Fluoride can be a very effective tool in preventing tooth decay when used properly. When determining how much fluoride your child should have, there are many factors, including the amount of fluoride in their water and other food/drink sources, whether or not their medical doctor has included fluoride into any multivitamins, and their overall risk for decay. As a general rule, though, unless we have met and personally made an alternative plan, the above photo applies to most kids. The photo on the left is a grain-of-rice sized amount of fluoridated toothpaste, which is appropriate for children under three years old. I started using this much on my kids as soon as they had teeth visible in their mouths. The photo on the right is a pea-sized amount of fluoride, and is appropriate for children from three to six years old (assuming they are decent “spitters” by then – if not, you may want to stick with the smaller amount until they can spit a little better). If a child has had many cavities or if they have other factors that put them at higher risk for tooth decay, we like to make a custom plan which may include a higher-fluoride toothpaste, or a fluoride supplement (drops, chewable tablets, or an in-office applied fluoride varnish). Like most medications, fluoride can have unwanted effects if too much is used, and if they consume many times too much it can even be poisonous – so moderation is key. Keep fluoride toothpastes, mouthrinses, and supplements out of reach of your young children to keep them from ingesting too much, and supervise their brushing. You should be brushing for your child as much as possible, until they have the skill and responsibility to do a great job every time (my guideline is if you would trust them to do a good job washing your car, then they are probably old enough to brush their own teeth with no help :). I could go on and on about the nuances of fluoride use, but I hope these general guidelines have been helpful. Please feel free to reach out and contact me if there are any questions I can help you with!