Pediatricians Echo CDC Caution on Using Too Much Toothpaste

Recently the Centers for Disease and Prevention (CDC) analyzed the results of a survey conducted by the National Health and Nutrition Examination Survey (NHANES) and concluded that children are using too much toothpaste when brushing their teeth and as a result are swallowing too much fluoride.

The CDC warns that children, especially in the stages of developing teeth, who are using too much toothpaste with fluoride can end up with fluorosis which changes the enamel structure of their teeth by causing discoloration, pitting or striping.

Dr. Michelle Terry, a pediatrician at Seattle Children’s Hospital, says that advertising contributes to the over usage of toothpaste and does not encourage restraint. In their advertisements, toothpaste commercials show that the whole toothbrush is covered with toothpaste which she says is about 10 times the amount that is needed. Her statements were shared with Medscape Medical News.

The advertising as well as the use of flavorings like bubble-gum and fruit may help to encourage children to brush their teeth but the flavorings also tempts children to swallow the toothpaste rather than spitting it out.

Here are the recommendations by the CDC and the American Dental Association: children should start using fluoride toothpaste at age 2 with only a drop of it the size of a grain of rice until age 3.  Then they recommend from ages 3 to 6 to use toothpaste only the size of a pea. They report that at around age 6 years children begin to develop the swallowing reflex enough in a way to prevent children from accidentally ingesting toothpaste.

NHANES 2013 to 2016’s survey involved 5157 parents with children ages 3 to 15 years of age and was just published on February 1, 2019 in the Morbidity and Mortality Weekly Report. For the first time since the 2013/14 survey cycle, questions were asked about toothpaste and brushing habits of children and teens.

The survey results revealed that the amount of toothpaste used was more than what was recommended by dentists in 38% of children ages from 3 to 6 years..

Dr. Terry believes that perhaps the reason for this is that instructions on good oral health and proper teeth brushing and amount of toothpaste to be used is either overlooked because of time constraints during doctors visits or because there is usually so much information on childcare for parents to remember.

However, she adds that the recommended amounts of toothpaste that should be used is listed on the tube of toothpaste, but perhaps parents aren’t thinking to check there.

The CDC also recommends brushing teeth twice a day to prevent dental cavities from the age of 2 years.  However, the survey showed that only 38 percent of children and teens brushed only once per day.

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