Fluoride toothpastes sold in the U.S. generally contain between 1,100 and 1,450 parts per million (ppm) fluoride (the equivalent of over 1 mg of fluoride for each gram of paste). Although the fine print on the back of the toothpaste tube instructs users not to swallow and to use only a “pea-sized” amount, advertisements continue to depict heaping swirls of paste on the brush, (Basch 2013), and manufacturers continue to market fluoride toothpastes in bubble-gum, fruit, and candy-like flavors (Basch 2014). Using child-appealing flavors is particularly dangerous because young children have poorly developed swallowing reflexes, and invariably swallow large amounts of the paste they add to the brush.
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