Many parents wait until their children are at least 6 years old before giving them fluoride toothpaste but dental experts now suggest that kids should use fluoride toothpaste early.

The American Dental Association (ADA) has advised parents not to wait until their child turns two years old before brushing their teeth with fluoride toothpaste. ADA has recommended parents to use rice-grain-size toothpaste for the child's first teeth and increase this later on to pea-size blobs when they reach the age of three.

ADA had previously recommended that kids younger than two, brush their teeth only with water and move only to a pea-size amount of fluoride toothpaste when they are 6 years old. The new recommendation to start giving kids fluoride toothpaste as soon as their first tooth appears is based on the result of a systematic review published in the Journal of the American Dental Association Feb. 1, which assessed the effectiveness and safety of fluoride on children 6 years old and below.

"For half a century, the ADA has recommended that patients use fluoride toothpaste to prevent cavities, and a review of scientific research shows that this holds true for all ages," said Edmond Truelove, chair of ADA's Council on Scientific Affairs. "Approximately 25 percent of children have or had cavities before entering kindergarten, so it's important to provide guidance to caregivers on the appropriate use of fluoride toothpaste to help prevent their children from developing cavities."

Author of the scientific review "Fluoride toothpaste efficacy and safety in children younger than 6 years," Helen Ristic, scientific information director at the American Dental Association in Chicago, and her colleagues, found that brushing the teeth with fluoride toothpaste can help prevent tooth decay and cavities in children who are under 6 years old. Ingestion of pea-sized amount, however, can lead to dental fluorosis, which is characterized by staining of the tooth's enamel.

"To minimize the risk of fluorosis in children while maximizing the caries-prevention benefit for all age groups, the appropriate amount of fluoride toothpaste should be used by all children regardless of age," the authors recommended. "Dentists should counsel caregivers by using oral description, visual aids and actual demonstration to help ensure that the appropriate amount of toothpaste is used."

Tooth decay can be prevented but it remains prevalent among children and adolescents in the U.S. "Although dental caries are largely preventable, they remain the most common chronic disease of children aged 6 to 11 years and adolescents aged 12 to 19 years," The Centers for Disease Control (CDC) reported.

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