With scary new labels on toothpaste, many parents are left wondering what to do when they catch their child eating toothpaste straight from the tube, but given the relatively low fluoride content in most brands, it's fairly difficult for a child to consume a lethal dose of fluoride at home.
For example, a pea-sized amount of toothpaste has about 0.24 milligrams of fluoride, about the same as a glass of tap water. According to the Columbia University College of Dental Medicine, the lethal dose for an 8-year old child weighing 45 pounds is 655 milligrams. Your child would have to consume more than four tubes of toothpaste to reach this level. For a 2-year-old, 22-pound child, the lethal dose is 320 milligrams, or more than two full tubes of toothpaste.
Of course, not all pastes are created equal. Most toothpaste contains between 1,000 and 1,500 parts per million of fluoride (ppm) [source: Wagner]. A standard 4.5-ounce tube of Colgate for Kids, at 1,100 ppm contains 143 milligrams of fluoride [source: Fluoride Action Network]. A 2-ounce tube of prescription ControlRX, at 5,000 ppm contains 282 milligrams of fluoride, a nearly-lethal dose for a 2-year old [source: NIH]. Parents should take extra care to lock up these types of prescription dental products, as well as any fluoride supplements, which can easily contain enough fluoride to kill a child.
Even doses as low as 0.1 milligrams of fluoride per kilogram of body weight, while unlikely to be fatal, can still cause acute poisoning symptoms, ranging from nausea to headaches. A 22-pound child can suffer from fluoride poisoning at doses as low as 1 milligram, while a 45-pound child would need to ingest 2 milligrams to experience similar symptoms. A single teaspoon of children's toothpaste contains about 5 milligrams of fluoride, making it more important than ever for parents to limit access to this product [source: Fluoride Action Network].
The National Institutes of Health (NIH) encourages parents to call the American Association of Poison Control Centers at 1-800-222-1222 any time they have a question about poisoning, whether or not it's an emergency situation. NIH also recommends that parents head to the emergency room if they suspect their child has consumed a tube of toothpaste or more [source: NIH].
While it's possible for a child to consume a lethal dose of toothpaste, it's also exceptionally rare. Between 1989 and 1994, Poison Control received more than 10,000 reports of potential fluoride overdose from toothpaste. Just two of these were life-threatening cases, and neither resulted in death [source: Fluoride Action Network].