Recommending 1000 ppm fluoride toothpaste for caries prevention in children

The caries prevalence among Singapore children remains high, with almost 50% affected by the age of 6 years. Among oral hygiene homecare, toothpastes with a minimum fluoride concentration of 1000 ppm or greater have been shown to be more effective at preventing caries. Previous concerns with dental fluorosis have led to the marketing of non-fluoride and low-fluoride toothpastes specifically for children. In the local context, many parents start their children on these products due to ingestion concerns and recommendations of the product, rather than on sound advice from a healthcare professional. The latest recommendation is to use a smear size of 1000 ppm or greater fluoride toothpaste in children under 3 years of age with high caries risk. For children aged 3 years and older, a pea size of 1000 ppm or greater fluoride toothpaste should be used. As medical physicians are typically the first healthcare encounter for many children, they are well positioned to provide recommendations on the concentration and amount of fluoride toothpaste to be used in young children