Best Toothpaste for Kids: What I Use at Home and How Much to Use

The best toothpaste for kids has fluoride, a short ingredient list with no dyes, and a flavor your child will put up with. The amount matters as much as the tube. Use a rice-grain smear until age 3 and a pea-sized amount after that. At home, I've used Orajel Naturals Kids and Tom's of Maine Silly Strawberry. Almost no toothpaste is lead-free, so I choose brands with low heavy metal levels and keep the amount small.

My Picks at a Glance

I pick a kids' toothpaste by fluoride first, the ingredient list second and flavor third. The brand comes last.

The best brands have the simplest ingredients. Everything in a tube competes with everything else. Calcium is trying to get into the tooth, and every extra additive is one more thing in its way.

How Much Toothpaste for Kids, by Age

Use a rice-grain smear of fluoride toothpaste from the first tooth until age 3, then a pea-sized amount. That's about 0.1 gram and 0.25 gram. You should barely make a dent in the tube.

Many parents use more than that. A national survey published in CDC's MMWR found that more than 38% of children ages 3 to 6 used more toothpaste than recommended. Nearly 80% of kids ages 3 to 15 also started brushing later than recommended.

Some boxes even say to use a "1-inch strip" and the long ribbon you see in commercials is far too much.

The amount matters because young kids swallow some of what's on the brush, and until about age 6 most can't reliably spit. A systematic review of children under 6 found that swallowing pea-sized amounts or more can lead to mild fluorosis, faint white flecks or streaks on the permanent teeth.

Most US labels tell you to ask a dentist for children under 2. My answer is the rice-grain smear from the first tooth.

The 5 Best Toothpastes for Kids

1. Orajel Naturals Kids Anti-Cavity Fluoride Toothpaste: My Everyday Pick

Best for: toddlers and kids who need fluoride, starting with a smear at the first tooth.

This one checks every box on my list. It has fluoride, a short ingredient list, no dyes, and no sodium lauryl sulfate. I partner with Orajel.

• Active: 0.24% sodium fluoride
• What else is in it: sorbitol, water, silica, glycerin, cellulose gum, a coconut-derived cleanser, stevia, and natural flavor.
• Trade-off: like nearly every kids' fluoride paste in the US, it has the same fluoride strength as regular adult toothpaste. The amount on the brush is your job.

2. Tom's of Maine Kids Anticavity Fluoride, Silly Strawberry: The One I Switched My Son To

Best for: kids who want a fruit flavor, and parents who prefer a natural brand.

I moved my son to Tom's of Maine Silly Strawberry after looking into heavy metals in kids' toothpaste. It still has some lead in it, as nearly every toothpaste does, but far less than the brand we used before. With kids, you take the better option you can get.

• Active: 0.76% sodium monofluorophosphate
• Taste: not every kid loves it. My son didn't at first, and he got used to it.
• Trade-off: it contains sodium lauryl sulfate and calcium carbonate, which work as a mild abrasive. Tom's also sells a fluoride-free version. For a child who gets cavities, I use the fluoride one.

3. Spry Kids Tooth Gel: For Babies and Fluoride-Free Families

Best for: babies learning to brush, and low-risk kids in families who skip fluoride.

The original Spry Kids Tooth Gel has five ingredients: purified water, xylitol, calcium glycerophosphate, cellulose gum, and grapefruit seed extract. The brand describes it as safe to swallow.

Dr. Jennifer Vitez, DMD, of Pathway Dental Group in California, pointed our team to Spry's kids' gel as one she can recommend to parents who want a fluoride-free option. Her reason is the form of calcium. Calcium glycerophosphate dissolves well, while many "calcium" pastes use calcium carbonate.

"The problem with a lot of calcium-based toothpaste is that they use calcium carbonate, but it's more like an abrasive, and it's not well dissolvable," she said.

• Trade-off: no fluoride. Xylitol helps most as a partner to fluoride. A Cochrane review found that a xylitol and fluoride toothpaste cut cavities in children by 13% compared with fluoride alone, on low-quality evidence.
• My rule: if a child on a fluoride-free gel gets a cavity, that's when I add fluoride.

4. Elementa Silver Tooth Gel: For Cavity-Prone Kids, Paired With Fluoride

Best for: kids who get cavities, as a gentle extra step alongside fluoride.

Elementa is the brand I use for myself and my son. The tooth gel comes in bubble gum, has no fluoride and no dyes, and uses nano silver, calcium, xylitol, and natural flavor. I have a discount code with Elementa: JOYCE20 takes 20% off.

• Why I trust it: Elementa pays for third-party heavy metal testing, which most brands skip because it's expensive. It won't come back with zero lead either, since almost no toothpaste does, but it comes back well below the safety threshold for kids.
• How I use it: it could be a standalone product, but I pair it with fluoride. Using it ahead of fluoride helps the fluoride get through the biofilm.
• Trade-off: no fluoride, so it doesn't replace a fluoride paste for a cavity-prone child.

5. OraNurse Unflavored Toothpaste: For Kids Sensitive to Taste and Foam

Best for: kids who gag when brushing, hate mint, or melt down over foam.

OraNurse has no flavor, no foaming agent, and no sodium lauryl sulfate. It was made for people sensitive to strong flavors. For a child who refuses every fruit paste, a tube with no taste at all can end the standoff.

• Fluoride: 1,450 ppm sodium monofluorophosphate, a little stronger than most US kids' pastes.
• Trade-off: the higher strength makes the rice-grain and pea-sized amounts even more important. It's a UK brand, so you'll usually order it online.

Fluoride or Fluoride-Free for Kids?

For a child who gets cavities, I use fluoride. For a child who has never had one, fluoride-free can be fine with regular checkups.

I'm okay with parents skipping fluoride toothpaste when their kids don't get cavities. Once a child has cavities, my question is why they aren't using it.

The research backs fluoride for kids:

• Baby teeth: a systematic review of children under 6 found that fluoride toothpaste reduced decay in baby teeth for kids at high risk.
• Permanent teeth: a Cochrane review of 96 trials found that 1,000 to 1,500 ppm fluoride toothpaste reduces cavities in children and teens. The certainty was moderate to high.

The trade-off is fluorosis. A 2024 Cochrane review looked at kids who brushed with 1,000 ppm fluoride or more from ages 1 or 2 until 5 or 6. They probably had a higher chance of fluorosis in their permanent teeth, mostly mild.

Most kids' fluoride pastes in the US run about 1,000 to 1,100 ppm, the same as regular adult toothpaste. You control the dose through the amount on the brush.

Cavity risk also runs in families. "If parents don't have their decay risk checked, their decay risk gets passed down through contact, through love to the kids," says Dr. Vitez.

A meta-analysis of genetic studies found that cavity-causing bacteria pass from mother to child. Getting your own teeth checked protects your kids too.

Dr. Vitez worries about parents caught between conflicting advice. "You have companies or dentists even telling you, don't use this, use that, don't rinse," she said. "And then you're experimenting with kids' mouths as a parent."

Is There Lead in Kids' Toothpaste?

Almost every toothpaste contains trace lead and other heavy metals, kids' brands included. The goal is the lowest amount you can find, used in the right amount.

Lead is in everything. An organic potato pulled from the ground has some lead in it. With kids, the goal isn't a toothpaste with zero lead. The few pastes that test at zero tend to have nothing in them that helps teeth. I look for the least lead in a paste that still protects them.

"There's going to be heavy metals or lead in every single product," says Dr. Vitez. "It's the dosage and the method."

The research lines up with that:

• Heavy metals are common. A 2025 systematic review found heavy metals in toothpaste in all 11 studies it included, and called for specific limits for toothpaste.
• Used as directed, the dose is small. A 2025 risk assessment looked at test results for 50 toothpastes. It concluded the metals weren't expected to meaningfully raise toxicity risk with normal use.
• Food is the bigger source. In all but one case, a toddler's lead dose from toothpaste was far lower than from food. Dietary lead averaged 1.7 micrograms a day for kids ages 1 to 3.
• The amount matters here too. Even if a child swallowed a full pea-size amount, only one of the 50 pastes went over California's 0.5 microgram daily limit for lead.

The analysis relied on one lab result per product, and the authors work for a consulting firm whose past clients include food companies.

"Natural" Doesn't Mean Lower Lead

Ingredients dug from the ground or made from shells can carry trace lead with them. Dr. Vitez named bentonite clay, common in "natural" toothpastes and tooth powders, as an ingredient that can contain lead. She added that clay from a brand that sources and tests it can be fine.

Calcium supplements show the same pattern. In a 2000 study of 136 brands, supplements made from natural sources like bone meal, dolomite, and oyster shell carried more lead than refined calcium.

How to Choose a Lower-Lead Toothpaste

• Ask for third-party heavy metal testing. I think every kids' brand should do it.
• Check for a Prop 65 warning. Dr. Vitez tells parents to look closer at any toothpaste carrying California's Proposition 65 warning for lead.
• Prefer refined ingredients over clays and shell-based calcium in a kids' paste.
• Keep to the rice-grain and pea-sized amounts. Less paste means less of everything in it.

What I Check on a Kids' Toothpaste Label

I read the drug facts box first and the front of the tube last. Here's my checklist:

• Fluoride and its strength. Sodium fluoride and sodium monofluorophosphate are the two you'll see on most kids' tubes. Look at the percentage.
• A short ingredient list. The fewer extras, the less the ingredients compete.
• No dyes. Dyes are unnecessary. Crest Kids Sparkle Fun lists Blue 1 and mica, and Colgate Kids Maximum Cavity Protection lists Blue 1 and Yellow 10. Both protect against cavities, and I'd still choose a dye-free tube.
• SLS-free, if your child gets canker sores. A systematic review found that SLS-free toothpaste reduced the number and pain of canker sores in people prone to them.
• Xylitol as a bonus. Xylitol helps most as a partner to fluoride.
• The form of calcium. The type of calcium matters. Calcium carbonate mostly scrubs, while calcium glycerophosphate and calcium acetate dissolve, which is why Dr. Vitez prefers them.
• Heavy metal testing. Look for it on the brand's site, or email and ask.
• A flavor your child accepts. The best paste is the one your kid will let you use twice a day.

Toothpastes I Don't Recommend for Kids

Nano-hydroxyapatite kids' pastes. I used to be optimistic about nano-hydroxyapatite, and I changed my mind. When you look at the mechanism, it doesn't do what it's marketed for. My concern is the evidence, and I've never called it unsafe.

The strongest trial in kids tested a microcrystalline hydroxyapatite paste, which isn't the nano form. Over one year with 207 children, it performed no worse than fluoride on early cavities. The kids brushed three times a day, and the paste maker funded the study. One trial isn't enough for me to trade fluoride away for a cavity-prone child.

Pastes with dyes or glitter. They make brushing look fun and do nothing for teeth.

Untested "natural" pastes built on clay or shell-based calcium. Without heavy metal testing, you can't know what came out of the ground with them.

How to Get Kids to Brush With Toothpaste

What helps most is choice, company, and a paste your child can tolerate.

• Offer two flavors you've already approved and let your child pick.
• Brush together. Kids copy what they see.
• Switch to unflavored or no-foam paste if your child gags or fights the taste.
• Use the right brush. The best toothbrush for kids has a small, soft head.
• Clean between teeth once they touch. Baby cavities love to grow there.

One of my favorite hacks is to put toothpaste on floss and do a "spot treatment" on baby cavities that grow between the teeth. That's the one area brushing can't reach. There aren't many studies on this, but I don't think it can hurt, and it beats watching a baby cavity and hoping it reverses.

What If Scenarios

What If My Child Swallows Toothpaste?

Young kids swallow some toothpaste, which is why the amounts are so small. A smear or pea-sized amount now and then is expected. If your child eats a large amount from the tube, call Poison Control at 1-800-222-1222.

What If My Child Already Has Cavities?

Use a fluoride paste twice a day and ask about fluoride varnish at checkups. I'm a big proponent of topical fluoride varnish right after a dental cleaning. The teeth are clean, and the biofilm has just been removed, so it's the best moment for it. An early white spot can sometimes heal naturally, while a hole needs a dentist.

What If My Child Hates Mint?

Kids who hate mint usually do fine with fruit or bubble gum toothpaste flavors. If your child rejects every flavor, try an unflavored paste like OraNurse.

What If We Don't Use Fluoride?

Keep sugar to mealtimes, keep checkups on schedule, and watch for chalky white spots near the gumline, the first sign of an early cavity. A gel with xylitol and a dissolving form of calcium, like Spry, is the fluoride-free option I'd start with. If a cavity appears, I'd switch to fluoride.

What If My Baby Just Got a First Tooth?

Start brushing twice a day with a soft infant brush and a rice-grain smear of fluoride toothpaste. A smear is all a baby needs.

What to Do Next

Pick one fluoride toothpaste from the list, measure a rice grain or a pea for your child's age, and brush together twice a day. If you see chalky white spots, brown spots or a hole, book a dental visit.

Find a dentist near you

Sources

1. Thornton-Evans G, Junger ML, Lin M, Wei L, Espinoza L, Beltran-Aguilar E. Use of Toothpaste and Toothbrushing Patterns Among Children and Adolescents, United States, 2013-2016. MMWR Morbidity and Mortality Weekly Report, 2019;68(4):87-90: https://pubmed.ncbi.nlm.nih.gov/30703075/
2. Wright JT, Hanson N, Ristic H, Whall CW, Estrich CG, Zentz RR. Fluoride toothpaste efficacy and safety in children younger than 6 years: a systematic review. Journal of the American Dental Association, 2014;145(2):182-189: https://pubmed.ncbi.nlm.nih.gov/24487610/
3. American Dental Association Council on Scientific Affairs. Fluoride toothpaste use for young children. Journal of the American Dental Association, 2014;145(2):190-191: https://pubmed.ncbi.nlm.nih.gov/24487611/
4. Walsh T, Worthington HV, Glenny AM, Marinho VC, Jeroncic A. Fluoride toothpastes of different concentrations for preventing dental caries. Cochrane Database of Systematic Reviews, 2019: https://pubmed.ncbi.nlm.nih.gov/30829399/
5. Wong MCM, Zhang R, Luo BW, Glenny AM, Worthington HV, Lo ECM. Topical fluoride as a cause of dental fluorosis in children. Cochrane Database of Systematic Reviews, 2024: https://pubmed.ncbi.nlm.nih.gov/38899538/
6. da Silva Bastos VA, Freitas-Fernandes LB, Fidalgo TK, et al. Mother-to-child transmission of Streptococcus mutans: a systematic review and meta-analysis. Journal of Dentistry, 2015;43(2):181-191: https://pubmed.ncbi.nlm.nih.gov/25486222/
7. Chengappa K, Rao A, Shenoy R, Pai M, Jodalli P, Br A. Heavy metal content of over-the-counter toothpastes: a systematic review of in vitro studies. Frontiers in Dental Medicine, 2025;6:1543972: https://pubmed.ncbi.nlm.nih.gov/40206235/
8. Massarsky A, Unice KM, Kreider ML. Health risk implications of heavy metals in toothpaste. Public Health Toxicology, 2025;5(2):9: https://doi.org/10.18332/pht/207273
9. Scelfo GM, Flegal AR. Lead in calcium supplements. Environmental Health Perspectives, 2000;108(4):309-313: https://pubmed.ncbi.nlm.nih.gov/10753088/
10. Riley P, Moore D, Ahmed F, Sharif MO, Worthington HV. Xylitol-containing products for preventing dental caries in children and adults. Cochrane Database of Systematic Reviews, 2015: https://www.cochrane.org/CD010743/ORAL_xylitol-containing-products-preventing-dental-caries-children-and-adults
11. Alli BY, Erinoso OA, Olawuyi AB. Effect of sodium lauryl sulfate on recurrent aphthous stomatitis: a systematic review. Journal of Oral Pathology and Medicine, 2019;48(5):358-364: https://pubmed.ncbi.nlm.nih.gov/30839136/
12. Paszynska E, Pawinska M, Gawriolek M, et al. Impact of a toothpaste with microcrystalline hydroxyapatite on the occurrence of early childhood caries: a 1-year randomized clinical trial. Scientific Reports, 2021;11(1):2650: https://pubmed.ncbi.nlm.nih.gov/33514787/
13. Orajel Super Mario Anticavity Fluoride Toothpaste, drug facts label: https://otclabels.com/lib/otc/otc-meds/orajel-supermario/
14. Tom's of Maine Children's Silly Strawberry, drug facts label: https://otclabels.com/lib/otc/otc-meds/childrens-silly-strawberry/
15. Kid's Spry Xylitol Tooth Gel, ingredients: https://professional.xlear.com/products/kids-xylitol-tooth-gel
16. Elementa Silver Tooth Gel: https://elementasilver.com/products/tooth-gel
17. Kids Crest Cavity Protection Sparkle Fun, drug facts label: https://otclabels.com/lib/otc/otc-meds/kids-crest-cavity-protection-sparkle-fun/
18. Colgate Kids Maximum Cavity Protection, drug facts label: https://otclabels.com/lib/otc/otc-meds/colgate-kids-maximum-cavity-protection/
19. Dr. Joyce Kahng, DDS. Instagram, 15 March 2025: https://www.instagram.com/reel/DHOya1dyxQJ/
20. Dr. Joyce Kahng, DDS. Instagram, 17 March 2025: https://www.instagram.com/reel/DHTZBvvJwjf/
21. Dr. Joyce Kahng, DDS. Instagram, 27 March 2025: https://www.instagram.com/reel/DHuOnmYyiV1/
22. Dr. Joyce Kahng, DDS. Instagram, 12 September 2021: https://www.instagram.com/reel/CTulAHrJOGw/
23. Dr. Jennifer Vitez, DMD, Pathway Dental Group. Recorded interview, 22 September 2026

FAQ

Written and reviewed by Dr. Joyce Kahng, DDS

Dr. Joyce Kahng is a cosmetic dentist, veneer expert, and the founder of Orange + Magnolia Dental Studio in Costa Mesa, CA. With 16+ years in practice and a following of 1.5M+ across Instagram, TikTok, and YouTube, she's known for making dentistry actually make sense. She's been featured in Forbes, Vogue, Allure, Glamour and GQ, and is the creator of the VeneerLIFT™.

Our editorial process · written by Dr. Kahng, corrected in the open.