Appropriate dispensing


Sir, I have enjoyed the series of cover images in Volume 209 of the journal, where abstract art depicts one of the GDC specialties. The cover on Issue 6, however, representing paediatric dentistry, raises an issue which is often overlooked when depicting images of a toothbrush and toothpaste. The graphic shows two brushes, overloaded with copious amounts of paste, a not uncommon finding in illustrations and photographs used in health education material aimed at young children and their parents. Since the early 1990s1 it has been agreed that the amount of toothpaste used by children should be restricted to a smear (under three years) or pea-size amount (3-6-years-old) – a message endorsed on tubes of fluoride containing toothpaste sold in the UK and recognised in national2,3 and international4 clinical guidelines.

Whilst recognising the freedom that abstract art enjoys and the professional nature of the intended audience on this occasion, your cover provides an opportune reminder to those involved in producing health education material, of the importance of reinforcing in pictures and graphics, the message about appropriate dispensing of toothpaste for young children.


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    Pang D T, Vann W F . The use of fluoride-containing toothpastes in young children: The scientific evidence for recommending a small quantity. Pediatr Dent 1992; 14: 384–387.

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    Scottish Intercollegiate Guidelines Network. No 83. Prevention and management of dental decay in the pre-school child. A national Clinical Guideline. Edinburgh: Scottish Intercollegiate Guidelines Network, 2005.

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    Department of Health. Delivering better oral health – an evidence-based –toolkit for prevention. 26 September 2007.

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    American Academy of Pediatric Dentistry. Guideline on fluoride therapy. Reference Manual: Clinical Guidelines. 2008

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Chestnutt, I. Appropriate dispensing. Br Dent J 210, 52–53 (2011).

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