ADA objects to Texas attorney general’s statement about fluoride toothpaste recommendations

Association recommends children, adults brush twice daily with fluoride toothpaste

The American Dental Association is affirming the safety and efficacy of fluoride in recommended amounts and clarifying its recommendations regarding the use of fluoride toothpaste for children in response to a recent statement by the Texas attorney general.

In a May 1 news release, Attorney General Ken Paxton announced he had launched an investigation into Colgate-Palmolive and Procter & Gamble, accusing them of marketing toothpaste products to parents and children in ways that are “misleading, deceptive, and dangerous.” In the release, he said recommendations from the ADA and the Centers for Disease Control and Prevention for children’s fluoride toothpaste use are based on “the well-known acute and long-term risks associated with fluoride overdose.”

In a statement, the ADA said it “strongly objects” to Mr. Paxton’s assertion, which “grossly mischaracterizes” its recommendations.

The ADA affirms the use of fluoride, in recommended amounts, as safe and effective in preventing tooth decay for both children and adults. It recommends children and adults brush twice daily with fluoride toothpaste that has earned the ADA Seal of Acceptance, clean between teeth daily with floss or another interdental cleaner, eat a balanced diet and visit the dentist regularly.

Brushing with fluoride toothpaste has been shown to reduce caries in children. The ADA recommends that a smear of toothpaste the size of a grain of rice be used from the time a child’s first tooth erupts until age 3. When they are 3 to 6 years old, children should use a pea-sized amount of toothpaste and be supervised while brushing to ensure they spit rather than swallow the toothpaste.

These recommendations are based on estimates of the amount of fluoride that reduces caries to the greatest extent without causing adverse effects from the National Academies of Sciences, Engineering and Medicine’s Health and Medicine Division.

Fluoride toothpaste is the most commonly used form of self-applied fluoride worldwide, and it makes up more than 95% of toothpaste sales in the U.S., according to the CDC.

The ADA Council on Scientific Affairs independently evaluates dental products submitted by manufacturers for the ADA Seal of Acceptance program to ensure the products meet specific ADA criteria for safety and effectiveness. Only products that meet the criteria are awarded the Seal.

Dentists can find information and resources to share with patients regarding fluoride at MouthHealthy.org/fluoride.