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Which Toothpaste Should I Use?

Whiter, Brighter, Fresher – Which Toothpaste, Doc?

Synopsis: Buy a name brand containing fluoride. It should be ADA (American Dental Association approved) Get the plain vanilla version. If you try a new toothpaste and your mouth starts feeling irritated, for heaven’s sake, stop using it!

Secret #1 the FDA classifies toothpastes as cosmetics unless a medical claim is made (ie. reduces cavities). Whiter, brighter and fresher are adjectives passed down from the soap industry. Is it any coincidence that the two big names in American toothpastes are Colgate-Palmolive and Procter and Gamble?

Secret #2 – The secret is not the toothpaste. It’s the mechanical massage and cleaning that keeps your gums and teeth healthy. Your body is what fights the germs.

Secret #3Toothpastes for the most part are detergents with abrasive, lubricant, fluoride and flavoring agent. Variants contain antibacterials (triclosan is one); Desensitizing agents (Potassium Nitrate); Anti-tartar ingredients (pyrophosphates). Every company will show you how much better clinically their paste is than their competitor’s. Your mileage may vary.

So why buy a large name brand? Because a large corporation can’t afford a scandal – it could ruin their product line. They are going to market a fairly benign product that does no harm. This is exactly what you want. Your mouth is a very sensitive place and you can damage it with harsh chemicals! Also, a brand name toothpaste will sell out more rapidly from the store shelf ensuring that the product is fresher.

What about additives?

  • Sensitive Teeth (potassium nitrate) – The desensitizing additives really work. Use the desensitizing toothpaste as your only brand for at least a tube or two. Personally, I use Sensodyne Pro-enamel. Most all desensitizing toothpastes contain the same active ingredient – potassium nitrate.
  • Anti-tartar (pyrophosphates) – I have not been impressed with this ingredient. Soon after it was introduced to the market, there were sensitivity issues associated with it. In turn, the concentration was decreased by the manufacturers. Any effect is minimal.
  • Anti-bacterial (triclosan) – killing bacteria is a tricky thing. Not all bacteria are bad. Personally, I don’t want the extra chemical in my toothpaste on a regular basis.Occasionally, when I want to decrease the bacterial count in my mount (like when I have a sore throat), I will use a prescription mouthwash with chlorhexidine.
  • Anti-stain – Peroxide does remove stain but it loses ts oomph very easily. Peroxide based toothpastes have to be fresh and used regularly as directed to have any significant effect. Another way to remove stain is with abrasives (grit).This is a two-edged sword. In the short-term you remove stain, but with regular use you will remove tooth! I saw one toothpaste at a natural foods store that used kaolin (clay) as an abrasive – YIKES! Sure – it was all natural and hazardous to your teeth.
  • SLS – (Detergent) – Sodium Lauryl Sulfate (SLS) is a detergent also used in shampoo. It  removes stuff (my scientific name for organic matter) from your teeth and gums and gives you that very clean feeling. It also removes the protective salivary layer. If you have a dry mouth or canker sores, look for SLS free toothpaste (Pro-enamel and Rembrandt are SLS free)
  • High Fluoride toothpastes like Prevident.  I prescribe a high fluoride toothpaste (Prevident 5000) for my patients who have exhibited a high decay rate or are at risk for a high decay rate. This has 5 times the amount of fluoride in your regular toothpaste. They work well if you follow the directions. Let me repeat that! Follow the directions!
  •  Baking Soda – Won’t hurt you. It breaks down very quickly when brushing. Note #1: if you are salt sensitive, you should understand that baking soda is an additional source of sodium in the diet. Note #2: Avoid mixing table salt with baking soda! Salt is very abrasive and will damage your teeth.
  • Glitter! is often made from mica. Hey it’s cute and probably not harmful – but does it belong in my mouth? Similarly, toothpastes have lots of coloring agents – F,D & C dyes and titanium dioxide (white). I sincerely doubt that any of this could kill you. You should be more worried about driving on the highway!
  • Cinammon – can cause alteration of the lining of the mouth that is fortunately reversible. IMHO, It should not be in your toothpaste.
  • Hydrogen Peroxide (and other peroxides) are very fragile compounds. If it is in your toothpaste, it has probably lost the majority of its efficacy. Peroxide is fairly benign. It will bleach the teeth to some extent and kill some germs.

As you can guess, this is not the exhaustive list of additives. Again, they are for the most part benign. You spit the majority of the toothpaste out and at most are exposed to these ingredients for about two minutes a day. And even in those two minutes, these ingredients are buffered and diluted by saliva. Should you develop issues when using a new toothpaste, just stop using it!

Dr. Rick Liftig


Disclaimer: The information contained on Dr. Liftig’s website is meant to provide general information about dentistry. The information contained within this website is not intended to provide medical or dental advice, and should not be used as a substitute for medical and dental advice.  Consult your dentist or physician for your specific condition.  Dr. Liftig accepts no liability for the information provided pertaining to treatment.

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