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A Simple Guide to Prevent Dental Fluorosis in Your Children

Yes, Your Toothpaste Choice Can Help Prevent This 

The Centers for Disease Control and Prevention (CDC) estimates that more than 38 percent of children between the ages of three and six use too much toothpaste, putting them at risk of ingesting excessive amounts of fluoride (1). Moreover, children younger than six years old have poor swallowing reflexes and tend to ingest much of the toothpaste on their brush (2). To top it off, many toothpastes are flavored to accommodate our children’s sensitive palates and include flavors like bubble gum, strawberry, orange, and watermelon which can entice children to swallow even more willingly. While typical symptoms of fluoride ingestion are mild, there are detrimental dental consequences every parent should be aware of (3). Here is what you should know if your child accidentally swallows toothpaste or mistakes it for food.

This Happens When Your Child Swallows Too Much Toothpaste

Symptoms associated with fluoride toothpaste ingestion are generally mild. Swallowing toothpaste with fluoride can cause an upset stomach in minor cases and nausea, vomiting and diarrhea in more serious cases. However, ingestion can sometimes have longer term dental consequences if repeated (3).

If a young child regularly ingests fluoride while their teeth are still developing, they may be at risk of developing a defect of the tooth enamel called dental fluorosis. This condition is one of the most common dental defects in kids under age 8 and can take many forms on our little one’s teeth. Typically, an infected tooth will become stained with white splotches or streaking, and in more severe cases, dark brown spots and pitting of the tooth enamel, according to Kids Health (4). In these severe cases, aside from the psychological effects your children may feel about the appearance of their teeth, treatment can become quite costly. In mild to severe cases, micro abrasion, bonding, and veneers are each treatment options – all requiring enamel removal with long-term treatments that can run to $500 - $2,500 per month (5).

So Why is Fluoride in Our Toothpaste Anyways, And Where Else Is It?

It is well known that fluoride helps to prevent and reverse the early stages of tooth decay in proper doses. Fluoride in toothpaste helps prevent cavities and promotes good dental hygiene by slowly breaking down the enamel and increasing the rate of the remineralization process (6). Aside from dental hygiene products, fluoride can also be found in our water supply. For more than 60 years, water fluoridation has proven to be a safe and cost-effective way to reduce dental caries (7). However, when combined, these two sources of fluoride can rack up our daily intake to potentially dangerous limits – a highly controversial topic among parents and industry experts.

Let’s do some quick math on fluoride intake from our two primary sources – drinking water & toothpaste – keeping in mind the daily recommended intake should never break 1 mg of fluoride for children under 8, according to The National Institutes of Health’s Daily Adequate Intake (AI’s).

To start, the optimal fluoride level in drinking water to prevent tooth decay should be 0.7 milligrams of fluoride per liter of water (8). Considering toddlers are recommended to drink up to 1 liter per day and children aged 4-8 are recommended to drink up to 1.2 liters per day, the daily threshold for recommended fluoride intake can be nearly met or completely met, at any age group, through water intake (9).

To overexpose even further, a single strip of toothpaste covering the length of a child’s brush contains between 0.75 to 1.5mg of fluoride (10). This means that when children brush twice per day and drink their recommended daily water intake, fluoride levels would range from 2.2 mg to 3.7 mg - doubled and tripled the daily AI. Despite how easy overexposure can be, there are ways parents can actively manage the intake of fluoride in their children.

Establish Proper Brushing Habits to Prevent Fluorosis

Parents can use the following 6 techniques & guidelines recommended by the CDC to help prevent the growth of dental fluorosis in their children while using fluoridated toothpaste (11):

  1. Supervise your children when they brush to ensure they are not swallowing
  2. Limit tooth brushing to two times per day
  3. Keep fluoride toothpaste and other dental products out of reach to avoid ingestion
  4. Avoid mouthwash in children under age six
  5. Consider using the “smear” technique in children younger than age three to lessen the risk of overexposure
  6. Limit the amount of toothpaste to “pea-sized” for children aged three to six



Being vigilant during your children’s brushing routine is key to preventing fluorosis. Awareness of the potential consequences of too much fluoride and what impact this can have on the development of teeth is a great first step. Following this guide can help ensure your whole family is on the right path in maintaining healthy dental hygiene.


Choosing Fluoride-Free Toothpaste

Choosing a fluoride-free children’s toothpaste can help alleviate your concerns about your kids swallowing toothpaste. Kinder Karex Hydroxyapatite Toothpaste for Kids is fluoride-free and has an added benefit of hydroxyapatite as a primary ingredient.

No risk of fluorosis means confidence your children are safe if they accidentally swallow. Kinder Karex Toothpaste is gentle enough to start using on an infant as soon as the first tooth appears, and the neutral or mild taste is not minty or fruity; its flavor was selected by kids for kids.

What proper brushing habits are you teaching your kids? Share your story with us on Instagram!