Fluoride During Childhood

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Topic Overview

Fluoride is a mineral that helps prevent tooth decay and dental cavities. It may be added to local water supplies, toothpastes, and other mouth care products. Pediatric dentists recommend that you use a rice-sized amount of fluoride toothpaste up to age 3. Ask your dentist if this is right for your child. Use a pea-sized amount for children ages 3 to 6 years.footnote 1

Studies show a reduction in tooth decay in children if fluoride is added to or is found naturally in a community's water supply.footnote 1 To find out how much fluoride is in your drinking water, call your local water company or the state health department. If you have your own well, have the state health department check your water to find out if your family needs fluoride from other sources. Normal amounts of fluoride added to public water supplies and bottled water are safe for children and adults.

If your child has a high risk of getting cavities, your dentist may recommend additional sources of fluoride. These include supplements or a gel or varnish that the dentist would apply to your child's teeth. Use supplements only as directed. And keep them out of reach of your child. Too much fluoride can be toxic and can stain a child's teeth.


Too much fluoride swallowed during the early childhood years may cause white, brown, or black spots or streaks on the outside of the teeth (fluorosis). This may also cause the tooth enamel to become rough.

  • Fluorosis develops during the first 8 years of childhood while the outer enamel layer of the teeth is still growing.
  • Fluorosis is not harmful to your general health. In rare, severe cases of stains caused by too much fluoride, a dentist may bleach the teeth to remove stains or may bond resin fillings onto the tooth to cover stains.

Can fluoride be dangerous?

Fluoride is safe in the amounts provided in water supplies but can be toxic in large amounts. Toxic levels depend on your child's weight. A lethal dose of fluoride for a 3-year-old child is 500 mg and is even less for a younger child or infant. Keep all products containing fluoride, such as toothpastes and mouthwashes, away from children. If you think your child may have swallowed too much fluoride, call your local poison control center or the National Poison Control Hotline right away at 1-800-222-1222.

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  1. American Academy of Pediatric Dentistry (2013). Guidelines on fluoride therapy. American Academy of Pediatric Dentistry. http://www.aapd.org/media/Policies_Guidelines/G_FluorideTherapy.pdf. Accessed December 3, 2013.

Other Works Consulted

  • Bailey WD (2009). Community water fluoridation. In NO Harris et al., eds., Primary Preventive Dentistry, 7th ed., pp. 212–238. Upper Saddle River, NJ: Pearson.
  • Campbell PR (2009). Topical fluoride therapy. In NO Harris et al., eds., Primary Preventive Dentistry, 7th ed., pp. 245–271. Upper Saddle River, NJ: Pearson.
  • Weyent RJ, et al. (2013). Topical fluoride for caries prevention. American Dental Association Center for Evidence-Based Dentistry. http://ebd.ada.org/contentdocs/Topical_fluoride_for_caries_prevention_2013_update_-_full_manuscript.pdf. Accessed November 8, 2013.

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ByHealthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Adam Husney, MD - Family Medicine
Specialist Medical Reviewer Arden Christen, DDS, MSD, MA, FACD - Dentistry

Current as ofFebruary 17, 2015