Toothpaste overdose

Poisonous ingredients include:

• Sodium fluoride
• Triclosan

Ingredients are found in:

• Various toothpastes

Swallowing a large amount of regular toothpaste may cause stomach pain and possible intestinal blockage.

These additional symptoms may occur when swallowing a large amount of toothpaste containing fluoride:

• Convulsions
• Diarrhea
• Difficulty breathing
• Drooling
• Heart attack
• Salty or soapy taste in the mouth
• Slow heart rate
• Shock
• Tremors
• Vomiting
• Weakness

DO NOT make a person throw up unless told to do so by poison control or a health care professional. Seek immediate medical help.

If the product was swallowed, immediately give the person water or milk, unless told otherwise by a health care provider. DO NOT give water or milk if the person is having symptoms (such as vomiting, convulsions, or a decreased level of alertness) that make it hard to swallow.

Determine the following information:

• The person's age, weight, and condition
• The name of the product (as well as the ingredients and strengths, if known)
• The time it was swallowed
• The amount swallowed

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

If you swallow toothpaste that does not contain fluoride, you may not need to go to the hospital.

Those who swallow a lot of fluoride toothpaste, especially if they are small children, may need to go to the hospital emergency department.

At the emergency room, the provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Blood and urine tests will be done. The person may receive:

• Activated charcoal to prevent the rest of the poison from getting absorbed into the stomach and digestive tract.
• Airway and breathing support, including oxygen. In extreme cases, a tube may be passed through the mouth into the lungs to prevent aspiration. A breathing machine (ventilator) would then be needed.
• Calcium (an antidote), to reverse the effect of the poison.
• Chest x-ray.
• ECG (electrocardiogram, or heart tracing).
• Endoscopy: a camera down the throat to see burns to the esophagus and stomach.
• Fluids through a vein (by IV).
• Medicines to treat symptoms.
• Tube through the mouth (rare) into the stomach to wash out the stomach (gastric lavage).

People who swallow a very large amount of fluoride toothpaste and survive 48 hours usually recover.

Most nonfluoride toothpastes are nontoxic (nonpoisonous). People are very likely to recover.

Dhar V. Dental caries. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 338.

Meehan TJ. Care of the poisoned patient. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 135.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.