Fluoride toothpaste and supplements: Safe for your toddler?

My 18 month old is taking Luride, a fluoride supplement. Is it safe to brush with a fluoride toothpaste?

Question:

It is safe to use a fluoride toothpaste even with fluoride supplements. Children tend to swallow toothpaste and the dosages of fluoride tablets take into account the extra fluoride ingestion from the paste. Dentists tell parents to only place a small dot of paste, never larger than a match head, on the brush. This minimizes the amount swallowed.

Information on Luride

Background:

Luride (a registered trademark) is a brand of sodium fluoride used to prevent dental caries (cavities) in children. This product is produced by Colgate Oral Pharmaceuticals, Inc. and is available in tablet or drop form. Both forms do not contain sugar or saccharine and are available in cherry, orange, lemon and lime flavors. When prescribed correctly, Luride and other fluoride supplements have been shown to reduce tooth decay.

Luride provides fluoride for children living in areas where the fluoridation level in the drinking water is 0.7 parts per million (ppm) or less. This is important because we know that fluoridated drinking water (1 ppm F) decreases cavities while teeth are developing. Sodium fluoride prevents cavities before teeth erupt (systematically) and after teeth erupt (topically) by promoting remineralization of the tooth enamel (outer covering of teeth). This increases the tooth's resistance to acid attack by the bacteria that are naturally present in the mouth.

Dosage (Tablets):

The amount of Luride prescribed depends on the amount of fluoride in the drinking water in your community. Your dentist and pediatrician should know this information. You can also check with your water district to determine the level of fluoride in your drinking water. Each Luride full strength tablet contains 1.0 mg fluoride (F) from 2.2 mg sodium fluoride (NaF). Dosages are also available in half (0.5 mg) and quarter (0.25 mg) strengths. The dosage prescribed depends on several factors including the level of fluoride in your drinking water. Luride is also available in a tablet form that does not contain artificial colors or flavorings.

Dosage (Drops):

Again, the amount of Luride prescribed depends on the amount of fluoride in the drinking water in your community. Your dentist and pediatrician should know this information. You can also check with your water district to determine the level of fluoride in your drinking water. Each milliliter of Luride equals about 18 drops. Each of these drops contains 2.25 mg fluoride ion (F-) from 4.97 mg sodium fluoride (NaF). This is about 0.125 mg fluoride per drop.

Overdosage and Adverse Reactions: (Tablets and Drops):

Prolonged daily ingestion of excessive fluoride will result in some degree of dental fluorosis. This is also often referred to as "teeth mottling". This condition causes varying degrees of brownish discoloration and pitting of the teeth. The total amount of sodium fluoride in a bottle of 120 tablets, for all strengths, conforms with the American Dental Association's safety recommendations for the maximum dosage dispensed at one time. Allergic rash has been reported in very few cases. Do not use the 1.0 mg fluoride for children under age 3 years or in areas where the water contains 0.3 ppm or more of fluoride. Do not use tablets or drops in areas where the drinking water exceeds 0.7 ppm fluoride. The tablet form is not recommended for infants that may choke on the chewable tablet. As with any prescription drug, be sure to keep them away from children.

References:

  1. Accepted Dental Therapeutics, Ed. 40, American Dental Association, Chicago, (1984) pp. 399-402.
  2. Accepted Dental Therapeutics, American Academy of Pediatrics (1979) 63:150-152.
  3. Physicians Desk Reference, (1994) 48th Ed. Medical Economics Data Production Company, pp. 839-840.
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