Alright, tie your shoe laces; here we go…I get these questions or variations of these questions… EVERY DAY; What toothpaste is the best?, Which toothbrush should I use, manual or electric?, Does it matter what floss I use?, I use XYZ mouthwash, is that okay?. So I am gonna go through each question; but if I were to do it one post it would be freakishly long so, I am going to break it up into several posts. That way you don’t have to wade through bunch of info that you don’t care about to get to what you do care about. As always, I am basing my recommendations on my education, personal use, and what happens when my patients are my Guinea Pigs (he he he). I am not endorsing any particular product (even if you see a product in one of my pictures, it was a coincidence; unless someone wants to pay me for advertising…then it is not coincidence). Also please see my disclaimer.
Okay toothpaste. Let’s start at the beginning; put it on your toothbrush… No but seriously, most people are more in tune to what they are putting into their bodies now a days. But when you look at the back of a toothpaste tube it looks very intimidating and unhealthy (lots of “bad chemical” sounding words) however, most are generally harmless and are not in any amount to be harmful to you unless you eat toothpaste with a side of toast, which is something I will cover (minus the toast). So first I will unlock the mystery of the ingredient list of toothpaste. Generally, the ingredients of most toothpaste are the same:
1) Detergent – makes the toothpaste “suds up” – usually Sodium lauryl sulfate in some fashion
2) Cleaning and polishing agents – the nitty-gritty of the toothpaste (pun intended) – usually calcium carbonate or some form of silica, or in gel synthetic silica zero gel or synthetic fluid complex aluminosilicate salt
3) Binder – basically it binds the solid and liquid ingredients together so you have a uniform product after storage on store shelves – usually a colloid or natural gums
4) Humectants – prevents hardening – usually glycerol or sorbitol
5) Preservatives – prolong shelf life and prevent bacterial growth (yuck) – usually alcohol, formaldehyde, or some other really long chemical sounding word. *this one of the ingredients that has come under fire lately due to formaldehyde being a carcinogenic.
6) Sweetening agents – used because toothpaste does not have a pleasant or any taste at all before sweetening agents are added – usually artificial sweetener or sorbitol
7) Flavoring agents – the same as sweetening agents – essential oils or menthol
8) Coloring agents – makes the toothpaste pretty – vegetable dyes
9) Fluoride – prevent decay – usually sodium fluoride, or sodium monofluorophosphate
Recently other ingredients have been added by dental product companies: tartar control, whitening, sensitivity prevention, etc… I’m going to list those as well:
1) Tartar control – thought to prevent formation of tartar – usually zinc salts, Triclosan, or pyrophosphate salts
2) Whitening – removes staining on enamel caused by smoking, coffee, tea, wine, etc… – usually hydrogen peroxide or some form of dioxide or hydroxide and additional silicas
3) Sensitivity reduction – either blocks tubules in teeth, thicken tubular fluids, or block response from nerve of tooth – potassium nitrate
Whew! Now that we know all that here is what I tell my patients: Does your toothpaste have fluoride in it? Does your toothpaste have the ADA seal on the box? Do you like your toothpaste? If the answer to all of those questions is yes, then that is the best toothpaste for you! How do you like that?!
Issues caused by toothpaste
I do have patients that complain (ABOUT EVERYTHING! just kidding) that their cheek tissue sloughs off or their teeth have been sensitive lately. The first thing I ask is what type of toothpaste they use. Some patients react adversly to the SLS (Sodium Lauryl Sulfate) which causes their tissue to slough or peel off or canker sores to appear. I then recommend that they find a toothpaste that do not contain SLS for example: some Sensodyne toothpastes do not contain SLS and Tom’s of Maine does not contain SLS either. Usually they have a reduction in symptoms after using one of the toothpastes I mentioned.
There are many things that contribute to tooth sensitivity (this might be another post in the future). However, when I have a patient complain of increased sensitivity (especially a young person) they are usually using a Whitening toothpaste. Whitening toothpastes contain more abrasive material to physically clean the stain off of your enamel (much like the polish your hygienist uses when she polishes your teeth but on a smaller scale). People tend to use these toothpastes daily… please (hopefully they are brushing twice a day), so they are brushing with a toothpaste that has extra abrasives twice a day. I advise these patients to only use this toothpaste once a day (at night) or every other day to limit the amount of abrasive materials they are subjecting their teeth to and another toothpaste for the other times. In addition to the extra abrasiveness of whitening toothpastes, they often include a bleaching agent which can also cause sensitivity. Additionally tartar control toothpaste can cause increased sensitivity. It also has more abrasive particles in it’s make up.
Myths about toothpaste
There is a lot of crazy theories on the internet. The latest one I have heard is that the colored bands on the bottom of the toothpaste tubes indicate the different ingredients in the toothpaste. For instance:
Green – Natural ingredients
Blue – Natural +Medicine ingredients
Red – Natural + Chemical ingredients
Black – All Chemical ingredients
Oh, where do I start with this? Well my first thought is why in the heck would a toothpaste company use a “code” that was so easy to break, that their consumers would figure out harmful chemicals were in their toothpaste. Secondly, a toothpaste with the ADA seal has to not only meet FDA regulations but also meet ADA regulations. “Big brother” is not using toothpaste to get you. They are too busy hacking into your computer and phone cameras. Secondly, all toothpaste has some natural, chemical, and medical ingredients (see above) no big surprise! So here is what the color codes really mean? It is something the tube manufactures (not toothpaste manufacturers) uses in manufacturing so the laser guides of their machines know where to cut the plastic. EVIL TUBE MANUFACTURES!!
Oh fluoride, why do people hate you so? You are only trying to help. So the figures for fluoridated toothpaste are the following: cavities can be reduced by 20%-30% by using fluoridated toothpaste. However, with any healthcare product it should only be used as directed. Children under the age of 2 (or any that cannot or in the instance of my 3-year-old will not spit) should not use toothpaste with fluoride. Older children should only use a pea-sized amount with direct supervision, which means yes you need to stand right there and watch them. Adults can use about ½ inch or less.
Whew! I didn’t realize I was this passionate about toothpaste. I can’t wait to see how crazy I get with toothbrushes….until next week.