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Posted on August 15, 2014
What’s in a Toothpaste?

We have to remember in selecting a toothpaste that the marketing and selling of toothpaste in a billion dollar industry and is heavily influenced by advertisement. We have also seen a recent trend in that new toothpastes are not bothering any longer with the American Dental Association seal of approval. In response, old stalwarts like Crest and Colgate have also not strived for that distinction. It has become buyer beware. Here are a few facts that may help you select a good toothpaste for your family.

The three main ingredients that make a scientifically proven difference in a toothpaste preventing cavities are Fluoride, abrasives and detergents.

Fluoride is a naturally occurring mineral that in the presence of saliva with calcium and phosphates, actually can rebuild the mineral structure of enamel. It does this by replacing the hydoxy ion of the enamel crystal call hydroxyapetite with fluoride ion to produce fluoroapetite crystals. This fluoride enhanced enamel crystal is less soluble and more acid resistant making the teeth harder and less prone to cavities caused by plaque acid.

In toothpaste, different types of Fluoride salts are used. The most common is Sodium Fluoride that can be flavored and is usually present in a concentration of 0.243% weight/ volume or about 1100 parts per million fluoride. Tap water has about 1ppm fluoride, and saliva has about 0.01ppm fluoride. After you brush your teeth, the fluoride concentration stays high enough in your mouth for 1-2 hours and allows your teeth to remineralize or repair. Drinking water also raises the fluoride level, but snacks and sugared drinks allow bacteria to produce acid and demineralize your teeth. This cycle is endless unless demineralization outpaces remineralization and a hole or cavity is formed. That is irreversible! Luckily I can recommend a good dentist for you or your parents.

Abrasives are the second main ingredient. I tell people this is simply flavored sand that helps scour off plaque from teeth. In the old days undissolved baking soda did the trick, but now words like silica hydrated silicates simply mean clean sand.

Detergents are the long chain negative charged molecules that surround the plaque in foam and are rinsed away. They are usually called SDS or SLS – sodium laurel sulfates. More SLS gives you more foam and toothpastes vary. Tom’s on Maine used to not have SLS and some people are sensitive to it, but alas Tom’s has it now too. Other detergents are poloxamers that also act to bind the ingredients of toothpaste together and keep them in suspension or emulsions.

Triclosam in Colgate toothpaste is also a detergent. You may recognize it as also the ingredient in antimicrobial soap. It has been clinically proven to lessen gingivitis or gum inflammation. In that regard it is great. Problem is that it makes the toothpaste taste soapy. It’s the Ying with the Yang, ain’t it?

Other ingredients include lubricators, sweeteners and anticalculus additives:

Glycerin is a slippery agent that allows liquids to squish against your teeth and leaves teeth feeling slick and maybe clean. This is one of main ingredients in mouthwash as well.

Sweeteners for toothpaste are usually sorbital or saccarhin. Sorbital is a sugar alcohol that tastes sweet but bacteria can’t use it very well to create plaque and it is calorie free. You also see it in sugar free gum. Xylitol is another sugar alcohol. It can actually stop the growth of the main cavity causing bacteria call strep mutans. Unfortunately, you need to eat about 6-10grams a day to get that effect. As of now Xylitol in toothpaste only makes it more expensive, not more effective.

One other ingredient may be worth noting. None of the child marketed toothpastes have it, but compounds such at tetrasodium pyrophosphate and its cousins disodium pyrophosphates and tetrapotssium pyrophosphates have been shown to reduce calculus build up. They do this by inhibiting the cross linking on minerals in your saliva. In order for them to work, the teeth must be first professionally cleaned to rid the mouth of any seeding calculus, and the toothpastes must be consistently used. For children who build calculus quickly or children who pool saliva, this may be worth looking into. Crest Tartar control is the best brand to get all three compounds.

I hope this helps you read a toothpaste label. If you have any questions about safety or what is marketing let me know. Lots of brands I won’t mention here, stretch the truth on sensitivity, whitening and other claims. And remember, in the United States at least, kid toothpaste has the same amount of fluoride as adult toothpaste. Please, please, monitor and assist your young child in brushing so they don’t swallow toothpaste and cause fluorosis on their permanent teeth! Yours, Dr. Greg