What Is The Most Effective Toothpaste?

By Kimberly A. Loos, D.D.S.

Introduction:

Advertising can be a seductive force! This statement is especially true with respect to dentifrices (toothpastes). The proliferation of specialty toothpastes over the last 5 years has clogged pharmacy shelves and confused many consumers. This product diversification helped American toothpaste sales exceed 1.4 billion dollars in 1994, according to Information Resources Incorporated. Advertisements suggest that we need a tartar control toothpaste for removing tartar, a whitening toothpaste to brighten teeth, and even a gum care toothpaste to prevent gum disease. Is this all true?

Many toothpastes share common ingredients. The average toothpaste is about 75umectant and water, 20% abrasive (silica or powdered calcium), 1-2 foaming and flavoring agents, 1-2 0x80ca210H buffers, 1-1.5oloring agents, binders and opacifiers, and 0.1-0.3 0.000000luoride. Most fluoride toothpastes contain stannous fluoride, sodium fluoride or monofluoride phosphate (MFP). So, what is the most effective toothpaste?

Answer: Any toothpaste that contains fluoride and is applied to the teeth correctly is an effective cavity preventative. However, there are other factors to consider when using a toothpaste! The truth is that there may not be one single brand of toothpaste that is the best. I elaborate on different types of toothpastes in the sections below.

Tartar control toothpastes:

Most studies suggest that tartar control toothpastes do not remove tartar. They do seem to prevent the accumulation of additional tartar, however. They do not reduce the tartar that forms below the gum line, which is the area where tartar can cause gum disease. This is why it is important for your dentist or hygienist to perform regular professional cleanings. Many companies, including Procter & Gamble, are currently working to formulate a tartar control dentifrice that also fights plaque and gingivitis.

Toothpastes vs. gels:

While gels may seem less abrasive than pastes, this is not the case. Actually, gels can be more abrasive because of the silica (sand) used to make them. However, both are safe, effective cleaners -- use whichever type you prefer.

Gum care toothpastes:

Gum Care toothpastes have questionable efficacy. This type of paste contains stannous fluoride as opposed to sodium fluoride found in other types of paste. While some studies show stannous fluoride may be helpful in reducing the incidence of gingivitis (a reversible form of gum disease), it has also been suggested that stannous fluoride is not as effective in protecting against cavities as sodium fluoride. Any toothpaste containing fluoride is recommended over non-fluoridated pastes.

Baking soda toothpastes:

Baking Soda toothpastes have mounted an incredible comeback in recent years. I have not seen any conclusive studies that prove baking soda toothpastes significantly reduce cavities compared to other toothpastes. Some people enjoy the taste and feel of baking soda or mint toothpastes. The attractive taste of baking soda and mint toothpastes may encourage people to brush longer. This is advantageous. However, many baking soda toothpastes may also contain peroxides which can irritate and damage gum tissue. These peroxide formulas can be dangerous. Advertisers have conditioned people to believe that the fizzing action of the combined baking soda and peroxide clean teeth. People think they are getting extra cleaning action from the bubbling activity but there is no scientifically proven therapeutic activity! The American Dental Association (ADA) believes that the current levels of peroxide in toothpaste are safe. Still, peroxide toothpastes are controversial. Peroxide toothpastes are not sold in Canada.

Abrasive "smoker's" toothpastes:

These toothpastes are not recommended as they can cause recession of the gums and abrasion (slow removal) of tooth structure. The best way to rid your teeth of smoking stains is to quit smoking and then have a professional cleaning by a dentist or dental hygienist.

Toothpastes for sensitive teeth:

About 20 percent of all adults will experience sensitive teeth during their lifetime. You should have any sensitivity checked by your dentist first to be sure it is not a symptom of a more serious problem. Sensitive toothpastes work for the 80-85 percent of the population that regularly brush with them. Generally, they are needed when a patient has had gum recession, thereby exposing the root of the tooth. Once this exposure occurs, a tooth can be sensitive to hot or cold temperatures or sweet and sour foods. Sensodyne is the major brand on the market. Now, many more brands are jumping on the bandwagon. Some brands use different ingredients, including potassium nitrate, sodium citrate or strontium, as their desensitizing agents. If one brand does not reduce sensitivity, try a different brand.

Whitening toothpastes:

Again, one must be careful when using these dentifrices due to their abrasivity. These should not be used exclusively but should be incorporated into a routine using a fluoride paste. Do not use a whitening paste every time you brush; use it only once every day or two. Certain brands can be more abrasive than others. Brands with sodium pyrophosphate are very abrasive. Rembrandt is one of the least abrasive whitening toothpastes. I question the effectiveness of whitening toothpastes. Some people claim to notice a brightening of tooth color, while others notice no change. This difference is partly due to variety in diet and tooth structure among people. If you are serious about whitening your teeth, you should discuss various options, including bleaching, with your dentist.

Bleaching kits:

It is highly recommended that you have your teeth whitened under the supervision of a qualified dentist. The "at home" bleaching kits available over the counter in many drug stores can be dangerous. The trays that contain the bleaching agent are not custom made which often causes leakage of the peroxide or other whitening agent. Gum tissue can be irritated or damaged by these kits.

The take home message:

Brush with a fluoride toothpaste for 2 minutes at least twice a day using a soft bristled toothbrush. Most people only brush their teeth for about 20 seconds on average! Your toothpaste should also bear the ADA (American Dental Association) seal of approval on the container, which means that adequate evidence for safety and efficacy have been demonstrated in controlled, clinical trials. The mechanical action employed using the proper brushing technique is more important than the brand of toothpaste you purchase. Contrary to what toothpaste commercials show, the amount of toothpaste or gel needed on your brush for effective cleaning should only be pea-sized. Flossing at least once a day is also very important because it removes food and plaque from between teeth where even the best toothbrush and toothpaste are ineffective. Studies suggest that plaque (bacteria) regrow on clean teeth about 4 hours after brushing. Brush and floss regularly!

History Of Toothpaste:

Ever wonder where toothpaste and mouthwash came from? Have you ever thought about what people used for toothpaste before the invention of Crest, Colgate or Aquafresh? . Below are some interesting, point form facts and recipes that may help satisfy your curiosity - or spur it on!! Our own thoughts or side comments are added in printing like this.

Back in the Days of Buddha....

• The activity of keeping the mouth clean dates all the way back to the religious figure Buddha. It has been recorded that he would use a "tooth stick" from the God Sakka as part of his personal hygiene regimen.

• In 23 - 79 AD the practice of oral hygiene included:

• Drinking goats milk for sweet breath

• Ashes from burnt mice heads, rabbits heads, wolves heads, ox heels and goats feet were thought to benefit the gums. (This probably wouldn't go over very well today)

• Picking the bones out of wolves excrement and wearing them (maybe in the form of a necklace?) was considered to be a form of protection against toothaches.

• Washing your teeth with the blood from a tortoise three times a year was a sure bet against toothaches as well.

• Mouthwashes were known to consist of pure white wine, or (get ready for this one) old urine kept especially for this purpose.

The 18th Century

• The earliest record of an actual toothpaste was in 1780 and included scrubbing the teeth with a formula containing burnt bread. (A common North American breakfast)

• Other toothpastes around this time called for:

1 1/2 oz. dragons blood (So that's where they all went!!)
1 1/2 oz. cinnamon
1 oz. burnt alum

Beat the above ingredients together and use every second day.

The 19th Century

• In the 19th century, charcoal became very popular for teeth cleaning purposes.

• Most toothpastes at this time were in the form of a powder.

• The purpose of the tooth powder was not only to clean the teeth, but to give fresh breath. (Hmmm....that idea isn't so outdated!!)

• The succulent strawberry (still available today) was considered to be a "natural" solution for preventing tartar and giving fresh breath.

• In 1855, the Farmers Almanac included this recipe for an appropriate toothpaste:

1 oz. myrrh (fine powder)
2 spoonfuls of your best honey (This does not refer to your significant other!!)
A pinch of green sage

Mix together and use every night on wet teeth.

• Another toothpaste included:

2 oz. cuttlefish bone
1 oz. cream of tartar
2 drachms drop lake
15 drops clover oil

Powder, mix, sift.

The 20th Century

• Liquid cleansers (mouth rinses) and pastes became more popular, often containing chlorophyll to give a fresh green color.

• Bleeding gums became a concern as well as aching teeth.

• In 1915 leaves from certain trees in South East Asia (Eucalyptus) were beginning to be used in mouthwash formulas.

 So....what's in the toothpaste of the '90's?

• sodium monofluorophosphate (not to be confused with MSG)

• color

• flavoring

• fluoride

• foaming agents

• detergents

• humectants (prevent the paste from hardening)

• Herbal toothpastes have gained popularity for people looking for a "natural" toothpaste or for those who don't want fluoride in their dental cleansers. Some herbal toothpastes contain:

• peppermint oil

• myrrh

• plant extract (strawberry extract)

• special oils and cleansing agents

Hey, didn't we see these ingredients in the toothpastes of the early 19th century?

And the 21st Century....

Your guess is as good as ours!! If the trends of the 20th century continue we should see more toothpastes that whiten and brighten the teeth, are canker sore friendly, and give you the ultimate brushing or rinsing experience. Let us know if you have any thoughts on what a toothpaste or mouthwash should be able to do for you.

The more things change, the more they stay the same!