Skip to content
News / June 1, 2009

Academy agrees updated fluoride guidelines

by Guy Hiscott

The European Academy of Paediatric Dentistry’s Board and Council have unanimously approved proposed guidelines on the use of fluoride in toothpaste for children.

This approval followed a six-month discussion period in an effort to achieve the highest level of consensus.

The consensus reached was that fluoride levels in toothpastes targeted at children aged six months to two years should have a concentration of 500ppm fluoride.  For children aged two to six years, the level should be 1000ppm, while for those aged over six years it should contain 1,450ppm. Dental professionals should also ensure they recommend that children under six years only use a pea-sized amount and for those aged over six years an application no larger than 1-2cm.

Dr William Fenlon and Dr Paddy Fleming, representing Ireland, commented: ‘There is much confusion on use of fluoride with children to prevent caries and as a pan-European scientific association we felt it imperative to provide guidance on the optimum levels.

‘The decrease in caries prevalence in most developing countries has been attributed mainly to the introduction of fluoridated dentifrices.

‘However, many children still suffer from this oral disease that can be prevented by simple home care measures. We therefore felt it was necessary to develop and update existing guidelines for the use of fluoride, and specifically fluoridated dentifrices with children.

‘Not only will this help manufacturers, it will also help dental and medical professionals across Europe to ensure the advice they give patients is accurate.’

The updated guidelines will appear shortly at the Academy’s site ( and will be published in the Academy’s official journal, European Archives of Paediatric Dentistry.

The EAPD also advocated that:
1. An oral health assessment should take place in the first year of a child’s life
2. An infant’s teeth should be brushed daily with a smear of fluoride toothpaste from the moment they erupt
3. Professional application of fluoride varnish is recommended on primary dentition for those at high risk of Early Childhood Caries (ECC). 

The EAPD also encourages professionals to give parents advice on how to reduce behaviours that promote the early transmission of Mutans Streptococci and to ensure they are aware that the frequent intake of sweetened drinks should be discouraged, especially at bedtime.

The recommendations to prevent the onset of ECC can be viewed at