Toothpaste

Are there positive reasons to use toothpaste?

Dear Doctor,
My hygienist showed me how to brush my teeth and she didn't use toothpaste. Are there positive reasons to use toothpaste?

Dear Ben,
It is true that plaque can be removed without the use of toothpaste, and especially when having a demonstration of oral hygiene techniques. It's a lot easier to see what's going on when your mouth is not foaming!

However there are many good reasons for using toothpaste which don't only depend on bacterial plaque removal, but also for a variety of others as well. For example, there are anti-cavity toothpastes, extra-whitening toothpastes, toothpastes with mouthwash, and toothpastes for sensitive teeth, toothpastes with stripes, clear toothpaste, and even liver flavored toothpaste for dogs.

All toothpastes contain the following ingredients: binders, abrasives, sudsers, humectants (a substance that retains moisture), flavoring, sweeteners, fluorides, tooth whiteners, preservatives, and water. Toothpaste comes in a variety of flavors, most often being some variation of mint spearmint, peppermint, regular mint and many others.

Fluoride was first added to toothpastes in 1914; in fact fluoride toothpastes developed in the 1950s very early on received the American Dental Association's (ADA) approval.

Probably the most researched of any toothpaste components is fluoride, which has scientifically proven anti-caries properties; it increases the resistance of teeth to demineralization — acid dissolution, and better yet also remineralizes teeth replacing calcium and reversing very early decay. Fluoride was first added to toothpastes in 1914; in fact fluoride toothpastes developed in the 1950s very early on received the American Dental Association's (ADA) approval.

One toothpaste brand has recently added triclosan, a widely used antibacterial, in hopes of helping to reduce plaque. Other items added to toothpaste are to whiten, remove stain, polish, desensitize, bubble and the list goes on.

Important Features and Ingredients of Toothpastes

Fluoride: You should only buy toothpastes that contain fluoride. On the label, this may be called stannous fluoride, sodium fluoride or monofluoride phosphate (MFP). This is the most widely researched and agreed upon basis for using commercial toothpastes. As long as the product has fluoride, it will help maintain dental health, reduce decay and help with sensitivity.

Desensitizing Toothpastes: These work for mild cases of tooth hypersensitivity, but may take weeks to be effective. The ADA recognizes two effective ingredients in treating sensitive teeth and gums: strontium chloride and potassium nitrate, although studies are more equivocal. These block the tube-like channels of the dentine, thereby reducing the ability of the nerves to transmit pain. They are meant for sensitivity caused by receding gums, not other causes like decay.

Tartar Control: The active tartar-control ingredient, tetrasodium pyrophosphate, has been shown to prevent tartar, but it can't remove tartar already on the teeth, which requires professional removal by a hygienist or dentist. Some people have reported mouth irritation, and do not do enough extra to warrant this risk.

Baking Soda: There is actually no proof that this has any effect at all. Baking soda may be too abrasive for continual use, and may actually lead to gum problems and irritation in the mouth. Some people, however, like the taste and feel of baking soda in the mouth.

Any toothpaste with the ADA seal has been proven safe and effective.

Peroxide: While the ADA believes current levels of peroxide in toothpastes are safe, some studies report that peroxide in high concentrations can irritate and damage gum tissue. The bubbling may make you feel like you're getting a better cleaning, but there is no scientific proof of this.

Abrasives: These are essentially for helping to remove plaque, and are usually in the form of silica. All ADA-approved toothpastes contain mild abrasives.

Whitening Ability: As mentioned above, no toothpaste has been proven effective in actually changing the color of teeth. The whitening toothpastes merely clean surface stains, but cannot change the underlying tooth color.

American Dental Association (ADA) Seal of Acceptance: The ADA awards its seal only after reviewing the “appropriate clinical and/or laboratory studies and scientific data.” Any toothpaste with the ADA seal has been proven safe and effective.

So you see there are lots of good reasons to use toothpaste and many choices to allow you to find one that is right for you.