Toothpaste Fluoride: Not Always Safe for Kids, Infants

It's been established for decades that adding fluoride to drinking water goes a long way toward preventing cavities and keeping teeth solid and strong. Using toothpaste is important as well.

However, even the small amounts of fluoride in today's drinking water have become the source of controversy in recent years, with some consumer groups claiming that too much fluoride can result in tooth discoloration, cause nausea, worsen diabetes and even contribute to problems such as thyroid disease, kidney disease and cancer.

While many of these claims have been debunked, or have yet to be proven scientifically, what is known is that too much fluoride isn't good for infants and young children. That's because it can lead to fluorosis, a condition which causes permanent white, yellow or brown spots to appear on the child's adult teeth as they appear. Toothpaste won't remove this staining. While it's usually more of a cosmetic concern, in severe cases fluorosis also can cause pitting of the tooth enamel. That's why the American Dental Association recommends that infants and children under age 2 never use fluoride-containing toothpaste, and any formula they ingest should be mixed with non-fluoridated water.

In children under age 7, only a pea-sized dot of fluoridated toothpaste should be used when brushing, and the child should be taught to spit out the toothpaste when he or she is finished, instead of swallowing it. (Swallowing too much toothpaste often causes nausea and stomachaches in both children and adults.) Once a child is past age 7, the risk of developing fluorosis is past.

Estimates are that every $1 spent on fluoridation saves about $120 in dental care costs down the road. That's because fluoride keeps teeth strong and solid by keeping key minerals from leaching out of the tooth enamel. Exposure to a small amount of fluoride on a daily basis is enough to keep most children and adults cavity-free. It's especially helpful in preventing cavities around the gum line. Fluoridated drinking water also has been widely endorsed by most major health organizations around the world for the past 50 years.

Like all public health measures, there are some individuals and groups who have expressed concerns about the addition of fluoride in drinking water. The answer to some of the more common misconceptions, listed here, is an emphatic "no." Specifically, there is no increase in cancer rates in communities with fluoridated water; fluoridation does not cause a decrease in bone health; and fluoride itself is not a poison. Nor is the fluoride added to drinking water obtained from the waste products of the phosphate fertilizer or aluminum manufacturing industries. Finally, the amounts of fluoride in water and commercial dental products are low enough that even an adult who takes in fluoride in his water, air, toothpaste, mouthwash and food won't receive a harmful amount. If you have concerns, however, it's best to clean your teeth with a fluoride-free cleanser, such as OraMD®. Even the toothpaste Crest makes has added fluoride.