All children should be encouraged to use a fluoride-containing dentifrice while toothbrushing, specifically a dentifrice with the seal of approval from the American Dental Association.

In particular, children under the age of three benefit from supervised brushing of their teeth. The amount of toothpaste that should be used is just a smear that covers the tips of the bristles, and there should not be any unsupervised access to the toothpaste.

While the child should be encouraged to expectorate freely at the end of the brushing, we know that these children cannot be expected to easily expectorate. Young children can swallow as much as 60% of the toothpaste that is dispensed which can possibly lead to systemic overexposure to fluoride with a subsequent mild discoloration of the developing teeth, therefore toothbrushing must be a supervised activity.

It is essential that young children at risk for caries have their teeth brushed daily with a fluoride-containing toothpaste.