Can early toothbrushing with fluoridate toothpaste lead to dental fluorosis?

Objectives: To evaluate the relationship of monitoring toothbrushing of children from 3 years old with fluoridate toothpaste and dental fluorosis in permanent anterior teeth. Methods: In 1998, 731 3-year-old children recruited from 10 kindergartens in Miyun County, Beijing, China took part in a clinical trial on evaluation the anticaries efficacy of a sodium fluoride toothpaste containing 1100 ppm fluoride. Children in the test group brushed their teeth twice a day with fluoridate toothpaste supervised by their teachers in kindergarten during weekdays. Children in the control group did not brush their teeth in kindergarten, but placebo toothpastes were dispensed regularly. After 2 years, 514 children remained in the study. Results: The mean caries increments of the test group (n= 258) and the control group (n=256) were 2.47 and 3.56 dmfs respectively. The reduction in dmfs increment was 30.6% (p=0.009). In 2007, 480 children were followed up. Their oral conditions and dental fluorosis on anterior permanent teeth were clinically examined. No significant difference on the prevalence of dental fluorosis (Dean's DFI) was found between the children in the test (n=236, 7.6%) and control groups (n=244, 7.8%). Conclusions: There is no evidence from this study to show that toothbrushing with fluoridate toothpaste by 3-year-old children increases the risk of dental fluorosis in permanent anterior teeth in this population.