A Smear, a Pea, or a Ribbon: Fluoride Dose per Brushing for Young Children and the Dispensing Rule That Keeps It in Range

Advice on how much toothpaste a young child should use is given in pictures, a smear or a pea, without stating the dose those pictures deliver. This study computes fluoride applied and swallowed for three dispensing amounts (smear 0.10 g, pea 0.25 g, full ribbon 0.60 g), two paste strengths (1000 and 1450 ppm), and two age bands, with stated swallowed fractions and a stated upper intake criterion of 0.10 mg per kg per day. For ages two to three at 1450 ppm, a ribbon applies 0.87 mg per brushing and brings total daily intake to 0.822 mg, 68.5 percent of the upper criterion, while a smear of 1000 ppm paste brings it to only 0.36 mg, 30.0 percent. For ages four to five a pea of 1450 ppm paste totals 0.409 mg per day, 22.7 percent of the criterion. The dispensing rule that follows is a smear for ages two to three and a pea for ages four to five. This study is simulated, not measured. SIMULATED, NOT MEASURED.