A new AAP clinical report aims to assist pediatricians in maximizing the use of fluoride for caries prevention while minimizing the likelihood of enamel fluorosis.

The updated recommendations call for earlier use of a fluoride toothpaste for children — as soon as the first tooth erupts — but limiting the quantity to a tiny “smear,” or grain of rice. After age 3, a pea-sized amount of fluoride toothpaste is recommended (see sidebar).

Previous guidance suggested waiting until age 24 months and then applying a pea-sized amount of toothpaste.

Fluoride Use in Caries Prevention in the Primary Care Setting, from the AAP Section on Oral Health, is published in the September issue of Pediatrics (


Because many children don’t receive dental care at a young age, pediatricians have an opportunity to help prevent caries, according to a new AAP clinical report....

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