In the eighth installment of her "Dangerous or Safe?" series, pediatrician Dr. Cara Natterson sets the record straight on toothpaste.

Brushing your teeth is one of the few things that you do every day -- twice a day or more -- for a lifetime. Toothpaste is designed to:

• keep our teeth healthy and strong
• prevent cavities
• freshen breath

The claims against fluoride include:

• vomiting and diarrhea
• seizures, tremors, and weakness
• respiratory distress
• heart attack and heart rate abnormalities (particularly slowing of the heart)
• fluorosis (white staining of the teeth)
• ingesting fluoride can weaken bones, increasing the risk for fracture
• questions about the effects on the reproductive system
  
• possible association with Alzheimer's disease

Research shows the ONLY claim in the list to be true is that ingesting too much fluoride can cause fluorosis. The other just haven't been fully researched yet.

At this point in time, the benefits of fluoride outweigh the risks.

Toothpaste tubes are labeled with cautionary words:

• use no more than a pea-sized amount of toothpaste for children under six and no fluoride for children under two
• because toothpaste tastes good to kids -- brushing with a small amount won't cause fluorosis, but eating large amounts may
• for the youngest brushers, spitting is a near impossibility, and hence the advisory that they use fluoride-free pastes

To find out Dr. Cara's bottom line on toothpaste, go to Is Toothpaste Toxic?, Page 2