Is my Baby or Toddler Getting Enough Fluoride?

JanelMS, RD, LDN, CBS

Read time: 3 minutes

What to know about your child getting enough fluoride

  • Fluoride in drinking water is generally considered safe by the American Academy of Pediatrics as well as the American Dental Association3,7

  • Can my little one use toothpaste with fluoride?

  • When to supplement with fluoride

Comprehensive reviews by scientific and public health organizations continue to confirm the safety and oral health benefits of fluoridation, or the process of adding small amounts of fluoride to community drinking water. Research continues to show that fluoride can help slow the progress of and even prevent dental cavities and tooth decay.1,2,3

Both fluoride in toothpaste as well as fluoride in drinking water are considered important tools in helping reduce the risk of tooth decay in children and adults.4,5

Fluoride in tap water, well water, and bottled water

Fluoridated water is considered a monumental public health achievement with regard to childhood tooth decay.1 The current recommendation for fluoride in community drinking water is 0.7 milligrams per liter.5 If your community water supply is at the recommended dosage of fluoride, and your baby drinks the water, they likely won’t need additional fluoride.2,6

If you pay for local community tap water, contact your community water department, or locate a customer service number on your bill and ask about the level of fluoride in your water. If you use well-water, have your water tested by your local health district or by a private lab.2

Note that most bottled water is not fluoridated. If it is fluoridated, it will say so on the label. To be sure, call the number on the label for more information.2

Fluoride for breastfed babies

If your baby is exclusively breastfeeding and is ready to be drinking water, in most cases fluoridated tap water is recommended, as breast milk is naturally quite low in fluoride.5 If your community has the recommended levels of fluoride in the water, begin introducing a few ounces of fluoridated water at the age of 6 months each day.7,8 This can also double as practice for your little one to drink from a cup or sippy cup.

Be sure to chat with your child’s healthcare provider to ask about which water source may be best for your little one.

Read more: Transitioning to Cups for Babies and Toddlers

Fluoride for formula fed babies

If your baby is formula fed, fluoridated water can be used to mix with formula in most cases. Sometimes, the combined fluoride in the formula along with the fluoride in the water may cause mild fluorosis, which is white markings on your child’s teeth.

If you have questions, check in with your child’s health care provider about the combined levels of fluoride in your formula and tap water before selecting your water source.2,3

Learn more: Formula Preparation: What Type of Water Should I Use?

Is fluoride in water safe for my child?

There has been a lot of buzz around fluoride in water and the potential that too much may cause negative health effects.9,10 To date, several large studies and reviews have not found strong evidence linking fluoride to increased health risks.11

For more information, the American Cancer Society and the American Academy of Pediatrics (AAP) have helpful write-ups on these issues here and here. Both recommend checking your water fluoridation levels, especially if you have well water, to help you make informed decisions about the use of different drinking waters.5

The AAP, the American Dental Association, and many other organizations continue to recommend water fluoridation and use of fluoride toothpaste.3,7

If you have any concerns, chat with your child’s healthcare provider for more information.

Can babies and toddlers use toothpaste?

In 2018, the American Academy of Pediatric Dentistry and the American Academy of Pediatrics updated fluoride recommendations in response to an increase in tooth decay in children under the age of 5 years.12

Their recommendations are to begin using a small smear (the size of a grain of rice) of fluoride containing toothpaste in brushing baby’s teeth as soon as they begin to come in, around 6 months.15 Tooth brushing is recommended to happen twice per day from this point on.

Continue to use this amount of tooth paste until your child is three years old, at which point you can begin using a pea-sized dab of toothpaste.15 At this age children are able to avoid swallowing during tooth brushing and spit out the excess paste.

Continue to teach your little one good tooth brushing practices from an early age. Encourage your little one to spit out excess toothpaste by demonstrating and having them imitate you.2,3,6

Other fluoride recommendations

Additional recommendations made by the American Academy of Pediatric Dentistry and supported by the American Academy of Pediatrics include:

  1. Start bringing your child in for dental visits by the age of one.3,6

  2. Fluoride varnish should be applied every 6 months by the pediatrician or dentist.2,3

  3. Give your baby or toddler a fluoride supplement only if prescribed by your pediatric dentist or physician.

Fluoride supplements are often prescribed for children at high risk for tooth decay and whose primary drinking water has a low fluoride concentration.13 Chat with your child’s healthcare provider or dentist to learn more.

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Everything You Need to Know About How to Prepare and Store Infant Formula

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Minimizing Added Sugar

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