Practical Guidelines for use of Fluorides

Home Care – Toothpastes

Toothbrushing Recommended
Age Special Considerations
Instructions Toothpaste Use
Low Caries Risk* Mod-High Caries Risk#

Once or Twice Daily

Begin to teach: Begin using low fluoride Use a smear of low
No
0-17 months Spit out toothpaste (500ppm) when fluoride toothpaste
Toothpaste
Don’t swallow first tooth erupts. (500ppm).
Don’t rinse

Twice Daily Use a pea-sized amount of

18 months – Spit out Low fluoride toothpaste Standard fluoride toothpaste low fluoride toothpaste (500ppm)
6 years Don’t swallow (500ppm) (1000-1500ppm). or a smear of standard
Don’t rinse toothpaste (1000-1500ppm)

At least Twice Daily

Standard fluoride
Spit out Standard fluoride toothpaste
6 – 12 years toothpaste Brush more frequently than twice daily.
Don’t swallow (1000-1500ppm).
(1000-1500ppm)
Don’t rinse

Standard fluoride toothpaste

At least Twice Daily Brush more frequently than twice daily.
Standard fluoride (1000-1500ppm).
13 years Spit out
toothpaste
and over Don’t swallow Or on professional advice:
(1000-1500ppm)
Don’t rinse Use high concentration fluoride toothpaste (5000ppm) twice daily.

* Low Caries Risk – Reside in community water fluoridation region. Child: No new cavitated or non-cavitated lesion themselves or parent/carer and siblings;
Adult: Without any moderate-high risk factors listed below. Adapted from CAMBRA (https://www.cdafoundation.org/Portals/0/pdfs/cambra_handbook.pdf)

# Mod-High Risk Factors – Active caries, Inadequate fluoride exposure; High sugar diet; Poor- fair oral hygiene; Low saliva flow; Individual or Family history of untreated caries; Orthodontic/dental appliances; Other
individual factors such as hypomineralised teeth, multiple medications, special health care needs. Adapted from CAMBRA (https://www.cdafoundation.org/Portals/0/pdfs/cambra_handbook.pdf)

^ These products do not have sufficient evidence to support their use (see over)

Adapted from Guidelines for the use of fluorides in Australia: update 2019. Aust Dent J 2020; 65: 30–38
Practical Guidelines for use of Fluorides
Home Care – Other Fluoride Products
Toothbrushing Recommended
Product Special Considerations
Instructions Use

Low Caries Risk* Mod-High Caries Risk#

Should not replace twice daily toothbrushing.

Mouthrinses Spit out. Not for young children. For
Not Recommended Use at a different time of day than twice daily
(200-900ppm F) Don’t swallow. children over 6 years to adults.
toothbrushing.

Fluoride Supplements
DO NOT USE^ DO NOT USE^ DO NOT USE^ DO NOT USE^
– Drops or Tablets

Professionally-Applied Fluoride Products

Recommended
Product Instructions Special Considerations
Use

Low Caries Risk* Mod-High Caries Risk#

Do not exceed max dosage:

Fluoride Varnish Apply up to 4 times 0.25ml for primary dentition
Not Recommended All people at risk of caries.
(22,600ppm F) per year. 0.4ml for mixed dentition
0.75ml for permanent dentition

Use where other forms

Fluoride Gel (1500- Not for children under 10 years.
of fluoride are not Not Recommended
12,300ppm F) For children over 10 years to adults.
available or suitable.

Silver Diamine
Fluoride (38%) May be indicated where traditional approaches
Apply twice a year. Not Recommended
to caries management might not be possible.

ADA021
Fluoride Foam DO NOT USE^ DO NOT USE^ DO NOT USE^ DO NOT USE^