According to the American Association of Pediatric Dentistry (AAPD), parents and caregivers should start exposing their babies to fluoride as soon as the first tooth erupts, which is around the age of six months.
Fluoride is a mineral that has been shown to help prevent tooth decay and cavities. It is commonly found in toothpaste, mouthwash, and community water supplies. However, when it comes to babies and young children, the question arises of how much fluoride is too much.
Some studies have suggested that excessive fluoride intake during early childhood can lead to dental fluorosis, a condition that affects the appearance of tooth enamel. On the other hand, inadequate fluoride intake can result in increased risk of tooth decay.
The majority of fluoride intake comes from fluoridated water, food and beverages prepared with fluoridated water, and dental products containing fluoride, including toothpaste, which should satisfy the requirements of the body. (What does fluoride do for the body).
According to the Food and Nutrition Board, newborns only require about 0.01 mg of fluoride until they are 6 months old, which is when the first tooth erupts, after which their fluoride requirement increases to 0.5 mg up to their first birthday.
The adequate daily intake increases gradually into adulthood as discussed below:
Recommended Fluoride intake
The Food and Nutrition Board (FNB) has come up with certain recommendations for the daily Adequate Intake (AI) of fluoride, which has been provided in the Dietary Reference Intakes (DRIs), as is assumed to ensure nutritional sufficiency.
Depending on age, daily AI may vary as follows:
Birth to 6 months
7 – 12 months
1 – 3 years
4 – 8 years
9 – 13 years
14 – 18 years
19 + years
Fluoride recommendations for babies
Although fluoride is important for dental health, it is also possible to have too much of it, which can lead to a condition called fluorosis. For this reason, it is important to follow the recommended guidelines for fluoride intake in babies. The American Dental Association (ADA) and the Centers for Disease Control and Prevention (CDC) provide guidelines for fluoride intake in babies.
- Both the ADA and the CDC recommend that infants under 6 months of age should not receive any fluoride supplements. These supplements comprise any tablets, drops, or lozenges that contain fluoride and are taken orally.
- For infants aged 6 months and above who live in areas where the water supply is not fluoridated, the ADA recommends a fluoride supplement of 0.25 mg/day until they are 12 months old, and then increase daily intake to 0.5mg until 3 years old.
- The same is recommended for infants who are exclusively breastfed and do not receive any fluoride supplements.
Fluoride toothpaste for babies and toddlers
The CDC, on the other hand, recommends that parents use a smear (the size of a grain of rice) of a regular fluoride toothpaste for children under 3 years of age, and a pea-sized amount for children 3-6 years old, when they’re better able to spit when brushing.
The toothpaste should contain no less than 1000 ppm fluoride. A pea-sized portion of toothpaste contains around 0.4 mg, and a smear about half as much, which meets the daily recommendation for your baby.
- Parents should help their children brush until at least they are five or six years old.
- Also keep the toothpaste out of reach of your child to prevent accidental swallowing. Ingesting a lot of toothpaste can pose a risk to your child’s health.
The CDC also advises parents to talk to their child’s dentist or pediatrician about their child’s fluoride needs and to have their child’s fluoride level checked.
How much fluoride is too much for your baby?
There is no research on the actual amount of Fluoride (F) that you’d have to consume for fluorosis to occur. That said, dental professionals agree on a threshold of 0.05 – 0.07 mg of Fluoride per KG or body weight for the individual user.
For a 5 to 10 kg baby, the threshold is 0.25 mg to 0.7 mg of Fluoride.
A child‐sized toothbrush covered with a full strip of toothpaste holds approximately 0.75 g to 1.0 g of toothpaste, and each gram of fluoride toothpaste, contains approximately 1.0 mg of fluoride.
So using a smear or pea-sized amount of toothpaste should be sufficiently safe for your baby.
Risks and benefits of fluoride for babies
Fluoride is known to have both risks and benefits, and it is important to understand the effects and symptoms of too much fluoride when considering its use for babies.
Tooth decay prevention
The main benefit of fluoride for babies is its ability to prevent tooth decay. Fluoride helps to strengthen the tooth enamel, making it more resistant to acid attacks that can lead to decay. However, it is important to note that the benefits of fluoride are dose-dependent, meaning that too much fluoride can actually increase the risk of tooth decay.
One of the main risks associated with excessive fluoride exposure in infants is dental fluorosis, a cosmetic condition that affects the appearance of the teeth. Dental fluorosis occurs when fluoride is ingested during tooth development, leading to white or brown spots or streaks on the teeth. However, dental fluorosis is generally considered to be a cosmetic issue rather than a health concern.
Other health effects
In addition to dental fluorosis and tooth decay prevention, there has been some research into other health effects of fluoride. Some studies have suggested that high levels of fluoride exposure may be associated with a range of health problems, including developmental issues, neurological effects, and thyroid dysfunction. However, these studies have been controversial, and most health authorities agree that fluoride is safe when used in appropriate amounts. (see symptoms of too much fluoride).
Factors to consider when determining fluoride intake for babies
Age and weight
The appropriate amount of fluoride for babies depends on their age and weight. The recommended fluoride intake for infants aged 0-6 months is around 0.1 milligrams per day, while infants aged 6-12 months should have an intake of approximately 0.5 milligrams per day.
Fluoride content in water and other sources
The fluoride content in the water supply should be taken into account when determining fluoride intake for babies. If the water supply has fluoride levels that are too high or too low, it may be necessary to adjust fluoride intake from other sources, such as food or supplements.
The nutritional status of the baby should also be considered when determining fluoride intake. A well-balanced diet that includes fluoride-rich foods, such as certain fruits and vegetables, can help meet the baby’s systemic fluoride needs.
Tips for parents and caregivers
Parents and caregivers can determine the fluoride intake of their babies by consulting with a pediatrician or a dentist. They can also check the fluoride content in the water supply and estimate the amount of fluoride intake from other sources, such as supplements or toothpaste.
Fluoride supplements, such as fluoride varnish and other fluoride treatments should only be given to babies who are at risk of developing tooth decay and have a low fluoride intake.
Fluoride is an essential mineral that can help prevent tooth decay, but it is important to use it in the right amounts for babies. Parents and caregivers should consult with a healthcare professional to determine the appropriate amount of fluoride for their babies based on factors such as age, weight, and fluoride content in water and other sources.
They should also be mindful of the risk of dental fluorosis and take steps to minimize this risk, such as reducing exposure to too much fluoride from multiple sources, including water, toothpaste, rinses, fluoride treatments, and so on.