Nearly all toothpastes sold in the US and UK contain fluoride - typically 1000-1500 parts per million. Commonly used mouth rinses contain 230-900 ppm. Fluoride is also present in candy-flavoured treatments and dentifrices. Fluoride products for preventing tooth decay may contain as much as 9000 ppm. Researchers at Madras Dental College and elsewhere found that the fluoride in fluoridated toothpaste, even if not swallowed, is quickly absorbed through the lining of the mouth and gums into the general circulation (Lancet, 1991; 337: 1213).

Toothpaste and vitamin preparations - and presumably baby formulas - containing fluoride cause allergic reactions in some children, toxic reactions in others (see www.cadvision.com/-fluoride/adverse). The resulting mouth ulcers don’t respond to antibiotics or local medications, but clear up promptly when non-fluoride toothpaste is substituted (Ann Allergy; 1967; 25: 388-91).

According to Accountability in Research (1997; 5: 225-37), Fejerskov showed in 1990 that fluoride ingested (as from fluoridated baby formulas) by children before their teeth have erupted results in improper calcification of enamel, making the teeth more susceptible to cavities (J Dent Res, 1990; 60: 692-700; Commun Dent Oral Epidemiol, 1990; 18: 46-56). Yet, a warning about overdosing formula-fed babies with fluoride was refused publication (Fluoride, 1987; 30: 125).

Toothpaste ads on TV show generous amounts being squeezed onto a brush, and some parents put a large glob of toothpaste on a child’s toothbrush rather than the pea-sized amount recommended.

Also, small children don’t have complete control of the swallowing reflex. In one test, most preschool children did not expectorate or rinse after brushing with fluoride toothpaste (Pediatr Dent, 1997; 19: 99-103). Fluoride is also present in some multivitamin/mineral tablets.

In the US, 25 per cent of children take fluoride supplements (Wall St Journal, December 21, 1998, p B1), but some physicians fail to consider total intake excluding the supplements (Am J Epidemiol, 1994; 140: 451- 71). If the water, too, is fluoridated, a child’s exposure can be eight times greater than established US safety levels (Earth Island J, 1998; Spring: 40-1).