Fluoride Action Network

Dentists, dental hygienists and dental students’ knowledge regarding recommended fluoride concentration in toothpaste for children.

Source: European Archives of Paediatric Dentistry [Epub ahead of print] | January 2nd, 2020 | Authors: Fux-Noy A, Ytshaki K, Herzog K, Shmueli A, Halperson E, Ram D.
Location: Israel
Industry type: Toothpaste


PURPOSE: The objective of this study was to assess the knowledge of dentists, dental hygienists and dental students regarding the Israeli Ministry of Health guidelines for using fluoridated toothpaste.

MATERIALS AND METHODS: An anonymous questionnaire was distributed to dentists, dental hygienists, and dental students in their final years at the Hebrew University-Hadassah School of Dental Medicine. Participants were queried regarding their knowledge of Ministry of Health fluoride concentration guidelines in toothpaste by the following age categories: under 2 years, 2-6 years, and above 6 years.

RESULTS: Thirty-two paediatric dentists (specialists and residents), 63 general dentists, 68 dental hygienists, and 69 students responded to the survey. Analysis of survey respondent’s knowledge of Ministry of Health fluoride toothpaste guidelines by age group found that 81%, 75% and 88% of participants selected a fluoride concentration within the recommended range for those under 2 years, 2-6 years and greater than 6 years, respectively. Only 58% of respondents were aware of the recommended fluoride concentration for all three age groups. Among respondents who answered all three questions, there was a significant association between correctly answering the fluoride questions and respondent’s profession (P = 0.026), with a larger percentage of paediatric dentist (76%) and dental students (66%) correctly answering all three questions.

CONCLUSIONS: Israeli dental practitioners should be educated about the Israeli Ministry of Health fluoride concentrations in toothpaste guidelines. The guidelines should be emphasised at annual meetings and in continuing education courses.

*Original abstract online at https://link.springer.com/article/10.1007%2Fs40368-019-00507-8


Adair SM. Evidence-based use of fluoride in contemporary pediatric dental practice. Pediatr Dent. 2006;28:133–42.

American Academy of Pediatric Dentistry. Policy on use of fluoride. Pediatr Dent. 2017;39:49–50.

Ammari AB, Bloch-Zupan A, Ashley PF. Systematic review of studies comparing the anti-caries efficacy of children’s toothpaste containing 600 ppm of fluoride or less with high fluoride toothpastes of 1,000 ppm or above. Caries Res. 2003;37:85–92.

Ashkenazi M, Cohen R, Levin L. Self-reported compliance with preventive measures among regularly attending pediatric patients. J Dent Educ. 2007;71:287–95.

CDC—MMWR. Recommendations for using fluoride to prevent and control dental caries in the United States. In: MMWR publications—recommendations and reports. 2001; 50: 1–42. https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5014a1.htm. Accessed 3 June 2019.

European Academy of Paediatric Dentistry. Guidelines on the use of fluoride in children: an EAPD policy document. Eur Arch Paediatr Dent. 2009;10:129–35.

Harris RV, Dailey YM, Ireland RS. General dental practitioner advice regarding the use of fluoride toothpaste in two areas with a school-based milk fluoridation programme and one without such a programme. Brit Dent J. 2002;192:529–33.

Jensen O, Gabre P, Skold UM, et al. ‘I take for granted that patient know’—oral health professionals’ strategies, considerations and methods when teaching patients how to use fluoride toothpaste. Int J Dent Hyg. 2014;12:81–8.

Lima TJ, Ribeiro CCC, Tenuta LMA, Cury JA. Low-fluoride dentifrice and caries lesion control in children with different caries experience: a randomized clinical trial. Caries Res. 2008;42:46–50.

Marinho VC, Higgins JP, Sheiham A, Logan S. Fluoride toothpastes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2003. https://doi.org/10.1002/14651858.CD002278.

Marinho VC, Higgins JP, Sheiham A, Logan S. Combinations of topical fluoride (toothpastes, mouthrinses, gels, varnishes) versus single topical fluoride for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2004;1:CD002781.

Morgan MZ, Verkroost S, Hunter L. Evidence-based prevention: a comparison of oral hygiene advice given by dental and dental care professional. Int J Dent Hyg. 2013;11:121–5.

Toumba KJ, Twetman S, Splieth C, Parnell C, van Loveren C, Lygidakis N?. Guidelines on the use of fluoride for caries prevention in children: an updated EAPD policy document. Eur Arch Paediatr Dent. 2019;20:507–16.

Walsh T, Worthington HV, Glenny AM, Appelbe P, Marinho VCC, Shi X. Fluoride toothpastes of different concentrations for preventing dental caries in children and adolescents (review). Cochrane Libr. 2010; Issue 1.

Widström E, Tillberg A, Byrkjeflot LI, et al. Chair-side preventive interventions in the Public Dental Service in Norway. Br Dent J. 2016;22:179–85.

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. JADA. 2014;145:182–9.

*Original abstract online at https://link.springer.com/article/10.1007%2Fs40368-019-00507-8