NEW DELHI: If your toddler chews on the toothbrush, licks and swallows toothpaste, make sure it is non-fluoridated. Fluoride ingested by children less than four years old can be harmful.

Maulana Azad Medical College (MAMC) dentist Dr Pankaj Goel told The Times of India, "Parents are not aware about the difference between fluoridated and non-fluoridated toothpaste. In fact, fluoride paste manufacturers often print on the packages that it may not be suitable for children below four."

Goel said, fluoride toothpaste when swallowed regularly and in considerable quantities may cause fluorosis in children. "This disease is caused by excess fluoride and effects the bones and teeth. In fact, we get to see quite a few people with stains on their teeth caused by excess fluoride," he said.

Fluorosis makes bones brittle and hampers the growth of a child. The bones may become crooked as well. "When a child learns to spit out the toothpaste, he or she can easily switch to a fluoride paste," said Dr Goel.

Max Health Care orthodontist Dr Ajay Raj Bhagat said this quantity was very small and there was practically no research evidence to show that ingested fluoride toothpaste had caused fluorosis. "Yet, I seldom recommend a fluoride toothpaste for children below four."

MAMC dental college principal Dr Mahesh Verma said, "Our medical literature says fluoride toothpaste must not be given to a child below five years."

He said, "But throughout my experience I am yet to come across a child who may have been harmed due to such toothpastes. It is precaution that can be followed. But people should also know that if a child does manage to swallow, no harm will be caused."