Toothpaste overdose

Definition

Toothpaste is a product used to clean teeth. This article discusses the effects of swallowing a lot of toothpaste.

This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call the local emergency number (such as 911), or 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.

Poisonous Ingredient

Poisonous ingredients include:

• Sodium fluoride
• Triclosan

Where Found

Ingredients are found in:

• Various toothpastes

Symptoms

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

Home Care

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.

Before Calling Emergency

Determine the following information:

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

Poison Control

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 number 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.

What to Expect at the Emergency Room

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).

Outlook (Prognosis)

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.

References

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. Approach to the poisoned patient. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 139.