Although your child shouldn't use fluoride toothpaste before the age of 2, chances are he or she is ingesting fluoride from other sources long before that. Fluoride is found in many foods, juices, and soft drinks and exists naturally to some extent in almost every water supply. In areas where the natural fluoride levels in the water supply are below the .7 parts per million (ppm) recommended by the ADA, municipalities often add fluoride to bring the water up to the desired level [source: American Dental Association].
Since a small amount of systemic fluoride (i.e., fluoride that is consumed or ingested rather than applied to the teeth) has been shown to be effective in reducing tooth decay, dentists and pediatricians will often recommend fluoride supplements for children over 6 months old whose water contains lower levels of fluoride [source: American Dental Association].
On the other hand, the "Journal of the American Dental Association" advises people living in areas where the fluoride levels in drinking water exceed 2 ppm to consider using bottled water or a water treatment system to reduce the risk of fluorosis in young children [source: Journal of the American Dental Association].
The toothpaste aisle of your drugstore or supermarket probably offers plenty of options for fluoride-free toddler toothpastes, but while these sweet-tasting cleaners (many of which feature popular cartoon characters on their packaging) might entice your child to brush, the CDC recommends simply using plain water and a small, soft-bristled toothbrush for children younger than 2 [source: Centers for Disease Control].
As your child approaches his or her second birthday, continue to reinforce safe brushing habits by reminding them to spit when they brush -- even if they're brushing only with water or fluoride-free "training toothpaste." At your child's two-year checkup, talk with the pediatrician about introducing fluoride toothpaste, then supervise brushing closely until you're confident that your child is reliably spitting -- not swallowing -- the toothpaste.
You'll need to call upon your best parenting patience here: According to the CDC, children have weak control over their swallowing reflex until age 6, so you'll most likely need to help for at least a few more years [source: Centers for Disease Control]. It's also important they use only the recommended amount of toothpaste -- that's a small, pea-sized amount, not a big stripe down the entire surface of the brush -- since despite all your best efforts, young children are still likely to swallow at least as much of the toothpaste as they spit out.