For many children, fluoride toothpaste is the largest source of fluoride intake. One strip of fluoridated toothpaste on a child-sized toothbrush contains between 0.75 and 1.5 mg of fluoride, which is more fluoride than is found in many prescription fluoride supplements (0.25 to 1.0 mg per tablet). Since young children are known to swallow a large amount of the toothpaste they place in their mouth, use of fluoride toothpaste–particularly when done without the supervision of a parent–can result in dangerous levels of fluoride exposure. Ingestion of excessive fluoride toothpaste is a major risk factor for dental fluorosis, and can cause symptoms of acute fluoride toxicity (e.g., stomach pain, nausea, etc).
Many Children Exceed Recommended Fluoride Intake from Toothpaste Alone
Studies have found that children can easily ingest more fluoride from toothpaste alone than is recommended as a total fluoride intake from all sources. As noted in the Journal of Public Health Dentistry:
“Virtually all authors have noted that some children could ingest more fluoride from [toothpaste] alone than is recommended as a total daily fluoride ingestion.” (Levy 1999).
A quick look at the data readily confirms the accuracy of this statement. As noted by Dr. Stephen Levy, two-to-three year old children ingest an average of 0.3 grams of toothpaste per brushing, which equates to 0.3 to 0.45 mg of fluoride. (Levy 1993). At two brushings per day, the average two-to-three year old would ingest between 0.6 and 0.9 mg of fluoride from toothpaste each day. Some children who brush twice a day will swallow far more than this. Research has found, for example, that 10% of children swallow more than double the “average” amount. Among these children, fluoride ingestion from toothpaste will range up to 2 mg per day.
To put these doses in perspective, the Institute of Medicine recommends that two-to-three year old children ingest 0.7 mg of fluoride per day from ALL sources, and that the “upper tolerable intake” is 1.3 mg/day. Many children will thus ingest more fluoride from toothpaste alone than is recommended as a total daily ingestion, and some will even ingest more than is deemed “tolerable.”
The following table contrasts the average fluoride intake from toothpaste (among children who brush twice a day) with the recommended daily intake from all sources.
|
Fluoride Intake from Toothpaste
vs. Recommended Daily Intake from ALL Sources |
|||
|
Age
|
Avgerage Intake
2 brushings (1,100 ppm F) |
Percent of
Recommended Total Intake* |
Reference
|
|
2
|
0.73 mg
|
104%
|
Naccahe ‘87**
|
|
2.5
|
0.59 mg
|
84%
|
Bentley ‘99
|
|
2-3
|
0.62 mg
|
89%
|
Simard ‘84**
|
|
2-4
|
0.6 mg
|
96%
|
Barnhart ‘76**
|
|
3
|
0.40 mg
|
57%
|
Naccahe ‘85**
|
|
3-6
|
0.84 mg
|
76%
|
Hargreaves ‘75**
|
|
4
|
0.86 mg
|
78%
|
Simard ‘84**
|
|
4
|
0.29 mg
|
26%
|
Ericsson ‘74**
|
|
5
|
0.44 mg
|
48%
|
Simard ‘84**
|
| * Recommended Daily Intakes are taken from Table 2 of the Institute of Medicine’s 1997 report: “Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride.” | |||
| ** Data derived from: Levy SM, Guha-Chowdhury N. (1999). Total fluoride intake and implications for dietary fluoride supplementation.Journal of Public Health Dentistry 59: 211-23. | |||
To learn more about fluoride intake from dental products, click here.
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