What’s in My Toothpaste?

Broaching the fluoride issue
By Cara Lucas

Have you ever thought about what’s actually in your toothpaste? What’s in that magic blend of minty white and blue that fights cavities and plaque? Should you beware of any suspicious ingredients as you skim through the list on the back of the box in the grocery aisle?

Enough questions—it’s time for some answers.

The American Dental Association recommends using only toothpastes that contain fluoride and exclude sugar. Other than those two inflexible standards, the ADA allows some latitude with regard to ingredients, which could include abrasives that remove debris; humectants that stop toothpastes from losing water; flavoring and/or sweeteners; thickening components; and detergents to create foam.

To get the ADA seal, a toothpaste must show safety and effectiveness in human clinical studies, and pass laboratory studies conducted by the ADA on fluoride availability and release. Most major brands (including Colgate and Crest) have been approved by the ADA. But don’t get too excited—that doesn’t necessarily mean they are safe. And keep in mind that consumer toothpaste companies are among the largest contributors to the ADA.

Fluoride

You’ve probably heard your dentist or hygienist recommend fluoride in your toothpaste. It is there to strengthen and remineralize the enamel (hard, mineralized part of the tooth) softened by exposure to acid in the mouth, which leads to tooth decay.

One report gathered 74 studies of applied fluoride use in dentistry and concluded that the benefits of the ingredient are “supported by more than half a century of research,” and that fluoride does indeed prevent cavities. Another study says that less tooth deterioration was shown in “the presence of fluoride toothpaste than in the presence of the non-fluoride toothpaste with an otherwise identical formulation.”

Lately, however, fluoride has received some backlash. There are several reasons for the fluoride counterattack, with the main controversy surrounding the issue of toxicity. Children are at risk of dental fluorosis, which is caused by excessive fluoride intake and can appear as white streaks on teeth or even brown, stained, and pitted teeth. According to the CDC this is because their permanent teeth are still developing under the gums. Once the teeth break through the gums they are no longer at risk.

Increases in the occurrence of mostly mild dental fluorosis have occurred as more sources of fluoride became available to prevent tooth decay. These sources include drinking water with fluoride, fluoride toothpaste—especially problematic if swallowed by young children—and dietary prescription supplements in tablets or drops (particularly if prescribed to children already drinking fluoridated water).

In the US, water and processed beverages (i.e., soft drinks and fruit juices) can provide approximately 75 percent of a person’s fluoride intake. For this reason the CDC recommends parents supervise the use of fluoride toothpaste by children under 6 to encourage them to spit out excess toothpaste. Also avoid the use of fluoride mouth rinses in children under 6 because the mouth rinse could be repeatedly swallowed.

But some research says that just about anyone can be at risk or even poisoned if they swallow small amounts of toothpaste on a regular basis. Some people are even leery of drinking regular tap water because it’s often being treated with fluoride. And they may have a point: There have been 34 human studies and 100 animal studies linking fluoride consumption with brain damage and evidence linking fluoride with a number of other health concerns. Due to these concerns, most of the world’s other developed countries have chosen not to fluoridate their water supply.

There is also strong evidence suggesting that whatever dental benefits fluoride conveys are achieved from topical treatment (i.e., toothpaste and mouthwash) rather than systemic (i.e., drinking water).

Other tainted ingredients

It turns out that it’s not just fluoride in toothpaste that can cause a problem—there are other ingredients to be on the lookout for as well. Saccharin, which gives toothpaste its sweet taste, has been linked to cancer in rats by several studies. There is, however, no clear evidence that it is linked to cancer in humans.

Another ingredient that some prefer to avoid is sodium lauryl sulfate. Not only is it an irritant, it has also been linked to canker sores (also known as aphthous ulcers) in several studies.

Finally, triclosan—an ingredient used to kill bacteria and prevent gingivitis—has been the subject of some scrutiny. While studies have found that it kills harmful germs in the mouth, it is important to note that some research has linked triclosan to hormonal alterations in animals.

Natural remedies

While this information might seem daunting, you don’t have to be afraid of brushing your teeth. There are lots of natural alternatives that don’t contain potentially harmful ingredients

The most basic toothpaste alternative is a simple tooth powder. You can use baking soda alone or combine it with salt for a gentle yet abrasive clean, or you can use a mineral powder like calcium and/or magnesium. Some prefer to add hydrogen peroxide to their tooth powder right before use.

You can add coconut oil to your recipe to form a paste (and for its beneficial antibacterial properties) and essential oils for flavor. If you are searching for a solution to the salty taste of the baking soda and salt, try adding xylitol to help combat the saltiness. Since xylitol is a sweetener, it may seem an odd thing to add to a toothpaste, but it actually helps reduce cavities by counteracting acidity in the mouth and increases tooth remineralization.

 

Homemade toothpaste

2 tablespoons coconut oil

2 tablespoons baking soda

2 tablespoons calcium magnesium powder

2 tablespoons xylitol or green stevia powder

2 teaspoons real sea salt

20 drops essential oil (like peppermint)

10 drops trace minerals

 

Toothpastes We Love

>>Auromere Ayurvedic Non-Foaming Toothpaste, 6.16 oz, $6, auromere.com

>>TheraNeem Toothpaste, Mint or Cinnamon, 4.23 oz, $8, organixsouth.com

>>Spry Xylitol Toothpaste, Spearmint or Cool Mint, 4 oz, $5, xclear.com

>>Nature’s Gate Wintergreen Gel, 5 oz, $6, natures-gate.com