Xu Chunsheng

Guangzhou Dental Doctor Oral Care Research Institute, China

The issuance of national standard—GB 30002-2013 Kids Toothbrushes has triggered debate about “whether kids toothpaste national standards shall be set”. The author believes that it is necessary to sort out the development of the kids toothpaste market. Through analyzing the characteristics of kids oral care, special technical requirements of kids toothpaste were defined, and some suggestions for the related decision-making of industry professionals were provided.

Definition of kids toothpaste

Toothpaste plays an important role in encouraging children to brush and take care of their teeth. According to the national standard, Classification and Terminology of Oral Care and Cleansing Products (being drafted),kids toothpaste aims at kids, and is in line with relevant regulations in terms of raw material, product, and labeling.The national standard—GB 8372-2008 Toothpaste,stipulates that soluble fluoride (free fluoride) content of kids fluoride toothpaste should range from 0.05% to 0.11%and the total fluoride content should range from 0.05% to 0.11%. And a warning statement must appear directly on the package.

Development of kids toothpaste market

In the early 1980s, to cater to the kids’ demands,Hangzhou Toothpaste Factory released the first Chinese kids toothpaste brand—Little White Rabbit. The toothpaste contains fluoride and strawberry flavor. As soon as hitting the market, it has been warmly welcomed by most consumers. For 20 years, Little White Rabbit maintained the leading position in Chinese kids toothpaste market.In 1980s, Nanchang Daily Chemical Plant launched Flower kids Toothpaste and Caoshanhu Kids Medicated Toothpaste successively. In 1990s, Shanghai Toothpaste Factory introduced Paopaowa Kids Toothpaste, and Chinese Kids Striped Toothpaste successively. In 1988,Liuzhou Toothpaste Factory launched Xianhu LMZ Kids Toothpast. In 1991, Guangzhou Toothpaste Factory launched Heimei Gel Kids Toothpaste. In 1992, Hefei Daily Chemical Industry Factory introduced Fangcao kids striped toothpaste. In 1993, Harbin Daily Chemicals Co.,Ltd. introduced Sankezhen kids striped toothpaste. The features common to all kids toothpastes launched in the 20thcentury were: 1) fruit flavor; 2) added fluoride, plant extracts or other ingredients that can protect kids oral health.

In the 21stcentury, the kids toothpaste market entered into a new stage—many major toothpaste brands developed kids toothpastes. The main domestic toothpastes are Nice Yayale Toothpaste, Frog Prince Toothpaste, MAXAM Paopaowa Toothpaste, Shuke Baby Toothpaste, LMZ Yufang Baby Toothpaste, etc. The main foreign toothpastes are Lion Anpanman Toothpaste For Kids, Colgate Kids Spiderman Blue Toothpaste and Darlie Baby Rabbit Toothpaste.

Currently, the kids toothpaste market has the following characteristics:

1) using many types of cartons in packaging and choosing interesting names for products to attract kids’attention;

2) providing products with fruit flavors that kids love,such as hami melon, sweet orange, strawberry, mango,honey peach, lemon, blueberry, apple, grape, and orange,etc;

3) using transparent silica which cleanses thoroughly yet gently, and the paste color corresponds to its fruit flavor;

4) adding efficacy ingredients such as 0.05%～0.11%fluoride and IgY (egg yolk immunoglobulin) to prevent dental caries, Vitamin E and Vitamin C to strengthen teeth and gums, calcium glycerophosphate to strengthen enamel, and the plant extracts to help block harmful bacteria in the mouth;

5) using lower dosages of foaming agents, menthol,and flavors in kids toothpaste (usually about 60% of adult toothpaste);

6) providing free gifts with purchase;

7) being sold separately on the toothbrush shelves.

Specificity of kids toothpaste

Characteristics of kids dental care

In childhood, kids cognitive ability, as well as, tooth eruption and development are different at different stages,so that the characteristics of oral care are different at different stages. Taking appropriate oral health measures,and the development of good oral hygiene habits, are not only beneficial for the prevention of oral diseases, but also for kids whole life. As kids grow and the oral environment changes, so do the specific toothpaste needs.

Infancy stage (0-1 year).While most babies don’t start getting teeth until they are six months old, infant dental care is important from the very beginning. It is a good idea to get in the habit of cleaning baby’s gums soon after birth. Caring for baby’s first teeth is very important,and helps set the stage for a healthy mouth. Before child gets his or her first tooth, the parents should wipe child’s gums with an infant gum massager, clean damp gauze or a washcloth. Toothpaste is not recommended.

Toddlers (1-3 years).Mutans streptococci (MS) are closely related to the development of dental caries and are usually established in the oral cavity during early childhood. Special attention should be paid to maintain child good oral hygiene.

Begin using toothpaste to brush child’s teeth when he (or she) is 2 years old. Be careful to use only a small dab of toothpaste (about the size of a grain of rice). Young children tend to swallow toothpaste when brushing,rather than spitting it out. Introduce fluoride toothpaste when child is old enough not to swallow it.

Preschool stage (3-6 years).Most children will have all their primary teeth by 30 months of age, and they can learn how to brush his or her own teeth at about age 3.Children should be brushing their own teeth morning and night by age 4, although the parents should assist children with tooth brushing to make sure that plaque is removed.Children need this help until their fine motor skills are more developed at about age 7. Parents should choose approved dental products for their children, help them brush and floss their teeth and teach them not to swallow the toothpaste. Parents should limit child’s consumption of any beverages that are high in sugar. Kids anticarie toothpaste should be used for children at this stage; adult toothpaste is not recommended.

School age stage (6-12 years).It is very important to take good care of the teeth of kids when they are 6 to 12 years old as they are at the greatest risk of dental decay at that time. Baby teeth are starting to fall out and make way for adult teeth. From the age of 6 years, children have the ability to brush their teeth alone. Make sure that the child brushes his teeth two times in a day. Also, continue supervising his brushing until around 8 years of age to make sure they brush their teeth properly. Fizzy drinks,fruit juices or fruit squashes are popular among children.Because they contain sugar or acid, they can have a harmful effect on the teeth. Fizzy drinks can cause the wearing away of teeth (erosion) due to their high acid content. Use toothpaste and a toothbrush designed for children such as kids toothpaste that can protect both the enamel and the gingival health. Adult toothpaste is not recommended.

Special technical requirements for kids

1) Toothpaste safety

Children have immature enamel and sensitive oral mucosa, and they have a habit of swallowing toothpaste. The safety requirements for kids toothpaste are stricter than that for adult toothpaste. The details are as follows:

Relative Dentin Abrasivity (RDA) is a method of measuring of the erosive effect of abrasives in toothpaste on tooth dentin. According to the ISO standard, every toothpaste with an RDA under 250 is safe. Parents should select low RDA valure kids toothpaste for children.Considering the relation among abrasion value and the type and the amount of abrasive, and particle size, the kids toothpaste should use hydrated silica (RDA value range between 70～90 , and particle size of 400 mesh) as an abrasive.

SLS (sodium lauryl sulfate) is a surfactant that makes things foam and a major ingredient in most popular toothpastes sold in the grocery store. This ingredient may cause the recurrence of aphthous ulcers, commonly referred to as canker sores. So parents should avoid choosing toothpastes which contain SLS.

The flavor contained in adult toothpaste has a strong irritating effect and the taste of adult toothpaste is strong affecting kids taste sense. The kids toothpaste comes in fruit flavor should be flavored using naturally occurring fruit extracts.

Fluoride known as ingredient that prevents cavities,actually can be very toxic to the body. Using natural alternatives to fluoride is the market trend.

2) Anti-carie efficacy

Dental caries is the most common chronic infectious disease of childhood. Early Childhood Caries (ECC)is a major health concern that continues to negatively affect the oral health of children today. In China, the prevalence ECC is a common finding relative to some European countries. If untreated, ECC causes pain and infection, which may not only interfere with a child’s correct chewing movement and nutrition intake, but may also impact on the development of permanent dentition and general heath. Due to improper feeding,tooth development, poor oral hygiene and other influencing factors, some children are at high risk for decay cavities.

Brushing with anticavity toothpaste is particularly important for preventing cavities. There are various kids toothpastes on the market. Currently, kids fluoride toothpaste is the best choice. The fluoride toothpaste can effectively strengthen teeth and prevent tooth decay, but it is necessary to be noted that children under 3 years shall not use fluoride toothpaste. The amount of fluoride in toothpaste must be controlled for preschool children.Only a pea-sized amount of toothpaste should be used.The adult fluoride toothpaste is not recommend for preschool children. Most of these will contain a high level of fluoride which is harmful to children.

Suggestions

Product segmentation has become mainstream

Currently, there are around 220 million children below the age of 14 in China, accounting for 20% of the population. Toothpaste marketed at children is double the price of ordinary toothpaste, so the market segmentation of kids toothpaste and adult toothpaste has been formed,and will be continuously consolidated and developed.Kids toothpaste in China is dominated by Cnice, Colgate,DARLIE, LION. Other well-known brands such as Little White Rabbit Toothpaste and Frog Prince Toothpaste,etc., are also constantly expanding their own market.

With competition in this market has intensified, kids toothpaste has been further divided into baby teeth care toothpaste (for children in the age range of 2～6 years),kids toothpaste (for children in the age range of 6～8 years), and permanent teeth care toothpaste (for children in the age range of 8～12 years).

Food grade toothpaste

Currently, some manufacturers claimed that their kids toothpaste product is food grade. In fact, “food grade”certification is not required for toothpastes in China.From the standard perspective, food grade toothpaste has a double meaning: all or almost all of the raw materials used in toothpaste meet the requirements for food additives,and all toxicological indexes of toothpaste reach standard of food industry; the toothpaste production environment meets the requirements for food production, and all hygienic indexes of toothpaste reach the food industry standards.

Food grade toothpaste means safer, and has been a hit with some consumers. It aims at infants because it is safe to swallow. Research showed that the cytotoxic effects of food grade toothpastes to the oral mucosa is much lower than that of adult toothpaste.

Fluoride-free anti caries toothpaste is the development direction of kids toothpaste

Fluoride in toothpaste can prevent cavities and tooth decay. Don’t use fluoride toothpaste in children who are younger than 6 years old to avoid the risk of fluorosis.Therefore, it is necessary to develop new anticarie agents that are more safe and effective. The studies showed toothpastes added with bioactive glass, IgY factor,phosphorus-containing agents, calcium-containing agents,and some traditional Chinese medicines (such as tea extract, Galla chinensis, Magnolia officinalis, Ginkgo biloba), also have certain anticarie effects. Fluorine-free anticarie toothpaste will be the key development direction of kids toothpaste in the next few years.

[1] Qi Xiaoqiu. The Third National Oral Health Epidemiological Investigation. Beijing: People’s Medical Publishing House, 2008.

[2] Kids toothpaste becomes the focus of the toothpaste segmentation market. http://finance. sina. com. cn/roll/20130223/120714626414.shtml (Accessed Feb. 23, 2013).

[3] Zhu Zhouhai; Liu Fengzhi; Huang Haitao; et al. Cytotoxicity in vitro study of several kids toothpastes. Daily Chemical Industry 2015, 45(4), 282-284.