Do Toddlers Need Toothpaste? (And When)

Baby’s first tooth is one of the most cherished times in a child’s development. However, many parents do not brush their toddler’s teeth as soon as they should during these developmental years. The reasons are many, but the most obvious is “They’re baby teeth and they’re just going to fall out anyway, so why worry about it?” However, brushing a toddler’s teeth it is, in fact, extremely important. Let’s take a closer look at why.

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Do Toddlers Need Toothpaste?

Studies from professional health organizations such as the American Dental Association (ADA) and the American Association of Pediatrics (AAP) state very clearly that yes, toddlers benefit from toothpaste. However, opinions vary on how early, how much and what kind of toothpaste is best for a very young child.

In the past, pediatric dentists (children’s dentists) typically recommended that parents of infants start out with an extremely soft-bristled toothbrush specifically made for babies, or even finger brushing when appropriate, particularly for very new teeth or even in the case of having no exposed teeth at all. In this way parents could just use a very light touch on the teeth and gums with only water or a smear, or the size of a grain of rice of toothpaste. The process of early brushing was also found useful because it can teach your baby to not fear brushing.

Of course it is very important to know when to introduce your toddler to toothpaste. Because a child under three years old cannot expectorate (spit out the toothpaste), earlier findings suggested that parents would want to ensure their child is old enough for this experience. Fluoride is very important for older children and adults to help prevent tooth decay, but it was previously not recommended for infants.

However, in 2014, due to a dramatic spike in tooth decay among children ages 0-5, the American Academy of Pediatrics (AAP), mirroring an earlier recommendation from the American Dental Association (ADA), issued a finding that rebutted this idea. They now suggest fluoride toothpaste can be used as early as the appearance of the first tooth, but only in exceptionally tiny amounts equal to a grain of rice, also called a “smear.”

When Should Toddlers Start Using Toothpaste?

The first question on a new parent’s mind is often “When is the right time to introduce my child to brushing with toothpaste?” Professional opinions on this vary, as noted above, but most agree it can begin as early as the appearance of the first tooth.

Before the recent findings, most dentists recommended starting an infant on fluoride-free toothpaste specifically designed for toddlers. Later, when the child is around two years old, parents could feel comfortable switching them to fluoride-based toothpaste. It was previously recommended that parents use a children’s toothpaste with soothing, pleasant flavors such as fruit or other tastes they are more likely to enjoy.

But the AAP now recommends parents begin the use of fluoride toothpaste earlier than was previously accepted. The AAP suggests that fluoride toothpaste can in fact be used on young children as soon as teeth begin to appear. Because an infant’s first tooth typically “erupts” (or becomes visible) around six months of age, the AAP has a few suggestions on the use of fluoride toothpaste:

1. Use only a tiny bit of fluoride toothpaste around the size of a grain of rice from the appearance of baby’s first tooth through three years old.
2. This amount may be increased to the size of a pea for children between the ages of three and six.
3. As an additional tip to preventing early tooth decay, the AAP also recommends that parents monitor their children’s consumption of sugary beverages. Water is the best option, but because some brands of bottled water don’t contain fluoride, the Centers for Disease Control and Prevention (CDC) advises families living in communities with fluoridated water to consider giving their children tap water rather than the more expensive bottled varieties.

One issue to consider, though, before moving your child onto fluoride toothpaste, is the occurrence of fluorosis. This condition results from an excess ingestion of fluoride when permanent teeth are starting to develop. Although it is mostly a cosmetic concerns – which may result in enamel pitting or brown spots in more severe cases – it is generally mild where white flecks may appear on the tooth. It is very important to never overuse fluoride toothpaste during your young child’s brushing.

As with any tooth-related concern, you should always consult a dentist with any questions you may have.

What Kind of Toothpaste Should a 2-Year-Old Use?

No matter whether you prefer to start your toddler on soft, water-only brushing, children’s (non-fluoridated) toothpaste, or common fluoride toothpaste, it is important to ease your child into an ADA-approved toothpaste when they are old enough for you to feel comfortable doing so.

The ADA approves many brands of toothpaste and they have stringent scientific standards of adherence from manufacturers which may help a parent make this decision, including the following:

1. A toothpaste must contain fluoride to obtain the Seal of Acceptance from the ADA 
2. No ADA-approved toothpaste may contain flavors that contribute to tooth decay, such as sugar or other additives, so a parent is safe in knowing the toothpaste will not worsen tooth decay in this way
3. Some ADA-approved toothpastes may also contain ingredients to assist in teeth whitening, preventing bad breath, reducing tooth sensitivity, or preventing tartar buildup or enamel erosion

In conclusion, your child requires constant care at every age to prevent tooth decay and other dental problems. Starting a child’s brushing as early as possible will reduce fear, allow the infant to appreciate the taste and enjoyment of a clean mouth, and set them on a lifetime of proper dental care. As the saying goes, “An ounce of prevention is worth a pound of cure.” Be sure to consult your pediatric dentist for more information, and happy brushing!