Toothpaste – it has been the foundation of the most basic of daily oral health routines dating back to ancient civilizations. But, how many people today actually know what makes up the concoction that we dab on our toothbrushes and scrub all over our teeth every morning and night? You’ll be happy to know that we’ve come a long way since the use of crushed bones and oyster shells, ashes, burnt eggshells and powder of ox hoof.
Toothpastes, also called dentifrices, are pastes, gels or powders that help remove plaque and strengthen tooth enamel. So, what are all of those substances listed on the side of the tube? The paste or gel itself takes its form from abrasives, water, humectants and binders. Other ingredients like detergents or surfactants; preservatives; flavor, color, and sweetening agents; fluoride; calcium phosphate; anti-bacterials; whiteners; and other agents may be added to provide certain properties to each specific toothpaste forumulation. All of these ingredients can be important for not only helping to prevent dental disease but also for giving the toothpaste the taste, appearance and feel in the mouth that makes a person want to brush with it.
Let’s take a closer look at some of the most common ingredients you will find in your toothpaste and why they are there.
• Fluoride is the key active ingredient in toothpaste that has been demonstrated in numerous clinical trials to prevent tooth decay. Fluoride affects the bacteria that cause tooth decay, but its primary action is to incorporate into the tooth structure (enamel and dentin) making the tooth more resistant to acid attack by decay-causing bacteria. It actually repairs (remineralizes) the tooth enamel that gets damaged by the acid producing bacteria present in almost everyone’s mouth. Without fluoride in the toothpaste, the cavity-preventing benefit from brushing your teeth is severely limited. Very few people brush thoroughly enough to prevent cavities by brushing alone. Over-the-counter (OTC) toothpaste in the U.S. contains fluoride at approximately 1,100 parts-per-million (ppm). There are several different fluoride formulations and all are effective in helping to prevent tooth decay. Other remineralizing agents such as amorphous calcium phosphate have demonstrated some decay prevention ability and are now being added to some toothpastes.
• Mild abrasives remove food debris and stains, as well as the sticky plaque that is always forming on the teeth. The goal is to make them abrasive enough for efficient cleaning, but not so abrasive as to damage the tooth enamel or the softer dentin or cementum that makes up the tooth root surface. Common abrasives you may see on your tube include calcium carbonate, sodium bicarbonate (baking soda), dehydrated silica gels, hydrated aluminum oxides, magnesium carbonate, phosphate salts and silicates.1
• Humectants are organic compounds that hold water and help the toothpaste maintain its moisture even when exposed to air. Examples include glycerol, propylene, glycol and sorbitol.1
• Binders or thickeners help keep the whole mix together in a nice paste or gel and stabilize this form. They provide the texture and flow to get the toothpaste onto the brush and keep it there. These include natural xanthum gums, seaweed colloids (carrageenan) and synthetic cellulose.1
• Flavor, color and sweetening agents make brushing enjoyable by providing visual appeal, pleasing taste and fresher breath. Specific ingredients vary, but common flavorings include spearmint and peppermint, though nowadays there seems to be toothpaste available in flavors for every taste including strawberry, bubblegum, vanilla, green tea, fennel and bacon – even scotch and bourbon. For a sweet taste, artificial sweeteners like saccharin or natural sweeteners like xylitol are added since they do not promote tooth decay.
• Antibacterial agents are added to reduce plaque growth, the sticky bacterial-laden film that forms constantly on the teeth and can eventually cause tooth decay and/or gingivitis and more serious gum diseases if not brushed away regularly. Some anti-plaque agents include triclosan and cetylpyridinum chloride.
• Detergents in toothpaste create foaming action that helps the toothpaste coat the teeth. The foam helps reduce surface tension on the tooth, and makes cleaning easier and food particles or debris less likely to reattach to the tooth before it can be spit out. They include sodium lauryl (dodecyl) sulfate (SLS) and sodium N-Lauryl sarcosinate. 1 Some toothpaste users have been reported to develop canker sores as a result of an allergic reaction to SLS, but SLS-free toothpastes are available.
• Preservatives prevent the growth of microbes in the toothpaste. Methyl paraben and sodium benzoate are also commonly found in food and beverage products.
• Whiteners, desensitizers and tartar preventers Other agents appear in toothpastes that make specific claims for whitening (carbamide peroxide or hydrogen peroxide); desensitizing sensitive root surfaces (potassium nitrate, arginine bicarbonate/calcium carbonate complex); and preventing tartar/calculus buildup (tetrapotassium pyrophosphate/tetra and disodium pyrophosphates, sodium hexametaphosphate). Even though some whitening toothpastes contain similar chemicals to those used in dental office bleaching, these toothpaste products work primarily by removing surface stains and don’t typically change the basic tooth shade like bleaching strips or bleaching treatments at a dental office.
For best tooth decay prevention, we recommend brushing with fluoride toothpaste at least twice a day. So, when is the best time to become one with your favorite toothpaste? Preferably right before bed and in the morning, but soon after meals is also very effective.
1 American Dental Association. Toothpaste. http://www.ada.org/1322.aspx Accessed January 2013.