Toothpastes: Do They Live Up To The Hype?
As a dentist, there’s one common question I often get.
“Which type of toothpaste is best to use?” My patients would often be in the supermarket isle and confused as to which toothpaste is best to give them healthy teeth.
What is the Best Toothpaste?
For a long time, it was a difficult question to the field because, even as an oral health professional, the information out there is sometimes hard to find.
In this article, we’ll go through the main ingredients and whether they actually live up to the hype.
But to start, here are THREE things that you should know about toothpaste that I tell my patients.
1) Your teeth don’t NEED toothpaste. Food is the biggest factor in your oral health. If you’re interested in having healthy, strong teeth, nutrition and FOOD are your best tools for good oral health. I tell ALL of my patients that what they eat during their day is far more influential for their teeth than any toothpaste ever will be.
2) Toothpaste, for the most part, was designed as an abrasive to help remove plaque during brushing. So besides the mechanical removal of plaque, many of the ingredients have been added outside the original purpose of toothpaste.
3) Before making a decision – talk to your dentist. Your oral health condition is unique, and toothpaste can be a useful adjunct to facilitate certain situations. But remember that – it’s intervention (not prevention). Good prevention begins with your dietary behaviour.
So let’s look at some of the most common toothpaste ingredients.
The most common and probably the most controversial toothpaste ingredient is fluoride.
Fluoride has many applications in dental treatment, including as a protective agent against tooth decay. However, it’s important to know that fluoride in most of the toothpaste you use at home is lower than what studies show to prevent tooth decay.
Fluoride Dangers You Should Know
The concentration of most toothpaste is at about 1000 parts per million. When you use a pea size toothpaste, the dose of fluoride ends up to be about the same dose as you would get from 1-1.5L of water. But this is the concentration of the fluoride that has been shown to be effective in water fluoridation. It prevents tooth decay when you swallow, and the fluoride is worked into your tooth enamel.
To be effective, you would need a concentration of up to 5000 parts per million. But this concentration isn’t allowed by the FDA because it’s too high and cause damage to your tooth enamel.
Fluoride in your toothpaste tube will usually be listed as:
- Sodium fluoride (NaF) is the most common source of fluoride
- Stannous fluoride (SnF2),
- Sodium monofluorophosphate
Stannous fluoride is has been shown to be the most effective, but it also potentially causes staining of teeth.
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Conclusion: Fluoride toothpastes aren’t as effective as they claim to be. If you have dental decay, you may need to see your dentist to use a higher concentration fluoride application. But for home use, you’re probably not helping by brushing with fluoride toothpaste.
And remember – food first!
Triclosan (Colgate Total)
Triclosan is an antibacterial agent that claims to prevent the spread of germs. It’s used in soaps, detergents, toys and surgical cleaning products.
The claim of triclosan is that it reduces plaque and gingivitis.
There’s a few problems with this. Reduction of plaque is primarily a mechanical process. You remove the plaque that houses bacteria that may cause decay.
Chemical agents, in general, have been shown to be not very effective in reducing plaque build-up itself.
The other problem is the mechanism of triclosan is poorly understood. The oral microbiome houses thousands and thousands of microbes that are beneficial for your oral health. The impact of a chemical like triclosan on these friendly bacteria is largely unknown.
But on top of this, the FDA has banned triclosan from antibacterial soap products because it’s not effective over plain soap and water.
There are also question marks on the safety and risks with triclosan showing harmful effects in animal studies.
Strangely, toothpaste is still allowed to use triclosan due to Colgate referencing many scientific studies supporting its use. The problem here is they are privately funded studies which make it difficult to draw conclusions from.
Conclusion: Do not use any toothpaste containing triclosan. It may be dangerous, and the evidence to support its effectiveness is very weak.
Teeth whitening toothpaste
There is a range of toothpaste that claims to be ‘teeth whitening’. They usually contain a peroxide which is a bleaching material.
The problem with this is that the concentration is very low. Teeth whitening with a bleaching material works by holding a bleach against the tooth with a mouthguard.
Teeth whitening toothpastes may help remove very superficial staining. But are unlikely to work for any significant ‘whitening’.
Conclusion: If you’re after a tooth whitening solution consult your dentist, teeth whitening toothpastes are largely ineffective.
Toothpastes that claim to decreases sensitivity use active ingredients that claim to block the feeling in the root of your tooth. Tooth sensitivity often comes from exposure or fluid moving through tiny holes in the surface of your teeth.
De-sensitizing ingredients include:
- Potassium nitrate
- Stannous fluoride
- Strontium chloride
Strontium chloride has had some concerns over its safety and is banned in some countries. Stannous fluoride may be the most effective to stop tooth sensitivity.
Conclusion: While desensitizing toothpastes may be effective for short term relief, they should only be that. The underlying reason for your tooth sensitivity should be investigated by a visit to your dentist.
Sodium Lauryl Sulphate (SLS)
SLS is a synthetic ingredient that is used in detergents and commonly used in many products including toothpaste. The reason for adding SLS to toothpaste is it makes it ‘foam’ in the mouth.
While SLS may feel good, there is no rationale behind why it promotes good oral health. It’s there simply, so you buy and use toothpaste. Also, SLS may have some harmful effects including causing ulcers in the mouth.
Conclusion: avoid any toothpaste containing SLS. There’s no benefit to your oral health.
Be a toothpaste detective.
While you may hear and see many great claims about toothpaste – the reality is many don’t live up to the hype.
You should always consult your dentist on what toothpaste you should use.
But remember, food is your number one way to keep your mouth healthy! For more information on how nutrition connects to your teeth, you can visit my website www.drstevenlin.com or social media @drstevenlin.
Dr. Steven Lin is currently the Principal Dentist at Luminous Dentistry, a dental practice on the Central Coast of New South Wales, Australia, that strives to give individuals of all ages the best possible smile.
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