Choosing Wisely:

Don’t recommend nonfluoride toothpaste for infants and children.

Rationale and Comments: The benefit of fluoride-containing toothpaste arises from its topical effect on dental enamel by interrupting enamel demineralization caused by bacterial acids and enhancing remineralization of the enamel surface. Anti-caries (anti-cavities) benefit begins with eruption of the first primary tooth. Brushing with nonfluoridated toothpaste provides no anti-caries benefit. Use of recommended amounts of fluoride toothpaste minimizes risks of fluorosis, a whitish discoloration of enamel.
Sponsoring Organizations:
  • American Dental Association
  • Sources:
  • Systematic review
  • Disciplines:
  • Pediatric
  • Preventive Medicine
  • References: • American Academy of Pediatric Dentistry. Guideline on Fluoride Therapy. Pediatr Dent 2014;36(6): 171-74.
    • American Dental Association Council on Scientific Affairs. Fluoride toothpaste use for young children. J Am Dent Assoc. 2014 Feb;145(2):190-1.
    • Wright JT, Hanson N, Ristic H, Whall CW, Estrich CG, Zentz RR. Fluoride toothpaste efficacy and safety in children younger than 6 years: a systematic review. J Am Dent Assoc. 2014 Feb;145(2):182-9.

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