How can I prevent dental fluorosis in my children?

There is some potential for developing dental fluorosis when young children consume fluoride during the time when teeth are forming under the gums (birth through age 8). To help prevent both tooth decay and dental fluorosis, the Centers for Disease Control and Prevention (CDC) recommends the following:

For parents: Children younger than 6 years have a poor swallowing reflex and tend to swallow much of the toothpaste on their brush. Toothpaste that is swallowed (but not toothpaste that is spit out) contributes to a child’s total fluoride intake.

As soon as the first tooth appears, begin cleaning by brushing without toothpaste with a small, soft-bristled toothbrush and plain water after each feeding. Begin using toothpaste with fluoride when the child is 2 years old. Use toothpaste with fluoride earlier if your child’s doctor or dentist recommends it.

  • Do not brush your child’s teeth more than 2 times a day with a fluoride toothpaste,
  • Apply no more than a pea-sized amount of toothpaste to the toothbrush, and
  • Supervise your child’s tooth brushing, encouraging the child to spit out toothpaste rather than swallow it. 
  • If your child’s pediatrician or dentist prescribes a fluoride supplement (or vitamin supplement that contains fluoride), ask him or her about any risk factors your child has for decay and the potential for dental fluorosis. If you live in an area with fluoridated water, fluoride supplements are not recommended.
  • You can use fluoridated water for preparing infant formula. However, if your baby is exclusively consuming infant formula reconstituted with fluoridated water, there is an increased potential for mild dental fluorosis. Additional information can be found in a CDC fact sheet on infant formula:

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