When it comes to toothpaste there is a bewildering array of choices! There are two broad categories of toothpaste - those that are marketed as 'pastes' and those that are marketed as 'gels'. Some companies market under the name 'toothgel'.
In addition to the choice of paste or gel, there are a number of other elements involved with toothpaste. These include:
- a variety of abrasive agents used in toothpaste
- the question of fluoride or no fluoride (and if you go for a fluoride based toothpaste, what type of fluoride)
- surfactants
- antibacterial agents
- flavorants
- remineralizers
- other miscellaneous ingredients
The main ingredients in toothpaste are water (typically 20 to 40%) and some kind of abrasive component which may constitute half or more of the typical toothpaste. Let's take a look at these various items.
Abrasives
Abrasives are insoluble particles and as such they help remove plaque from the teeth. There are number of possible abrasives that can be found in toothpaste products inducing aluminum hydroxide, calcium carbonate, calcium hydrogen phosphate (and there are a number of variations of this), various silicas, zeolites and hydroxyapatite. The links take you to Wikipedia where these substances are further explained if you are so interested.
What you want to be aware of is that abrasives cause a small amount of enamel erosion, called polishing action.
Surfactants
Some toothpastes but not all contain surfactants such as sodium lauryl sulfate (SLS) or other related surfactants, also known as detergents. SLS is very commonly found in many personal care products such as shampoos. The purpose of the surfactant is to act as a foaming agent primarily which enables more even distribution of the toothpaste and thereby improves its cleansing properties.
Antibacterial Agents
In the U.K, but less so in North American, you find triclosan added to toothpastes. Triclosan is an antibacterial and anti fungal agent. The chemical name for it is polychloro phenix phenol which is why I prefer to use the term Triclosan! Triclosan is currently being evaluated by the U.S. FDA and by Health Canada. It does appear to have an anti-gingivitis effect and studies by the Environmental Protection Agency (EPA) have found Triclosan to be an effective antibacterial. There are a number of health concerns being raised with Triclosan so the use of this antibacterial agent should be carefully be considered
Flavourants
Toothpaste, of course, comes in a wide range of colors and flavours which are primarily intended to encourage the use of the product. There common flavourants are:
- Peppermint
- Spearmint
- Wintergreen
There are many, many other flavors of course including anise, bubblegum, cinnamon, lavender, ginger, vanilla and lemon. There are even some more 'exotic' flavors such as peanut butter, iced tea and whiskey! And of course you can purchase unflavoured toothpastes.
Remineralizers
Some toothpastes contain remineralizers to help build back teeth enamel. Typically these are hydroxyapatite or calcium phosphate.
Other Miscellaneous Ingredients
Some toothpastes include ingredients to help suppress the tendency of the toothpaste to dry out. Sugar alcohols such as glycerol, sorbitol or xyilitol are used for this purpose. There are others. Some toothpastes include ingredients to reduce tooth sensitivity. Strontium chloride and potassium nitrate are common ingredients for this. Finally some toothpaste include ingredients to minimize the formation of tartar, typically sodium polyphosphate.
Fluoride
No discussion of toothpaste would be complete without talking about fluoride! It is still a somewhat contentious topic.
It should be noted that taken in large quantities, fluoride-containing toothpaste can be very toxic. However the risk of using fluoride is generally considered low enough that the use of fluoride containing toothpaste (1350 to 1500 ppm fluoride) is advised for all ages. For younger children a smaller volume of toothpaste is recommended and for very young children (less than three) just a tiny amount need be used. A valid concern for young children is the ingestion of toothpaste containing fluoride which can lead to dental fluorosis. Dental fluorosis is a discoloration of the enamel. In mild forms it presents itself as unnoticeable tiny white streaks or specks in the enamel. In more severe forms, the appearance of the tooth will be marred by discoloration or brown markings. Also the enamel may get pitted, rough and hard to clean. These spots and stains left by fluorosis are permanent and may darken over time.
Another thing to keep in mind with respect to fluoride is that you are exposed to it in a wide variety of ways. Fluoride is added to municipal water supplies, routinely added to mouthwashes, even soft drinks and canned goods.
Fluoride is, of course, added to toothpaste as the active ingredient to prevent cavities. Fluoride in toothpaste is viewed as being beneficial on the formation of dental enamel and bones.
There are a number of types of fluoride that can be found in toothpastes, the most common of which is sodium fluoride. There are others though such as stannous fluoride, olaflur (which is an organic salt of fluoride) and sodium monoflurophosphate. Some studies have shown stannous fluorides to be more effective than sodium fluoride in reducing the incidence of dental cavities and controlling gingivitis.
Other Health Concerns
Toothpaste is not intended to be swallowed. Doing so may cause nausea or diarrhea. SLS, discussed in Surfactants, may increase the frequency of mouth ulcers in some people as it can dry out the protective layer of oral tissues. There are some concerns about cinnamon containing toothpastes causing plasma cell gingivitis.
Taste
Toothpastes can alter taste perception. In particular, after using toothpaste, juices such as orange juice will likely have an unpleasant taste if the toothpaste contains stannous fluoride. This is attributed to a chemical reaction between the stannous fluoride and the acetic acid found in juice. SLS also alters taste perception generally making food taste more bitter.
Whitening Toothpastes
Many people seek out a toothpaste offering whitening properties and there are numerous manufacturers that make such claims. Many of the toothpastes marketed as whitening toothpastes have peroxide in them. Peroxide is used in many tooth bleaching gels. However, it is the abrasive in these toothpastes that removes the stains, NOT the peroxide. A whitening toothpaste will not alter the natural color of teeth or reverse discoloration by penetrating stains or decay. Rather the abrasive in the toothpaste can polish th teeth and additives such as sodium tripolyphosphate can help bread down and dissolve stains. Whitening toothpastes take time to make teeth appear whiter (typically two to four weeks). These toothpastes are generally considered safe for use twice a day but excessive use may damage tooth enamel.
Herbal Toothpastes
Many people are interested in herbal (or 'natural' toothpastes). The brand "Toms of Maine comes to mind as an example. These toothpastes do not contain dyes or artificial flavorings. Many of them do not have fluoride or SLS. Ingredients in these toothpastes may include such things as aloe, baking soda, eucalyptus oil, strawberry extract and/or essential oils. Some people even make their own toothpaste using similar ingredients. An example recipe is listed below.
It should also be noted that toothpaste is not really essential for brushing one's teeth. Teeth can be cleaned with a wet toothbrush alone.
Natural Toothpaste Recipe
Ingredients:
- 2 tablespoons bentonite clay (find clay here)
- 2 tablespoons baking soda
- 1 tablespoon dried, finely ground sage leaf (
- 1 tablespoon xylitol (optional, for adding sweetness)
- ½ tablespoon pure sea salt (find various sea salt here)
- 15-20 drops peppermint essential oil (find 100% pure essential oils here)
Combine dry ingredients in a bowl and mix thoroughly with a non-metal spoon. Drip essential oils into the mixture and stir well to combine. Transfer to a small container or jar with a tight fitting lid. To brush with tooth powder, simply dip your toothbrush into the powder, or carefully squirt onto a wet toothbrush. Brush teeth as usual. If you dip your toothbrush into the powder you should probably have your own personal jar!