Fluoride Toothpaste Guidelines for Infants and Children
Information Verified 3-1-09
Follow the Guidelines of Your Program, Organization, or Center
Early Head Start / AAPD / Open Wide / Bright FuturesHead Start
Infants / <1 year
No toothpaste / No teeth -
Water only
<2 years
Smear / <2 years
Small smear / <2 years
Plain water
High-risk kids:
Smear/Pea after consultation
Toddlers / 1-2 years
Small smear / <2 years
Smear / <2 years
Small smear / <2 years
Plain water
High-risk kids:
Smear/Pea after consultation
Children / 2 years +
Small smear / 2-5 years
Pea / 2 years +
No > Pea
(Small Smear) / 2 year s +
No > Pea
(Small Smear)
See other side for text version of guidelines.
Sources:
Head Start Oral Health Program Instruction, 12-14-2006.
AmericanAcademy of Pediatric Dentistry
Bright Futures Health Supervision Guidelines, 3rd Edition
Open Wide Oral Health Training for Health Professionals
Follow the Guidelines of Your Program, Organization, or Center
Head Start:
Beginning February 2007, the Office of Head Start (OHS) will monitor compliance with 45 CFR 1304.23 (b) (3) by reference to the following minimum requirements. Head Start grantees and delegate agencies will be considered in compliance with the requirement to effectively promote dental hygiene in conjunction with meals by ensuring the following:
- For children age two and over
Once daily, after a meal, Head Start staff (or volunteers, if available) should assist children in brushing their teeth using a small smear of fluoride toothpaste. - For children between one and two years of age
Once daily, after a meal, Head Start staff (or volunteers, if available) must brush children's teeth with a soft bristled toothbrush, using a small smear of toothpaste that contains fluoride. - For infants under the age of one
At least once during the program day, staff or volunteers must wash their hands and then cover a finger with a gauze pad or soft cloth and gently wipe infants’ gums.
AAPD:
- Starting at birth, clean your child’s gums with a soft infant toothbrush or cloth and water. As soon as the teeth begin to appear, start brushing twice daily using fluoridated toothpaste and a soft, age-appropriate sized toothbrush. Use a "smear" of toothpaste to brush the teeth of a child less than 2 years of age.
- For the 2-5 year old, dispense a "pea-size" amount of toothpaste and perform or assist your child’s toothbrushing. Remember that young children do not have the ability to brush their teeth effectively.
Open Wide:
- For infants and children under age 2, brush the teeth with a small smear of fluoridated toothpaste. Make sure the child spits out the toothpaste after brushing, but do not have the child rinse with water. The small amount of fluoridated toothpaste that remains in the mouth helps build strong healthy teeth.
- For children ages 2 and above, brush the child’s teeth with no more than a pea-sized amount (small smear) of fluoridated toothpaste. Make sure the child spits out the toothpaste after brushing, but do not have the child rinse with water. The small amount of fluoridated toothpaste that remains in the mouth helps build strong healthy teeth.
Bright Futures:
- For children under age 2, brushing the teeth with plain water twice a day (after breakfast and before bed). For children at increased risk for tooth decay, consulting with a dentist or physician about brushing the teeth with a pea-sized amount (small smear)of fluoridated toothpaste.
- For children ages 2 and above, brushing the teeth with no more than a pea-sized amount (small smear)of fluoridated toothpaste twice a day (after breakfast and before bed). Making sure the child spits out the toothpaste after brushing, but does not rinse with water. The small amount of fluoridated toothpaste that remains in the mouth helps prevent tooth decay.