Sir, I read with great interest the recent article in the BDJ entitled ‘Preventive management of carious lesions: from non-invasive to micro-invasive operative interventions'.1

Whilst it is stated that children's toothpaste should contain at least 1,000 ppm and no more than 1,500 ppm (w/w: 1,000 mg F/kg = 1.0 mg F/g) of fluoride,1 it is worth mentioning that fluoride concentration in toothpaste is dependent on the individual child's caries risk status.

I would like to draw your attention to ‘Delivering better oral health: an evidence-based toolkit for prevention' which recommends prescription of 2,800 ppm fluoride toothpaste for high dental caries risk patients aged ten years and over.2 The United Nations Convention on the Rights of the Child (UNCRC) 1989 definition of a child is any person under the age of 18 years.2 For those patients of high caries risk who are 16 years and over, 5,000 ppm fluoride toothpaste is recommended.3 This fluoride prescription regime is supported by the Scottish Dental Clinical Effectiveness Programme (SDCEP) as part of Enhanced Prevention actions for those children assessed as at an increased risk of developing dental caries.4

It must be noted that prescription of higher-dose fluoride toothpaste should be for a limited period and requires regular review of indication for use in light of reassessment of caries risk status.3,4