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 Unless
a dentist or other qualified health
professional advises otherwise, fluoridated
toothpaste should be introduced
at around age 2.
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Topical fluoride is probably the most
important source of prevention of tooth decay. Topical
fluoride reaches the teeth directly. It inhibits the
metabolism of the decay-producing bacteria in plaque
and stabilizes minerals in the teeth, thus preventing
or slowing down the caries process. Topical fluoride
is most effective when delivered at very low doses
many times a day through water, foods containing fluoride,
and fluoridated toothpaste.
Almost all toothpaste manufactured
in the United States provides topical fluoride.
Toothpaste
often becomes an unintended source of systemic fluoride
(rather than an intended source of topical fluoride)
when it is swallowed. Unless a dentist or other qualified
health professional advises otherwise, fluoridated
toothpaste should be introduced at around age 2.
The dentist or other qualified health professional
should
consider the fluoride level in the community drinking
water, other sources of fluoride, and factors likely
to affect susceptibility to tooth decay when weighing
the risks and benefits of recommending fluoride
toothpaste
to parents with children under age 2.[4]
Excess ingested fluorides may cause fluorosis. (See
Module 3,
section 3.5, Fluorosis.)
To prevent this, toothpaste should be dispensed in
a pea-sized amount (small smear). Children
should spit
out the toothpaste after brushing but should not
rinse with water. The small amount of fluoridated
toothpaste that remains in the mouth helps prevent
tooth decay.[1]
Another form of topical fluoride is
professionally applied fluoride (via varnishes,
gels, foams), which renews the high levels of fluoride
in superficial enamel (the outer layer). Topical
fluoride
may be especially effective for those children at
high risk for dental
caries because they lack fluoridated water,
have a history of caries, snack frequently on
foods high in sugar (see Nutrition
section, this module), or have a medical problem
that decreases caries resistance.
(See Module 7.) These treatments also enhance remineralization
of early carious lesions. Topical fluoride treatments
should be applied only by a dentist or other qualified
health professional.
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