The amount of toothpaste you put on a child's brush matters, because young kids swallow much of what they use. Too little fluoride leaves teeth less protected, and too much, over years, can cause faint white marks on developing adult teeth. The good news is that the guidance is simple: a tiny smear for babies and toddlers, a pea-sized dab for preschoolers, and an adult nearby until your child can really brush well.
How much toothpaste for kids at each age?
From the first tooth until about age 3, use a smear of fluoride toothpaste about the size of a grain of rice. From about 3 to 6, use a pea-sized amount. These are the amounts the American Dental Association recommends, and they apply to a regular fluoride toothpaste, not a special one.
A smear means the paste barely covers the bristles' tips, not a ribbon across the brush. A pea-sized amount is a small blob, not a full-length stripe like in the commercials. If you are unsure, err on the small side and make the brushing thorough, since the brushing does the cleaning, not the quantity of paste. The ADA fluoride page explains why fluoride is recommended from the first tooth.
What do you do about swallowing and spitting?
Toddlers swallow toothpaste, which is why the amount is so small. Teach spitting as a game: "spit it into the sink like a fountain." Do not rinse with a lot of water afterward, so a little fluoride stays on the teeth. For kids who will not spit, keep to the rice-grain smear, brush quickly, and wipe their mouth with a cloth.
Store toothpaste out of reach and avoid flavors that taste like candy, because children will eat it. If a child swallows a large amount, call poison control or your doctor for advice.
When should you stop helping?
Children usually cannot brush well alone until they have the hand control to write neatly or tie shoes, often around age 7 or 8. Until then, an adult should do the brushing or at least finish it. A good pattern is to let your child go first so they build the habit, then you take a turn to reach the back teeth and the gumline.
Keep a quick check going for a while longer, and ask your dentist what amount suits your child once they are past 6. Look for plaque left near the gums, usually a fuzzy film at the back molars. Our guide to kids' first cleaning lists questions to ask the dentist.
What if your child hates brushing?
Make it short, predictable and the same every day. Brush at the same times, let your child pick the brush, sing a song for two minutes, or brush your own teeth together. Position matters: stand behind a toddler and tip the head back against your arm so you can see.
- Brush twice a day, and make bedtime the one that never gets skipped.
- Use a soft, small-headed brush and replace it when bristles splay.
- Start cleaning between teeth with floss picks once teeth touch.
- Take your child to the dentist by their first birthday, or when the first tooth appears.
Call the dentist for white or brown spots, a tooth that hurts, swollen gums or a visible hole. Our piece on children's tooth hygiene covers more. This article is general information and does not replace advice from your child's dentist.