AAPD Response to CDC Study: Use of Toothpaste and Toothbrushing Patterns Among Children and Adolescents

On Friday, Feb. 1, the Centers for Disease Control and Prevention (CDC) released a study examining the use of toothpaste and toothbrushing patterns among children and adolescents in the United States from 2013-2016.  Overall, the report aligns with the AAPD recommendations by reinforcing the joint AAPD, AAP and ADA guidelines on fluoride toothpaste.  Additionally, the CDC report states, "Health care professionals can educate parents about using the recommended amount of fluoride toothpaste under parental supervision to realize maximum benefit"—which supports the critical importance of the age one dental visit and establishing a Dental Home.
 
However, in the report, the CDC recommends "…that children begin using fluoride toothpaste at age 2 years."  This diverges from AAPD recommendations, as outlined in our Guideline on Fluoride Therapy http://www.aapd.org/medi​a/Policies_Guidelines/BP_FluorideTherapy.pdf , which states that the use of fluoride tooth paste helps reduce the risk of cavities, and also provides specific guidance to use no more than a smear amount of fluoridated toothpaste for children less than three years of age. 
 
We stand by decades of reputable science supporting the effectiveness of fluoridated toothpaste in reducing dental caries in children. The beneficial effects increase in children with higher baseline level of caries, and supervision with the correct concentration of fluoride in the toothpaste, twice daily use and supervision.
 
The vision of the AAPD is for optimal oral health for all children, and we stand with the CDC in the critical importance of the age one dental visit and establishing a Dental Home.  Equally important, our profession sees the importance of preventing tooth decay that starts soon after the first tooth erupts.  Early Childhood Caries (ECC) is epidemic, especially among our low socioeconomic populations, having substantial effects on quality of life, and enormous cost to society.  In the U.S., tooth decay affects nearly 1 in 5 children under the age of 5.
 
The good news is that tooth decay is entirely preventable and an early dental visit, along with evidence-based prevention, including using the proper recommended amount of fluoride toothpaste used at the correct time, will lead to optimal preventive oral care, and ultimately, beneficial oral health habits for life.
 
 


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