With the recent increase in the decay rate among American children the American Academy of Pediatric Dentistry recommends that a fluoride containing toothpaste be used once the first tooth appears.  A ‘smear’, no larger tha a grain of rice, should be used twice a day.  Make sure you are only using a pea-sized amount of fluoride toothpaste in children aged 2-5. Encourage your child to spit and not to swallow the excess toothpaste after brushing to avoid getting too much fluoride.