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Fluoride and Children

What is fluoride?

Fluoride is a mineral that helps prevent tooth decay. It can be put on the teeth, found in the water supply, or taken as a supplement (called systemic fluoride). It also strengthens tooth enamel and reduces the harmful effects of plaque. Fluoride also makes the whole tooth more resistant to decay. And it helps with remineralization, which helps repair early decay.

Where is fluoride found?

The most common sources for fluoride are tap water and toothpastes.



Topical fluoride

  • Products with mild (available over the counter) or strong (by prescription) concentration of fluoride (for example, toothpastes or mouth rinses)

    • When your child's first tooth appears, start brushing their teeth twice daily using a very small amount of fluoride toothpaste, about the size of a grain of rice.

    • At about age 3, use no more than a pea-sized amount of toothpaste.

    • Rinses should not be used in children under 6 years old.

  • Fluoridated varnishes, gels, or foams may be put on the teeth by a dentist or other dental healthcare professional or primary care provider.

    • These may be applied every 3 to 6 months beginning when the first tooth appears.

Systemic fluoride

  • Public and private water supplies

  • Prescription supplements

  • Other sources include teas, soft drinks, and some bottled water

Once ingested, systemic fluoride is absorbed in the gastrointestinal tract. It's then spread all over the body in the blood supply. It also returns to the mouth in the saliva to continually bathe the teeth in fluoride.

Who should get extra fluoride?

The American Academy of Pediatric Dentistry advises children between the ages of 6 months and 16 years have some form of fluoride every day.

Your child's main source of fluoride may be from drinking water. It may have healthy levels of fluoride that your child needs. If your child's main source of tap water is not fluoridated, your child's healthcare provider or dentist may prescribe fluoride supplements. These come either as drops or tablets that are taken by mouth. The amount of fluoride that is prescribed is based on the child's age and amount of fluoride in the drinking water. Your child's dentist may also advise and apply fluoride gel, varnish, or foam if your child is at risk for tooth decay.

If your child mainly drinks bottled water, talk with your child's healthcare provider or dentist about using a product that contains fluoride. Most children still get enough fluoride from brushing and eating food prepared with tap water.

What are the health risks of fluoride use?

In general, fluoride is safe. Health risks of fluoride use are usually limited to misuse and to getting too much fluoride. To prevent these risks:

  • Don't swallow toothpaste or other dental hygiene products.

  • Keep toothpaste out of young children's reach. Make sure you help your child with toothbrushing until they are 7 to 8 years old.

  • Call the local water department or the health department to find out the fluoride level in your local drinking water.

Children 8 years or younger are at risk for dental fluorosis when they take in too much fluoride over a long period when teeth are forming under the gums. Fluorosis changes the appearance of tooth enamel and only occurs in developing teeth. It does not occur in teeth that have already come in. Talk to your child's healthcare provider or dentist if you notice changes in the appearance of the tooth enamel, such as white spots.