Risks for chil­dren of flu­o­ride-free tooth­paste


AS reg­u­lar read­ers will now be aware, den­tal de­cay is the most common chronic dis­ease of child­hood and den­tal ex­trac­tions are the most common rea­son for gen­eral anaes­thetic in the UK and Ire­land. Un­treated de­cay is as­so­ci­ated with pain, in­fec­tion, re­duced qual­ity of life, poor growth and de­vel­op­ment and is of­ten as­so­ci­ated with the pre­scrip­tion of mul­ti­ple an­tibi­otics for young chil­dren on long wait­ing lists for den­tal ex­trac­tions in the pub­lic sys­tem. Den­tal de­cay is also pre­ventable.

Clearly, den­tal de­cay is bet­ter avoided than treated and it is to this end that flu­o­ride tooth­pastes were in­tro­duced to the Euro­pean mar­ket in the 1970s and are avail­able over-the-counter in a range of con­cen­tra­tions. The ev­i­dence for the ef­fec­tive­ness of flu­o­ride tooth­pastes is very strong and is of very high qual­ity. In den­tal and med­i­cal re­search a Cochrane re­view is a sys­tem­atic way of look­ing at sci­en­tific re­search which only in­cludes stud­ies of ex­cep­tion­ally high qual­ity. Cochrane reviews there­fore are con­sid­ered to be a very wor­thy source of ev­i­dence.

The Cochrane re­view on the ef­fi­cacy of flu­o­ride tooth­pastes showed that when used twice daily, adult-strength tooth­pastes re­duce the risk of de­cay by almost 30 per cent. This is ob­vi­ously a very sig­nif­i­cant re­duc­tion. A word of cau­tion is that the ev­i­dence for low strength flu­o­ride tooth­pastes aimed at chil­dren is not as ro­bust. For this rea­son par­ents should al­ways be guided by a den­tal pro­fes­sional in se­lect­ing hy­giene prod­ucts for small chil­dren as the choice is best made based on an as­sess­ment of the child’s risk of den­tal de­cay.

Some­times par­ents come to see me and are baf­fled be­cause their child has de­vel­oped tooth de­cay. It is pos­si­ble to de­velop den­tal de­cay even when chil­dren con­sume a seem­ingly healthy diet. Of­ten the an­swer can lie in the fact that the child has not been us­ing a flu­o­ride tooth­paste.

There is a grow­ing range of flu­o­ride free tooth­pastes avail­able on the mar­ket th­ese days. Par­ents should think care­fully be­fore choos­ing flu­o­ride-free tooth­paste and if they do it is wise to dis­cuss the use of flu­o­ride-free al­ter­na­tives for de­cay pro­tec­tion with their den­tist.

Dr Daly is a Pae­di­atric Den­tist and pro­vides both rou­tine and spe­cial­ist care for chil­dren from 0-16 years. For more in­for­ma­tion about pae­di­atric den­tistry visit www.ker­ry­pae­di­atric­den­tal­prac­tice.com or phone 066 7117071.

It is pos­si­ble to de­velop den­tal de­cay even when chil­dren con­sume a seem­ingly healthy diet.

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