How Much Toothpaste?
Excessive ingestion of toothpaste can cause fluorosis (altered appearance of the permanent tooth enamel). In rare situations, such as consuming a large portion of a family sized tube, systemic toxicity including electrolyte abnormalities can result in a medical emergency.
Guidelines
- Use a small smear for children less than 3 years old (size of a grain of rice or a dab).
- Apply a pea-sized amount of toothpaste for children three years and older regardless of caries risk status.
- Most preschool children swallow much of the toothpaste placed on the brush.
- These guidelines take this into account and these amounts are safe to swallow, but spitting out should always be encouraged.
- Parents should keep toothpaste tubes out of reach of small children.
Less than 3 years
Small smear or "grain of rice"
3 years or older
"Pea-sized" amount of toothpaste
References
Clark MB, Keels MA, Slayton RL; AAP Section on Oral Health. Fluoride use in caries prevention in the primary care setting. SECTION ON ORAL HEALTH. Pediatrics. 2020; 146Â (6).
American Academy of Pediatric Dentistry. Fluoride therapy. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2023:352-8.
Krol D, Whelan K. THE SECTION ON ORAL HEALTH; Maintaining and Improving the Oral Health of Young Children. Pediatrics. 2023; 151(1): e2022060417.