Tufts Dental Medicine

It’s never too soon to start treating a baby’s teeth with fluoride, according to new guidelines issued by the American Dental Association (ADA). As soon as the first tooth erupts, parents should consult with a dentist and begin brushing the baby teeth with tiny amounts of fluoride toothpaste.

The advice, based on the ADA’s review of numerous recent studies of childhood oral health trends, is a departure from the organization’s longstanding recommendation that children under age 2 should not have fluoride beyond what already may exist in the water supply.

“We recommend that a child have their first dental visit as soon as the first tooth shows, and not later than the age of 1,” says Cheen Loo, DI10, associate professor and interim chair of pediatric dentistry at Tufts. While studies demonstrate that early fluoride use improves children’s oral health, Loo says that overuse can cause fluorosis, the discoloration and white spots or streaks on baby teeth.

At Tufts’ pediatric dental clinic, “we see a lot of kids coming in at the age of 1½ or 2, and they have cavities,” she says. “Because of their young age, we end up not being able to help them in the clinic, and have to treat them in the hospital operating room with general anesthesia. So we are really trying to prevent that from happening.”

And that’s why the American Academy of Pediatric Dentistry several years ago began recommending fluoride treatment as soon as a child’s first tooth erupts—well before the latest ADA guidelines, Loo says.