Kids using too much toothpaste says CDC

By Dr. Ananya Mandal, MDFeb 4 2019

According to the Centers for Disease Control and Prevention (CDC), children today are using too much toothpaste to brush their teeth. They add that this can be a concern because of excessive fluoride ingestion among the children.

The CDC released a report last week after a survey of parents and their children aged between 3 and 15 years. They found that over 40 percent of the children between ages 3 and 6 years are using more that the CDC and the American Dental Association recommendation about toothpaste quantity. Both agencies recommend that children aged between 3 and 6 need to use only a pea-sized amount of toothpaste while brushing.

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Children less than 3 years need to use only a rice grain size of smear of toothpaste on their brushes says the CDC and the American Dental Association. Their survey showed that only 12 percent children aged between 3 and 6 years used the smear amount and 49.2 percent used a pea-size amount. Preschoolers this age used either half load (20.6 percent) or full load (17.8 percent) of paste on their brush, the survey found. They noted that around 60 percent of the children and adolescents are using half or full load of toothpaste on their brushes. The survey also noted that only around 34.2 percent of the children aged between 3 and 15 years brushed their teeth once a day unlike recommendations that suggest brushing twice a day.

The CDC warns that using too much toothpaste can cause damage to the enamel. This is mainly because of the excess fluoride that is swallowed by children in the toothpaste. Excess fluoride ingested can lead to dental fluorosis that can damage the developing teeth and cause white marks and discolouration of the teeth.

The new report looked at the brushing and toothpaste use of around 5,157 children between 2013 and 2016. Current recommendations from the CDC as well as the American Academy of Paediatrics (AAP) suggest that children should begin brushing by the age of two years. However brushing with toothpaste is recommended by the ADA and the American Academy of Pediatric Dentistry, as soon as the baby starts teething, at around 6 months. This new survey reveals that most babies (80 percent) are made to start brushing after the age of 1 year.

“Excessive ingestion by young children can discolor and pit the permanent teeth,” according to the CDC. The report adds, “Recommendations aim to balance the benefits of fluoride exposure for prevention of dental caries with the potential risk for fluorosis when excessive amounts of fluoride toothpaste are swallowed by young children... The findings from this study highlight the importance of recommendations that parents supervise young children during brushing and monitor fluoride ingestion.”

Limitations of this survey were that parents self reported the brushing habits of their kids and were not observed first hand. Also the type of toothpaste (fluoride or non-fluoride containing) was not taken into account.