What amount of toothpaste do the American Dental Association recommend for children under age 6 to avoid fluorosis?

The American Dental Association recommends using a smear the size of a grain of rice for children under age 6 to minimize the risk of dental fluorosis. Fluorosis can occur when young children ingest excessive amounts of fluoride, which is often found in toothpaste. Since children in this age group typically do not have the coordination to spit out toothpaste effectively, using a very small smear helps ensure they are exposed to only a minimal amount of fluoride. This method strikes a balance, providing some caries protection while greatly reducing the risk of fluorosis.

In contrast, options suggesting larger amounts—like a pea-sized amount, a dollop the size of a quarter, or as much as older children—would increase the likelihood of fluoride ingestion. These larger amounts could exceed the safe limit for young children, thus increasing the risk of fluorosis, which is why they are not recommended. By adhering to the advice of using only a small smear of toothpaste, caregivers can help protect children's oral health while being mindful of fluoride exposure.