This post contains affiliated links. Please read my disclosure page.
A few years ago, when my daughter was a baby, I wrote the post ‘Does Your Baby Need a Baby Fluoride Toothpaste Or a Fluoride-Free Toothpaste?’. At the time, I wasn’t sure if I should be using a toothpaste with fluoride when my baby doesn’t know how to spit out the toothpaste yet. After speaking to my daughter’s dentist, I decided that I would use a fluoride-free toothpaste for my baby. I was told that a small amount of toothpaste with fluoride was safe to use for my daughter. However, I didn’t want to use a fluoride toothpaste when my daughter didn’t know how to spit out the toothpaste while brushing. I concluded at the time that there was more risks than benefits so I opted to use a fluoride-free toothpaste for my daughter. My daughter still had a risk of tooth decay since she still breast-fed at the time (and often fell asleep right after breastfeeding). Therefore, our daughter just received a fluoride treatment a few times upon dentist’s recommendation and didn’t use a toothpaste with fluoride. As my daughter was getting older, she was eating more food including sweets. Therefore, my daughter’s dentist recommended me to use a toothpaste with fluoride or at least alternate between using a fluoride toothpaste and a fluoride-free toothpaste. After all, fluoride is effective in preventing tooth decay. Now, my daughter is at the age where she can spit out the toothpaste while brushing. Should I be using a toothpaste with fluoride for my daughter now? If so, are there any non toxic kids toothpaste with fluoride available? In this post, I share with you if a toothpaste with fluoride is needed for kids and what non toxic kids toothpaste with fluoride is available.
Why Is There Fluoride In The Toothpaste?
Fluoride is a naturally occurring mineral. You can find fluoride in soil, salt, water and foods. Fluoride can protect and prevent teeth from decay. For children younger than age 8, when their teeth are growing, fluoride mixes with tooth enamel and hardens the enamel, making it resistant to demineralization. Demineralization is is the leading cause of tooth decay and cavities. Also for adults, fluoride protects tooth enamel and keep teeth strong and healthy. Therefore, it is typically used as an ingredient in many of the toothpastes. It is also included in public water supplies in the US and other countries to decrease the tooth decay and improve the dental health of the local population. According to the Center For Disease Control and Prevention (CDC), nearly 73% of the United States served by community water systems had access to fluoridated water.
How Much Fluoride Is In Public Water Supplies and Toothpaste?
A maximum amount of fluoride allowable in drinking water set by the US Environmental Protection Agency (EPA)is 4.0 mg/L. Optimal level recommended by the Department of Health and Human Service (HHS) is 0.7 milligrams per liter. Therefore, Fluoridated water in the US generally contains 0.7 parts per million (PPM) of fluoride. The American Dental Association (ADA) also recommends 0.7 parts fluoride per million parts water in water for dental health. (mg/L↔ppm 1 mg/L = 1 ppm)
According to a study, using a fluoride toothpaste is more effective in preventing dental decay than brushing with a non-fluoride toothpaste. In both children and adults, fluoride tooth paste had approximately 24% better results than compared to brushing with non-fluoride toothpaste. Also, higher concentrations of fluoride offered more protection. According to the study, the general opinion is that toothpastes should have about 1000 ppm (average concentration) of fluoride. 1450-1500 ppm are considered high concentrations and 500 ppm is a low concentration. Typical over-the-counter toothpastes contain 1000 – 1500 parts per million of fluoride.
Is Fluoride Harmful?
Despite the advantages of protecting teeth and keeping them healthy, fluoride, on the other hand, can also be harmful. For children younger than 8 whose teeth are growing, too much fluoride consumption over a long period of time can cause dental fluorosis. Dental fluorosis causes discoloration of teeth such as white spots on teeth and it can also result in brown stains and weakened teeth in severe cases. According to the American Dental Association (ADA), most fluorosis cases result from young children taking fluoride supplements or swallowing fluoride toothpaste when their drinking water is already fluoridated. Toothpaste containing higher concentrations of fluoride may offer greater protection against tooth decay but it can increase the risk of fluorosis at the same time. Fluoride intake amounts should be limited at appropriate levels.
Fluoride in toothpaste is absorbed well and 80% of absorbed fluoride is stored in the body (mostly in bones and teeth) in young children. Too much fluoride or the accumulation of fluoride over a long period of time can also cause skeletal fluorosis. Excess fluoride can also lead to bone fractures, thyroid problems, neurological problems, and other health problems. Fluoride is considered to be safe when ingested under the recommended amount but when ingested in large amounts, it can lead to serious health issues.
What Fluoride Level Is Safe?
As mentioned earlier, typical over-the-counter toothpastes contain 1000 – 1500 parts per million of fluoride. There are toothpastes containing lower amount of fluoride for children as low as 250 ppm. However, research shows that brushing with fluoride concentration under 550 ppm has same effects as brushing with non-fluoride toothpaste. Brushing with fluoride concentration under 550 ppm didn’t lower the occurrence of tooth decay. Fluoride-free toothpaste doesn’t protect teeth against decay the same way a fluoride toothpaste does. However, fluoride-free toothpaste still helps with cleaning teeth.
According to an article featured in Sage Journals, the recommendation for children under 3 years of age with high tooth decay (dental caries) risk is to use a smear size of 1000 ppm or greater fluoride toothpaste. For children who are 3 years and older, a pea size of 1000 ppm or greater fluoride toothpaste is recommended. Another study mentioned that children aged less than 6 years may swallow an estimated 0.3 g of toothpaste per brushing (which contains 0.3 mg of fluoride) and can accidentally swallow as much as 0.8 g. Therefore, the study recommends that children of 6 years of age and under should be supervised when brushing their teeth with fluoride toothpaste. The study also mentioned that only a pea‐sized amount of toothpaste should be used.
The U.S. Department of Health & Human Services also says that the estimated typical amounts of fluoride ingested daily from toothpaste are;
- 0.1 mg to 0.25 mg for infants, children aged 0 to 5 years
- 0.2 to 0.3 mg for children aged 6–12 years
Daily Adequate Intakes for Fluoride is;
- 0.01 mg for birth to 6 months
- 0.5 mg for 7-12 months
- 0.7 mg for 1-3 years
- 1 mg from 4-8 years
If your area offers fluorinated public water supplies (especially with high fluoride levels) or your family drinks water containing fluoride, you may want to discuss with the dentist about being safe using a toothpaste with fluoride. If drinking water is already fluoridated, swallowing fluoride toothpaste daily may provide fluoride intake levels higher than adequate daily intake amount depending on the water and a toothpaste.
Should My Child Use A Fluoride Toothpaste?
Fluoride toothpaste is generally safe. However, appropriate amounts should be used especially for babies and young children. The American Dental Association, and the American Academy of Pediatric Dentistry recommend fluoride toothpaste for babies and children. The American Dental Association recommends for children younger than 3 years, parents and caregivers should begin brushing children’s teeth as soon as they begin to come into the mouth by using fluoride toothpaste in the size of a grain of rice. Starting age of 3, they recommend to use a pea-sized amount of fluoride toothpaste. Fluoride at low, appropriate levels, can help children’s teeth develop strong and healthy, also it can help prevent cavities in children. If your baby or child has risk of developing tooth decay, you can consult with your child’s dentist for recommendations. If children younger than 3 years old have a low risk of tooth decay, a dentist may recommend simply to brush the teeth with a toothbrush and water or non-fluoridated toothpaste. If children have a high risk, a fluoride toothpaste in the size of a grain of rice or a fluoride treatment may be recommended. Children under 3 years have less daily adequate intake limits for fluoride than children older than 3 years old. Therefore, you should consult with the dentist for the risk of developing tooth decay, the risk of dental fluorosis and the use of a fluoride toothpaste to determine if your child should use a fluoride toothpaste.
Non Toxic Kids Toothpaste With Fluoride
It wasn’t easy to find non toxic kids toothpastes with fluoride. I came up with the overall the best rated kids toothpaste with fluoride at the Environmental Working Group (EWG). The Environmental Working Group (EWG)’s Skin Deep rates products including toothpastes for their ingredients. They look at ingredients of a toothpaste and rate how hazardous each ingredient is, then comes up with an overall hazard score. ‘EWG Verified’ or ‘1’ is the best rating while 10′ is the most hazardous. The toothpastes listed below are rated at ‘2’ (for the hello fluoride toothpaste) and ‘3’ (for the Burts Bees fluoride toothpaste) in their overall ingredients. I couldn’t find a kids toothpaste with a fluoride that was rated ‘EWG Verified’ or ‘1’.
The reason is because ‘flavor’ and ‘fluoride’ are not rated as non hazardous ingredients. Although no artificial flavor is used for both products, we do not know exactly what ingredients are in ‘flavor’. ‘Flavor’ is listed as one ingredient but the actual make up of this ingredient is unspecified. Therefore, whether it says ‘flavor’ or ‘natural flavor’, unspecified flavor which doesn’t lists actual ingredients are rated at ‘4‘ by the Environmental Working Group (EWG). Most kids toothpaste have some kind of flavor, whether it is natural, artificial or unspecified. Also, fluoride is rated at 2-4 which is ‘low’ to ‘fair’ in hazard rating. Therefore, these two toothpastes below have an overall rating of 2 and 3 by the EWG.
Hello Fluoride Toothpaste – Non Toxic Kids Toothpaste With Fluoride
Hello Fluoride Toothpaste contains fluoride to help prevent cavities and strengthen enamel.
It is ADA (American Dental Association) accepted. It is dye free, SLS free, paraben free, triclosan free, mint free, preservative free, and gluten free. There is also no artificial sweeteners and no artificial flavors. It is also vegan, cruelty free, never tested on animals (leaping bunny certified and PETA recognized).
Active Ingredient: sodium fluoride 0.24% (0.15% w/v fluoride ion)
Inactive Ingredients: sorbitol, purified water, hydrated silica, glycerin, xylitol, flavor, xanthan gum, titanium dioxide, cocamidopropyl betaine, sodium cocoyl glutamate, and stevia rebaudiana extract
Burts Bees Fruit Fusion Kids Fluoride Toothpaste – Non Toxic Kids Toothpaste With Fluoride
Burts Bees contains fluoride to prevents cavities. It is ADA (American Dental Association) accepted. There is no Sodium Lauryl Sulfate (SLS free), Triclosan & Parabens, Artificial Flavours & Sweeteners*, Preservatives & Blue, Red, Yellow Dyes and Plastic Microbeads in this toothpaste. This toothpaste is also not tested on animals. Tubes and cartons are 100% recyclable.
Medicinal Ingredient (w/w) : Sodium Fluoride 0.243% w/w
1100 PPM of Fluoride
Non-Medicinal Ingredients : Glycerin, Water, Hydrated Silica, Cocamidopropyl Betaine, Flavour*, Xanthan Gum, Carrageenan, Steviol Glycosides, Titaniumdioxide *Natural Source Flavour
*Sweetened with Steviol Glycosides
If your child has a high risk of tooth decay, you should consult with your child’s dentist to decide if your child needs a toothpaste with fluoride. You may also want to find out if your drinking water or public water supply contains fluoride. Especially for infants or babies who drink formula milk and have a high risk of tooth decay at the same time, this may be important since they have a lower fluoride daily intake limit. Children under 3 years most likely will swallow the toothpaste with fluoride while their teeth are being brushed. There are fluoride-free toothpastes available for babies and young children if you do not need or want a fluoride toothpaste. My daughter has been using the ‘Jack and Jill Natural Children’s Toothpaste Strawberry flavor‘ which is fluoride-free. Now, I am planning to alternate between the Jack and Jill Natural Children Toothpaste and the hello fluoride toothpaste. Now that she can spit out the toothpaste and understand she can’t swallow the toothpaste, I think it is safer for her to use a toothpaste with fluoride. If she will like the taste of the toothpaste is another story. My daughter being very picky with the taste of a toothpaste, I may have no other choice but to find an alternative. Happy brushing!
For non toxic art supplies for kids – ‘Non Toxic Art Supplies For Kids – Which Art Supplies Are Safe?‘.
For non toxic toys for toddlers, please read my post, ‘Non Toxic Gifts For Toddlers.’
For non Toxic toy brands, please read my post, ‘Best Non Toxic Toys – What Are The Best Non Toxic Toy Brands?‘
For healthy toddler shoes, please read my post, ‘Toddler Shoes Guide and Review – Toddler Shoes That Promote Healthy Foot Development‘.
For what foods to avoid for kids ‘Harmful Chemicals In Children’s Foods – What Foods To Avoid For Children‘.