Why does Kinder Karex not contain fluoride?

Many oral care products for children contain fluorides to prevent caries. Especially for children under the age of 6, the addition of fluoride to toothpaste is a subject of much debate. In the first years of life, the paediatrician usually prescribes vitamin D tablets to ensure healthy bone growth. These tablets often also contain fluoride.

In addition to fluoride tablets, there are many other sources in day-to-day life that also contain fluoride. For example, fluoride is contained in many foods, fluoridated salt and drinks without consumers being specifically notified thereof. This makes it difficult for parents to control how much fluoride their children ingest.


Foodstuffs and supplements containing fluoride

The Federal Institute for Risk Assessment from Germany has stressed that too much fluoride at a young age can damage the teeth and bones. It explicitly recommends that babies and young children only use one type of fluoride prophylaxis: either vitamin D with fluoride, fluoridated salt or fluoride toothpaste. Given that young children swallow most of the toothpaste, an overdose can occur unknowingly. Just the swallowing of toothpaste can result in the consumption of the same amount of fluoride as in a fluoride tablet or fluoridated salt. The majority of households in Germany use fluoridated salt.

Figure 1: Share of households with fluoridated salt

Professional societies agree upon new fluoride recommendations for children's toothpaste

Fluoride dosages in children's toothpaste are regulated by law. Toothpastes which contain more than 500 ppm of fluoride must, by law, include a warning, for example, "For adults only".

As such, the following recommendations from professional dental societies applied up to 2018:

  • Children aged from 0-2 years:
    1 x daily children's toothpaste with 500 ppm fluoride
  • Children aged from 2-6 years:
    2 x daily children's toothpaste with 500 ppm fluoride
  • Children aged 6 and upwards:
    2 x daily children's toothpaste with 1,000 ppm to 1,500 ppm fluoride

Since caries in primary dentitions has barely improved for some years now – almost half of all children in their first year at school have caries – the German Society for Paediatric Dentistry (DGKiZ) and the German Society for Preventive Dentistry (DGPZM), in consultation with further experts, have issued new recommendations for children's toothpastes. These recommendations provide for an increase in fluoride levels.

Since autumn 2018 the recommendation (not legally binding) has been as follows:

  • Children aged from 0-2 years:
    2 x daily rice grain-sized amount of children's toothpaste with 500 ppm
  • Children aged from 2-6 years:
    2 x daily pea-sized amount of children's toothpaste with 1,000 ppm fluoride
  • Children aged 6 and upwards:
    2 x daily children's toothpaste with 1,000 ppm to 1,500 ppm fluoride

Ultimately, parents are responsible for ensuring that the amount of toothpaste used equates to a grain of rice or pea and thus remain responsible for caries prevention.

With these new recommendations, the fluoride amount for children aged two and above has been doubled. There are numerous specialists who regard these newly defined fluoride thresholds critically. The chairperson of the Working Group for Adolescent Dental Care for Frankfurt am Main and Taunus district, Dr. Klaus-Günter Dürr, expressed his concerns to his dental colleagues in an open letter. He criticised the increase in fluoride content with the argument "a lot doesn't help lots" and the resulting increased risk of fluorosis (white marks on the remaining dentition) due to an overdose in preschool years.

Kinder Karex works without fluoride – with BioHAP

Kinder Karex toothpaste uses the toothlike active ingredient BioHAP. This stands for "biomimetic hydroxyapatite", the substance from which our teeth are made. This is an alternative to fluoride and offers numerous advantages:

  • It forms a protective layer on the surface of the tooth when cleaning the teeth. Consequently, it is harder for bacteria to adhere to the tooth and the biofilm (plaque) is reduced considerably. Plaque, which can produce aggressive acids, triggers caries.
  • Brushing daily with BioHAP can repair even small defects in the enamel and support remineralisation, i.e. the re-depositing of important minerals in the dental enamel. The hydroxyapatite builds up on the teeth and tooth necks, thus helping to prevent sensitive teeth.
  • Small children are often not yet able to spit out toothpaste properly so they end up swallowing most of it. When swallowed, BioHAP simply dissolves in the stomach and is thus not hazardous to health. As such, parents do not have to ensure compliance with the recommended fluoride doses.

Kinder KAREX in simple terms

modern caries protection | toothpaste for children without fluoride