probable exposure to fluoride from toothpaste: Assuming that an average-sized 2-year-old brushes her teeth twice a day and swallows the toothpaste,
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, a smear of toothpaste (about the size of a single grain of rice) would result in 0.013 milligrams of fluoride per kilogram of weight per day. But a pea-sized dollop would lead to 0.033 milligrams per kilogram. That’s approaching the level at which fluorosis might become a concern,
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, Wright says.
Since studies have shown that risk of fluorosis for some permanent teeth peaks around age 2, it makes sense to use just a smear of fluoridated toothpaste for children between ages 2 and 3, especially since fluoride comes from sources other than toothpaste. My city’s water is spiked with fluoride to reach levels of 0.7 parts per million. (In case you were wondering,
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, Brita filters don’t get rid of fluoride.) In such small amounts,
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, “you’re going to have to drink a boatload of water” to get enough fluoride to cause fluorosis,
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, Wright says. Likewise for food: Fish, particularly canned fish that contains bones, and tea both can have high levels of fluoride,
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, but those aren’t usually large parts of a young kid’s diet.
Perhaps a bigger concern: Parents should be careful about using too much fluoridated toothpaste — a pretty common habit,
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, studies have found. “People tend to think a little is good,
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, more is better,” Wright says.
Not so. For little kids who can’t spit toothpaste out yet, parents can wipe the excess toothpaste off their teeth after brushing. (But not with water, says Wright. A water rinse washes away some of

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