New Delhi: Your child may love the bubble gum-flavoured toothpaste, but the high fluoride content may actually be harmful. In light of the risks associated with excess fluoride in toothpaste, the Drugs Technical Advisory Board (DTAB) has agreed to amend the rules governing fluoride use in a meeting held on 16 May.

DTAB has decided to restrict the use of fluoride to 1,000 ppm (parts-per-million), two people aware of the matter said. Besides, it is also considering amendments to the Drugs and Cosmetics Rules, 1945, with respect to the labelling requirements for toothpastes. Companies will now have to mention the fluoride content for each tube and the expiry date.

“Parents are often advised to supervise their children while brushing to make sure that they are cleaning their teeth properly. But now there is another reason for being vigilant -- the tendency of children swallowing more toothpaste than advisable," said one of the people mentioned above.

According to the Central Drugs Standard Control Organisation (CDSCO), the problem arises when children use fluoridated toothpaste. The CDSCO received various representations regarding the issue of toothpastes having high fluoride content, with just a fine print specifying “pea size" toothpastes to be used under “adult supervision".

“The statutory warning is written in small letters and usually goes unnoticed. The children use more quantity than desired as a result of massive advertisements," the CDSCO stated in its proposal before the drug advisory body.

According to the US Food and Drug Administration, even relatively small doses of fluoride, when consumed, can induce symptoms of acute fluoride toxicity in children. Early symptoms of fluoride poisoning include gastrointestinal pain, nausea, vomiting and headache.

A 1995 study at the Medical College of Georgia School of Dentistry had found that half the children do not spit out or rinse out, but swallow toothpastes. Making matters worse, they tend to use too much toothpaste on their own, especially when they use flavoured children’s products. The FDA, in fact, mandates that all fluoride toothpastes sold in the country bear the poison warning, asking parents to keep tubes out of the reach of children under 6 years. “If you accidentally swallow more than used for brushing, seek professional help or contact a poison control centre immediately," it says.

“In India there is no such poison control centres and, therefore, concerns were raised with respect to provisions to provide change and amend the labelling conditions of fluoride content containing toothpaste for children," the CDSCO said.

According to market research firm Euromonitor International, toothpastes were a Rs9,180 crore industry in India in 2017.

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