balanced against the risk for dental fluorosis due to toothpaste ingestion by young children.
  • Toothpastes containing less than 1,000 ppm fluoride are not recommended for use at any age in New Zealand. Unfortunately, toothpastes in NZ are often not labelled in ppm and the names ‘sodium fluoride’ or ‘sodium monofluorophosphate’ are used instead.
    1000ppm fluoride equates to 0.22% sodium fluoride or 0.76% sodium monofluorophosphate.
  • To minimise the risk of ingestion of toothpaste, children should be supervised when brushing their teeth up until age 8 or 9.
  • A smear of toothpaste (five years and under) or a pea-sized amount (six years and over) should be used and children should be taught to spit out any excess.
  • Toothpaste should be kept out of reach of children.

    Children’s fluoride toothpaste


For more information see the New Zealand Dental Association pages on dental care and brushing for toddlers and children.