21st July 2025
We are delighted to share this Voices blog by Laura Warrilow, Specialist Paediatric Dentist at Birmingham Community Healthcare Trust, who shares the important role that health visitors play in supporting families with simpler and safer oral health.
Laura Warrilow – Specialist Paediatric Dentist – Birmingham Community Healthcare Trust
Health visiting has a key role to play in empowering families to make informed, evidence-based decisions that support their baby/ child’s health and development. Oral health is no exception—but when it comes to something as seemingly simple as choosing toothpaste, many families are left confused by conflicting advice, marketing claims, and a wide variety of products on the shelves.
Toothpaste Confusion: What’s the Right Choice?
The Delivering Better Oral Health1 guidelines recommend different concentrations of fluoride toothpaste depending on a child’s age and their individual risk of tooth decay. In theory, this makes sense—tailoring fluoride levels can help balance the need for protection with safety considerations in young children.
This has led to uncertainty, both among practitioners and the families we support, about which toothpaste to recommend, when to switch concentrations, and how to ensure babies and children are receiving the right protection.
Family toothpaste: A Simpler, Safer Alternative
In response to this confusion, public health initiatives are increasingly supporting the use of a family toothpaste—a single fluoride concentration (1450 parts per million Sodium Fluoride) used by all members of the household. This approach prioritises clarity, consistency, and evidence-based protection against dental disease.
Rather than juggling multiple toothpaste tubes marketed for children of different ages and trying to decode packaging claims, families can use one product for everyone. This not only simplifies routines and reduces the chance of mistakes but also provides a tangible cost benefit—especially important at a time when many households are feeling the impact of the cost-of-living crisis.
By choosing a family toothpaste, families can confidently purchase lower-cost supermarket own brands or discount store options, knowing they are still providing optimum protection against tooth decay. This can significantly reduce the financial burden of buying multiple “age-appropriate” products, many of which are more expensive and not always better suited to children’s oral health needs.
Key Benefits of the Family Toothpaste Approach
There are several compelling reasons to consider recommending a family toothpaste:
- Cost-effective: Families don’t need to purchase different toothpastes for different ages, which makes managing household budgets easier and more sustainable.
- Reduces confusion: A single concentration eliminates the guesswork for both families and healthcare professionals about what is appropriate and when to change.
- Avoids marketing traps: Some children’s toothpastes display misleading age labels or feature cartoon characters that imply suitability without necessarily meeting evidence-based fluoride recommendations.
- Delivers optimum protection: A fluoride concentration of 1450ppm offers the best defence against dental decay for most individuals, regardless of age or risk level.
- Eases the taste transition: Babies and children become accustomed to the taste of adult toothpaste earlier, avoiding the sometimes difficult switch from milder or non-mint children’s toothpaste flavours as they grow.
Safety First: It’s About Quantity, Not Just Concentration
One of the most common concerns about using a higher-concentration toothpaste with younger children is the potential risk of fluorosis or toxicity from swallowing too much fluoride. However, it’s important to reassure parents that safety is primarily determined by the amount of toothpaste used—not just the concentration.
The Delivering Better Oral Health guidance remains clear:
- Children under 3 years should use a smear of toothpaste (Figure 1).
- Children aged 3–6 years should use a pea-sized amount (Figure 2).
- All children should be supervised when brushing.
| Figure 1
Smear: up to 3 years |
Figure 2
Pea-sized blob: 3 to 6 years |
| (Credit image: Delivering Better Oral Health: an evidence-based toolkit for prevention). | |
By using the appropriate amount and encouraging children to spit (not rinse), families can feel confident that they’re supporting their child’s dental health safely and effectively.
Supporting Families Through Clear, Consistent Messaging
Through the universal reach of health visiting, practitioners are in a unique position to provide trusted, accessible advice to all families at a crucial time in their child’s development. Embracing the family toothpaste approach can reduce confusion, empower parents/carers, and ultimately improve oral health outcomes for the entire household.
Please promote this change through your work with families. This small change in recommendation could make a big difference—saving families time, money, and uncertainty while reinforcing our shared goal: healthy, happy smiles for every child.
Laura Warrilow – Specialist Paediatric Dentist – Birmingham Community Healthcare Trust
Further Resources
- Delivering Better Oral Health: An Evidence-Based Toolkit for Prevention
https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention - British Society of Paediatric Dentistry – Brushing Advice
https://www.bspd.co.uk/Resources/Oral-Health-Resources - Institute of Health Visiting – Oral health resources and e-learning are avalible in the HWHN Toolkit which are free to members via iHV LEARN.
