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Fluoride use in toothpastes has been well established to provide a replenishing of the fluoride rich outer layer of the tooth and has proven to fight cavities. The effect on the tooth is to prevent  demineralization and to help remineralize the enamel to  prevent bacteria and their byproducts from destroying the outer layer of tooth and penetrating to the weaker internal layer of the tooth.  Most toothpastes contain 1,000 – 1100 parts per million (ppm)  and are effective in fighting cavities.

The American Academy of Pediatric Dentistry recommends that fluoride toothpastes are not needed  in children younger than two and that are low risk for decay. Children at high risk for decay should use a smear of toothpaste on the brush. Children age 2 to 5 should use a pea sized amount of toothpaste.  These recommendations are based on preventing overuse of fluoride from ingestion that can cause a problem in the developing tooth enamel called fluorosis. Adults benefit from fluoride as well and the use of toothpaste on the brush in moderation is sufficient for daily use. The large triple rope you see on commercials is not needed.