A written warning on most tubes of toothpaste states, “Keep out of the reach of children under 6 years of age.”
The reason for the warning relates to the presence of fluoride in toothpaste that is used to prevent tooth decay. There is not enough fluoride in a tube of toothpaste to cause a fatality, however too much fluoride can be associated with a dental condition called fluorosis.
Too much fluoride can damage the enamel of developing teeth, both the primary and permanent teeth. Once the teeth have fully erupted, fluoride will not damage the enamel. Therefore, it is important children do not ingest too much fluoride while the enamel is being developed.
In fluorosis the appearance of the teeth, mainly the enamel, is affected by too much fluoride. Most cases are mild and consist of white spots on the tooth or on the tip of the tooth. Chalk-like lines may also be present.
The more severe forms of fluorosis include pits on the enamel or an irregular enamel surface. The enamel may also be stained, which can be yellow or tan.
The main sources of fluoride are drinking water, soft drinks and juices, toothpaste and fluoride tablets.
It is recommended that small children use only a pea-sized amount of fluoridated toothpaste when brushing their teeth. They should also be taught not to swallow their saliva when brushing their teeth.
Parents should discuss with their child’s pediatrician or dentist if the water in their community is fluoridated and if there is a need to take fluoride vitamins.
If the enamel is affected, treatment is available to improve the appearance of the teeth.
Although pediatric and dental societies recommend municipal fluoridation of water, there are some groups who oppose this action. One argument is that fluoride is not really effective in preventing decay and, in fact, it may be harmful. They also believe that such fluoride legislation takes away a person’s right to make their own decisions concerning their health and the health of their children.
Dr. Murray Feingold is the physician in chief of the National Birth Defects Center, medical editor of CBS4 TV and WBZ radio, and president of the Genesis Fund. The Genesis Fund is a nonprofit organization that funds the care of children born with birth defects, mental retardation and genetic diseases.