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. 2025 Aug 7;29(9):398.
doi: 10.1007/s00784-025-06477-0.

Fluoride application in middle childhood. A cross-sectional study

Vera Wiesmüller  1 , Stephanie Müller  2 , Amelie Großhans  1 , Ulrike Lepperdinger #  3 , Ines Kapferer-Seebacher #  1
Affiliations

Fluoride application in middle childhood. A cross-sectional study

Vera Wiesmüller et al. Clin Oral Investig. .

Abstract

Objectives: Fluoride application is crucial for caries prevention; yet guidelines for middle childhood remain limited. This study evaluated the daily fluoride exposure of children aged six to 12 years and compare the findings with the available recommendations.

Methods: Children applied their usual amount of toothpaste to a manual toothbrush, which was weighed before and after application. Additionally, data on residence in relation to fluoridation of tap water, frequency of oral hygiene practices, the oral hygiene products used, additional fluoride supplementation, and parental knowledge regarding fluoride prophylaxis was collected to determine daily fluoride exposure. The data were analysed in accordance with current recommendations.

Results: The study included 458 children aged 8.0 ± 1.77 years. Age-appropriate toothpaste was used by 76.4%. The mean quantity of toothpaste utilised was 0.42 ± 0.27, while 0.5-0.75 g are recommended. The mean daily fluoride intake via toothpaste was found to be 1.01 ± 0.81 mg. 94.1% of the study cohort does not meet the recommendations of the German Society for Preventive Dentistry. Only a third of the cohort used at least one supplementary fluoride source in addition to toothpaste (37.7%). 43.48% of legal guardians expressed the opinion that fluoride prophylaxis is recommended for their child.

Conclusions: The results highlight an urgent need for parental education.

Clinical relevance: In an area of low-fluoridated drinking water children over six years should use a full brush length (>0.5 g) of fluoridated toothpaste (approximately 1450 ppm) twice daily, along with an additional fluoride source such as fluoridated salt, mouthwashes or gels. Study register of the University Hospital Innsbruck (clinical trial registration number 20220331-2872).

Keywords: Children; Dental caries; Dentistry for children; Fluorides; Prevention; Toothpaste.

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Conflict of interest statement

Declarations. Study approval statement: This study protocol was reviewed and approved by the Ethics committee of the Medical University of Innsbruck, Austria, approval number EK 1417/2021. Consent to participate: Prior to inclusion all legal guardians signed an informed written consent and privacy rights of human subjects have been observed. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Weight of toothpaste used per application with different fluoride concentrations. The results demonstrate that there was no adjustment in the amount of toothpaste used based on different fluoride concentrations (p > 0.05). The majority of children (70.6%) used less toothpaste than recommended by the German Society of Preventive Dentistry which stipulates the use of 0.5 to 0.75 g toothpaste. Only 23.1% met the recommended fluoride exposure via toothpaste
Fig. 2
Fig. 2
Accordance with the recommendation of the German Society for Preventive Dentistry. The German Society for Preventive Dentistry recommends for middle-aged children the use of 0.5 to 0.75 g toothpaste with a fluoride concentration of at least 1400 ppm two times per day in combination with the use of fluoridated table salt (recommendations highlighted in grey). Only 5.9% of our cohort met all recommended criteria
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References

    1. Wen PYF, Chen MX, Zhong YJ, Dong QQ, Wong HM (2022) Global burden and inequality of dental caries, 1990 to 2019. J Dent Res 101(4):392–399. 10.1177/00220345211056247 - PubMed
    1. World Health Organization (2019) Ending childhood dental caries: WHO implementation manual, Geneva. CC BY-NC-SA 3.0IGO, Licence
    1. Walsh T, Worthington HV, Glenny AM, Marinho VC, Jeroncic A (2019) Fluoride toothpastes of different concentrations for preventing dental caries. Cochrane Database Syst Rev 3(3):CD007868. 10.1002/14651858.CD007868.pub3 - PMC - PubMed
    1. Pollick H (2018) The role of fluoride in the prevention of tooth decay. Pediatr Clin North Am 65(5):923–940. 10.1016/j.pcl.2018.05.014 - PubMed
    1. Kaiser D, Neumeister L, Stößer L, Hetzer G (2006) Fluoridkonzentration Im Speichel und in der Plaque nach Verzehr Fluoridsalzhaltiger Speisen. Oral Prophyl 28:110–114

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