November 29, 2012

Which Toothpaste Is Best?

Standing in the dental aisle, trying to decide which toothpaste to buy, is as confusing as
trying to find a needle in a haystack. After a bit of searching for that needle, everything starts to look the same and you end up blindly grabbing.

The same goes for deciding on a toothpaste.

When you stand before the hundreds of toothpaste options in the grocery store, how do you choose between tubes that shout New & Improved, 33% More Cavity Protection, Fresher Breath, or Whitens 10X Better...? Using the internet to help you decide which toothpaste is best for you can be very useful. Also very confusing. However, we need to learn how to filter out any information that is biased or not current. THIS, my friends, is a job for your friendly dental hygienist.

THIS is where I come into the picture.

[Fun fact: Most people will buy the moderately priced product that is conveniently situated at eye level, thanks to that product's marketing team.]

Let me begin by explaining the initial, basic function of toothpaste: to freshen breath and to motivate you to brush. That is it, friends.

So, technically, it is possible to brush without toothpaste. In fact, the most important part of brushing is HOW you brush, NOT what toothpaste you use.

HOWEVER, don't get any funny ideas because this is 2012--we know better than to go without. These days we are lucky enough to be able to add certain ingredients to our toothpaste to help out other oral problems like cavities, gum disease, bad breath, and sensitivity. The biggest and most important of these added ingredients is fluoride. No matter how controversial you think fluoride is (I always recommend you check out your facts and sources), there has been enough research completed in the USofA to know that the majority of Americans need a certain amount of fluoride in their diet on a daily basis. If you would like to argue that point, email me.

What this means to you, is that as long as your toothpaste has fluoride in, then it does not matter which one you buy. My favorite? Aim. Minimal ingredients. Always on the bottom shelf. Always less than $1. A little retro-looking. Tastes good, too!
So what's with all these other claims? For a toothpaste to claim that it fights plaque, whitens teeth, decreases sensitivity, or prevents cavities, it has to have certain ingredients in the formulation. Many of these ingredients are tried and true. Others are newer and can be controversial. When deciding on a toothpaste, start with the basic, like Aim. Then build from that... Do you have sensitive teeth? Do you want whiter teeth? Do you get a lot of cavities? Do you have gum disease? Let me break down the most common claims for you:

  • Anti-cavity: Any toothpaste with the proper amount of fluoride in may claim this.
  • Anti-plaque: These toothpastes must include essential oils or one of the many antibacterial agents on the market (alcohol, stannous fluoride, Triclosan***).
  • Anti-tartar: Plaque is always the first step in building tartar (aka calculus). Therefore, any toothpaste that claims it is anti-plaque can also automatically claim  that it is anti-tartar (more on that later).
  • Strengthens enamel: Again, any toothpaste with fluoride in may claim this.
  • Whitens: For a toothpaste to claim that it can whiten teeth, it either has to include an abrasive particle (hydrated silica, baking soda, etc) or a bleaching agent (carbamide peroxide or hydrogen peroxide).
  • Sensitivity: Fluoride, in general, always helps with sensitivity. In addition, many popular sensitivity toothpastes (aka Sensodyne) use ingredients such as potassium nitrate to chemically aid in preventing pain.
  • Freshens breath: Since this is a cosmetic claim and mostly subjective, it is not as closely regulated (aka just throw in a mint leaf and anyone can claim it).

***I would like to specifically introduce you to Triclosan, the magic ingredient behind Colgate Total. Triclosan is a broad-spectrum antimicrobial agent. What this means, is that is kills lots of bacteria in your mouth. Colgate's claim is that for 12 hours it will kill the bacteria that causes plaque. While this is good and great, I have two problems with it: 1) Although it was proven safe and effective in the past, the FDA is investigating it once again due to recent complaints. They are to release an updated report sometime soon; 2) There are over 500 different types of bacteria in your mouth- bad bacteria AND good bacteria. Triclosan not only kills the plaque bacteria but the good stuff as well.

So, let's say that you get cavities, have bad breath, and want whiter teeth. Then choose any toothpaste that claims to whiten. What if you have never had a cavity, but your hygienist says you have a plaque problem, plus you want white teeth? Choose a toothpaste that whitens and is anti-plaque. If your only problem is sensitive teeth? Then use a sensitivity toothpaste. If you are fine with your teeth? Aim.

There are two toothpastes that claim to do all of the above: Crest ProHealth and Colgate Total. So if you want to cover all your bases, then use one of those.

Beware of any toothpaste that states New & Improved. Many times, this means that the amount of one, single ingredient (such as a flavoring) has been slightly changed... making it "new" and raising the price.

If you are still confused after all of this, just go browse the cheap toothpastes on the lowest shelf. They get lonely down there.

I wanted to be brief, so I will leave it at that. As always if you need clarification, feel free to email me.

Now, if you wonder which floss you should use? Well, that's a much easier discussion to have. That's up next.

Your friendly dental hygienist, (m)

*As always, I try to present the most current, valid, un-biased facts on dentistry. I promise I will clearly note when I am giving my opinion. The medical field is always changing, so when new research comes out, I will do my best to update you. If you are curious to know where I get my facts, please go here and here or feel free to contact me.

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