THE FOLLOWING IS AN EXCERPT FROM A FEBRUARY 10, 2014 PRESS RELEASE PUBLISHED BY THE AMERICAN DENTAL ASSOCIATION:

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To fight cavities in children, the American Dental Association's (ADA) Council on Scientific Affairs (CSA) is updating its guidance to caregivers that they should brush their children's teeth with fluoride toothpaste as soon as the first tooth comes in.

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To help prevent children's tooth decay, the CSA recommends that caregivers use a smear of fluoride toothpaste (or an amount about the size of a grain of rice) for children younger than 3 years old and a pea-size amount of fluoride toothpaste for children 3 to 6 years old.  "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 L. Trulove, D.D.S,, chair of the Council of Scientific Affairs.  "Approximately 25% 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."

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Dental decay is the most common chronic childhood disease with more than  16 million children suffering from untreated tooth decay in the U.S., according to the U.S. Centers for Disease Control.  Oral disease causes children to miss 51 million school hours and their parents to lose 25 million work hours annually.  Additionally, oral disease disproportionately affects children from low-income families and these children have almost twice the number of decayed teeth that have not been treated by a dentist as compared to others in the general population.

 

CSA previously recommended using water to brush the teeth of children younger than 2 years old and to brush the teeth of children 2 to 6 years old with a pea-sized amount of fluoride toothpaste.  

 

THE FOLLOWING IS AN EXCERPT FROM A FEBRUARY 12, 2014 BLOG POST PUBLISHED IN THE NEW YORK TIMES: 

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While the ADA now suggests using a fluoride toothpaste on children as soon as their first tooth comes in, they also emphasize using only the tiniest amount to minimize the risk of mild discoloration.  White spots or streaking of the teeth could indicate a condition called "fluorosis", which is caused by ingesting fluoride toothpaste at a young age. 

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"The goal is to minimize the amount of fluoride consumption to reduce the risk of fluorosis while simultaneously adding a preventative tool for kids 2 and under that we haven't recommended previously," said Dr. Jonathan Shenkin, a spokesman for the ADA and a pediatric dentist in Augusta, ME. 

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The new ADA guidelines stress that children should spit out toothpaste as soon as they are able, but not being able to spit does not preclude the use of a rice-grain-size bit of fluoride toothpaste. 

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Dr. Man Wai Ng, the dentist in chief at Boston Children's Hospital, applauded the new recommendation and said, "it's a great thing for parents to know:  'Use a tiny amount of fluoride and brush two times a day to counter the effects of frequent snacking.'" 

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A version of this article appears in print on 02/13/2014, on page A18 of the New York edition with the headline: Fluoride Brushing Urged for Children Under 2.