How much fluoride toothpaste should be placed on a child under the age of 3?

• A. Smear layer or rice-sized amount
• B. A pea-sized amount
• C. A full-length smear
• D. None

Answer: (A)

Young children under three are prone to swallowing toothpaste, so the amount used must be very small to give caries protection without excessive fluoride ingestion. The recommended amount is a smear on the brush, or about the size of a grain of rice. This tiny amount provides fluoride to help prevent decay while minimizing the amount swallowed. Supervise brushing and encourage the child to spit out as much toothpaste as possible. As they get older and can spit more reliably, you can increase to a pea-sized amount around age three. A larger amount, such as a full-length smear, would expose a toddler to more fluoride than is appropriate and isn’t advised for this age. Not using toothpaste would miss out on protective fluoride benefits.