5 things you should know to choose the best toothpaste for kids
On a recent trip to Target, I checked out the toothpaste aisle. It was unbelievable the options available. When I was growing up, I had to walk uphill in the snow just to get to school, AND the stores where my parents shopped only had one toothpaste option: mint. I can imagine how overwhelming it must be now to determine which is the best toothpaste for kids.
Keep reading for a few key tips to help you find the best choice for your child. Hopefully, this will make tooth brushing time at your home go smoother (although we both know the toothpaste will always end up on the mirror anyway).
Let’s start with our littlest patients or children younger than two.
You might be thinking, “Whoa, whoa, whoa. Should my kid even be using toothpaste? Do the best toothpaste for kids have fluoride?”
The American Dental Association (ADA) recommends brushing with water alone or a non-fluoridated toothpaste in children younger than two, then transitioning to pea-sized amounts of fluoridated toothpaste on the toothbrush for children ages two through six years old.
The American Academy of Pediatric Dentistry (AAPD) endorses a “smear” of fluoride for children younger than two years, then switching to a pea-sized amount of toothpaste for children between the ages of two through six years old.
So, those are two different pieces of advice from experts, and that’s not helpful. Here’s what I think as an experienced pediatric dentist.
FAQs about the best toothpaste for kids
What is the first step in choosing the best toothpaste for my child?
The most crucial factor in selecting the best toothpaste is finding a toothpaste that your child is excited to try. Initially, your child might be resistant to toothpaste, so luckily, there are many options and flavors to choose from.
Let them go wild! Allow them to try the strawberry-flavored toothpaste or even the chocolate one. They might want to use the one with Elmo on the bottle or the one with sparkles. That might be initially a “training toothpaste” (e.g., fluoride-free). And, that’s okay!
Many children will start with non-fluoridated toothpaste, and then—as they become accustomed to brushing and spitting out the toothpaste into the sink—you will be able to move them to one of the best toothpaste for kids that has the cavity-fighting protection of fluoride.
This is especially true for kids who like to eat toothpaste. Swallowing too much fluoride is not healthy, so work with your child on spitting until moving them to a fluoridated toothpaste is recommended.
Does my child need toothpaste that contains fluoride?
If your child is older or has risk factors that make them “high caries risk” (likely to develop decay), fluoridated toothpaste is recommended.
Risk factors include if your child has:
- a previous history of decay or noted incipient cavity lesions beginning noted during a recent dental exam
- a medical condition that makes brushing more difficult
- medications they take that may alter the mouth’s chemistry (e.g., dry mouth)
- a family history of decay
- frequent exposure to between-meal sugar-containing snacks or sugary drinks
Fluoride in toothpaste is typically compounded as sodium fluoride, stannous fluoride, or monofluorophosphate and is responsible for protecting against tooth decay. Fluoride must be listed as an active ingredient for toothpaste to achieve the ADA seal of acceptance.
Multiple studies support the finding that fluoride and fluoridated effectively reduce cavity formation in children by at least 40%, making them a vital component of the best toothpaste for kids.
Is the best toothpaste for my child an adult paste or a kid’s toothpaste?
Kids' toothpaste and adult toothpaste have the same amount of active ingredient fluoride in them, so choosing one over the other will not affect the protective benefit from cavities.
The differences between kids’ toothpastes and adult toothpastes are the flavor and texture. Kid toothpaste tubes usually have fruitier flavors, like “silly strawberry” or “groovy grape.” Adult toothpaste usually has a strong mint component to its flavor profile that kids will often process as being “too spicy.” That strong minty fresh feeling found in adult toothpaste often is overwhelming to kids. Picking flavors that are familiar to them is a great starting point.
The next difference is the amount of abrasive in each kind of toothpaste.
Adult toothpastes contain more abrasives such as aluminum hydroxide, silica, and hydroxyapatite. These are the materials in toothpaste that help to remove surface stains from the teeth and help to polish and remove plaque.
Kids’ toothpastes may have these components but in a lesser amount which is more suited for young tooth enamel. If you have a child who struggles with stain build-up or if you feel their kids’ toothpaste never gets their teeth really “clean,” then moving to an adult toothpaste may be a good choice as long as they can tolerate the flavor.
How much toothpaste should my child use?
Do you remember those ads in the ’80s that featured a tube of Aquafresh that had the toothpaste with blue, white, and red stripes? Then it showed a toothbrush with a long, beautifully multi-colored strip of toothpaste on top of the brush head that ended with a little swirl on top like an ice cream cone? Whoa, that’s waaaayyyy too much toothpaste was on that brush. It showed probably about a week's worth of the amount of toothpaste you would need.
A report from the CDC in 2019 found that up to 40% of children were using too much toothpaste when they brushed. Parents should help their children place the toothpaste on their brushes. A smear of toothpaste is roughly about the size of a grain of rice and is the most appropriate amount of toothpaste for a child until the age of three. After three years old, the appropriate amount is closer to the size of a green pea.
Parents should be involved with brushing until they feel confident in their child’s technique. This can be as early as the elementary age, but some kids may need assistance or, at the very least, a toothbrushing check from their parents occasionally through middle school. When you decide the best time to transition, do so incrementally.
Have your child be responsible for their morning brush. Brushing in the morning is meant to freshen breath and remove the bacteria buildup that happens overnight. Adult supervision is still advised for the evening brush because it is responsible for removing all food debris left on the teeth from the day. This is important to remove because we do not produce as much saliva at night, so our bodies won’t naturally wash away the debris.
The saying goes, “You brush in the morning to keep your friends, and you brush at night to keep your teeth.”
My child refuses toothpaste! What should I do?
If your child is averse to toothpaste and is really against using it, that’s okay. If you think about it, it really is weird to smear an intensely-flavored, paste-like substance in our mouth just to spit it out again. This is especially hard for kids with low oral sensory thresholds.
Toothpaste is an effective preventative measure in the fight to prevent dental decay, but it’s not the only factor.
It is far more critical that your child brushes without toothpaste if the other option is them refusing to brush at all. Toothbrushing alone will mechanically remove the plaque and bacteria that builds up on a tooth’s surface, helping present gum disease and cavity formation.
What are the benefits of using fluoridated toothpaste?
You do lose the added layer of protection you get with fluoridated toothpaste and the benefit of the low-level abrasive silica contained in toothpaste to help clean away surface stains more effectively.
However, the alternative to a child who refuses to toothbrush if there is any toothpaste on the brush means that all the food eaten throughout the day stuck in the grooves and crevices of the teeth will linger on the tooth for more extended periods.
The plaque will be allowed to build up along the gumline contributing to gingivitis. Your child’s breath will be … intense. So sometimes, the best toothpaste for kids is no toothpaste. That’s okay. Just go back to the basics.
How can I help my child get comfortable using toothpaste?
Start back with really thorough parent-assisted brushing on a regular schedule morning and night.
Once your child has become comfortable with the brush and water, attempt a minimal amount of toothpaste on the brush again. It can be fluoridated or non-fluoridated. You are just trying to acclimate them to both the feeling of toothpaste and its flavor.
If they have a positive reaction, continue the same amount for at least two weeks. Then increase the amount of toothpaste every two weeks until you reach the desired amount or roughly about the size of a pea. If at any time you need to scale back, that’s fine.
Oral hygiene is only one piece of the oral health puzzle.
Help your child’s smile stay healthy and strong
Growing Grins Pediatric Dentistry, a top-rated dentist for kids in Westfield, is now accepting new patients. We invite you and your child to come in and see our team for a pediatric dental visit.
Our specialists can’t wait to help your child’s growing grin bloom.
Call our office at 317-896-9600 to schedule an appointment, or use our online form to request a visit and tell us a bit about your little one.
Request an appointment