The other day I was in Target shopping for toothpaste, and I thought, “Wow, do Americans really need this many toothpastes?”
At first glance I couldn’t even find the toothpaste I normally use, no doubt because the packaging had changed. It’s probably “new and improved.” Aren’t they all?
Ignoring the hyperbole of “advanced”, “intense” and “extreme”, I started looking at the ingredient lists on the backs of the boxes. I know exactly which ingredients I want to see to get the most effective toothpaste at the lowest price.
For me, the most important ingredient in a toothpaste is fluoride. Fluoride strengthens the teeth by preventing mineral loss, making teeth more resistant to decay. All toothpastes approved by the American Dental Association (ADA) contain fluoride. I know many people question the safety of fluoride, especially in drinking water, but a thorough evidence review in 2008 concluded that fluoridation is both safe and effective. (Children under the age of 6 need supervision with fluoride toothpaste because ingesting large amounts can cause enamel fluorosis, a developmental condition in which white spots appear on permanent teeth.)
Most toothpastes contain sodium fluoride. A few contain stannous fluoride, a different form of fluoride ion. Such toothpastes usually cost more as their makers argue stannous fluoride is more effective at preventing tooth decay and gingivits, but the evidence doesn’t support that claim enough to warrant the increased cost.
I also have sensitive teeth, which are caused by exposed nerve endings where the tooth’s enamel and dentin layers are too thin. The most common ingredient in sensitive toothpastes is potassium nitrate. Potassium nitrate works by numbing the nerve endings.
There are a few ingredients I don’t want to see in my toothpaste. First is triclosan. It is a mild antibiotic that is supposed to prevent plaque formation and gum disease (gingivitis). The Food and Drug Administration (FDA) has approved the use of triclosan in toothpastes to fight gingivitis, but recent studies question its safety. The FDA is in the process of reviewing available evidence on the safety of triclosan, but has not yet published its findings. Until then, I am avoiding it.
(Triclosan is so common in toothpastes, soaps, deodorants and other personal products that it can be found in the urine of 75 percent of Americans over the age of 5.) 😯
I also avoid toothpastes with silica (sand). Silica is an abrasive that “whitens” the teeth. Actually, over time it thins the surface of the tooth and causes sensitive teeth. No thanks.
There are many more considerations when buying toothpaste – gel or paste, flavors, tube or pump – but make sure you are getting the ingredients you want and avoiding those you don’t. Ignore the advertising hype that just encourages you to pay more than you need to.
The ADA has a list of common toothpaste additives, such as thickeners and foaming agents.
The mechanical brushing of your teeth and flossing (twice a day!) are the most effective ways to keep your mouth clean and healthy.