In choosing a toothpaste consumers usually consider how clean their mouth feels after brushing, the taste of the toothpaste and the desire for their teeth to be brighter. Dentists, on the other hand, judge toothpaste on how effective it is in improving your oral health.  Plaque If not removed by brushing and yes…flossing, at least every 24 hours, hardens into calculus (tarter), and makes teeth and gums more susceptible to decay and gum disease.  Tooth decay, gingivitis and periodontitis are no joke and can result in the need for fillings, bleeding swollen gums, root canals, mobile teeth and tooth loss. Additionally quite a few experts believe that periodontal disease may cause systemic problems, including but not limited to heart problems, low birth weight babies, dementia, arthritis.  That being said, oral health is serious business.

Today we will breakdown what is in your toothpaste!

Fluoride:  is the main active ingredient found in almost all toothpastes.  It wasn’t until about 50 years ago that fluoride was first added to toothpastes.  It helps with calcium uptake thereby strengthening the enamel and making it less susceptible to decay. Fluoride only makes up about 0.1%- 0.2% of most toothpaste, although prescription-strength fluoride toothpastes contain more than 1% of fluoride. 

Abrasives:  are added to aid in removal of plaque from the tooth.  Toothpaste is rated on a scale of RDA 1-200, according to its abrasiveness. The American Dental Association (ADA) recommends using a toothpaste with an abrasive index of less than100.  If toothpaste with higher index of abrasiveness is used on a regular basis, irreversible damage may result which includes enamel and root surface wear which may cause tooth sensitivity.  Tooth enamel re-mineralizes daily from the supply of ionic calcium and phosphorus in the saliva.  Scratching the surface of the tooth with an abrasive such as hydrated silica harms the enamel and prevents re-mineralization, much like using sand to clean glass.  Severe wear could eventually occur.

Detergents:  are added to prevent the toothpaste from dripping as well as giving consumers the sensation of ”clean” with the foaming and bubbles.  Assodium lauryl sulfate (SLS) is the most common detergent used in toothpaste.  Some may experience canker sores as a reaction to these detergents.  If you are one of these people who get frequent canker sores you may want to change your toothpaste to one that does not contain SLS. Dr. Collins is another brand of natural toothpaste that can be found without SLS.

Flavors:  are added to give the toothpaste a pleasant taste and smell.  Variations of mint are most popular but many enjoy cinnamon, fruit flavors, bubblegum, anise, the list goes on and on.  Crest recently came out with CHOCOLATE!!!!

Moisturizers:  are added to keep the toothpaste moist and prevent it from drying out.  Examples of some commonly used moisturizers are glycerin, sorbitol, and water

Preservatives:  are added to prevent microbes from growing in the toothpaste and spoiling it.  If it weren’t for these ingredients we would need to refrigerate toothpaste.  Methylparaben is used as a preservative in some toothpaste. Parabens have received some negative attention in recent years for iatrogenic activity – meaning they can add to the risk of some cancers, including breast cancer. During my trip to Whole Foods there were tons of paraben free options including Toms and Jason’s.  I do encourage everyone when using these more ”natural” brands to please buy those still containing Fluoride. 

Colors are added to give the toothpaste an attractive appearance.  Some toothpastes have glitters added for special effect or have two colors in a stripe. 
Sweeteners if toothpaste didn’t taste good it would be impossible to get people to brush.  Saccharin, aspartame, or xylitol are some of the common sweeteners used in toothpastes. 
Thickeners are added to prevent the toothpaste from being too runny.  Carageenan and xanthan gum are common thickeners added to toothpastes.

Antibacterial Agents:  Certain toothpastes contain Triclosan, which is an antibacterial and anti-fungal agent.  It is commonly found in antibacterial soaps.  Toothpastes which contain Triclosan are known to prevent plaque from forming around the teeth for up to 12 hours and claim to have a positive effect on the health of the gum by reducing inflammation.  Alternative antibacterial agents are those with tea tree oil.

Peroxide are added to those toothpastes that have whitening effect.  Peroxide is a whitening agent and is the main ingredient used in most tooth bleaching products. Peroxide can irritate sensitive gums, causing extreme tenderness.  This is not recommended for those with sensitivity.
Desensitizing Compounds are added to desensitizing toothpastes to reduce tooth sensitivity.  Sensodyne is the OTC preferred brand of toothpaste for those with sensitivity.  Two commonly used desensitizing compounds are:  Potassium Nitrate and Strontium Chloride. 

Baking Soda is added to help with stain removal.  Baking soda is not abrasive and has been used as a tooth cleanser for more than 150 years. 

Enzymes: Glucose Oxidase, lactoperoxidase and lysozyme are enzymes that are added to reduce dry mouth and increase saliva production.  Biotin products commonly contain these ingredients to aid patients who are suffering from dry mouth.

Whew!  To wrap it up here is a story of recent a Crest Toothpaste Recall, even the experts on toothpaste sometimes get it wrong.