? So....what's the BEST toothpaste?
A common question that I get almost everyday is "Doc, what's the best toothpaste?" Well, let me give you a couple of facts on toothpaste. There's three real big concepts.
Number one, how abrasive is the toothpaste? Number two, what are the chemicals used in that toothpaste? Number three, does it have the ability to remineralize? Staying away from whitening toothpaste is important. The way they whiten is actually by abrading the tooth. Actually taking off a micro-layer of that tooth structure. Since humans don't regenerate enamel, I would stay away from anything that has the potential to thin or weaken the enamel over time. If you have veneers, don't use whitening toothpaste. Because of this being abrasive, the glazes can actually be removed, and this makes the porcelain more porous and dull looking over time.
When discussing the chemicals that are in the toothpaste, one thing that we want to stay away from is something called sodium lauryl sulfate, or SLS. What it is is a surfactant. It actually makes the bubbles that are in the toothpaste. Sodium lauryl sulfate actually originates from coconuts, but this chemical is far from being natural. Sodium lauryl sulfate can increase the incidence of abscess ulcers, and has actually been linked to a few cancers in certain studies.
It is also important to make sure that the toothpaste is free from something call triclosan. While it's added for its antibacterial properties, it's also an endocrine disrupting compound, and it should be of serious concern. It has been associated with the promotion of bad things like breast cancer, ovarian cancer, prostate cancer, testicular cancer. Even preterm weight babies. We can also look at the content of fluoride. Not because it's so toxic in toothpaste, the levels meaning, but because we get exposed to it in our water, so I feel it's adequate that we don't have to keep augmenting the fluoride content that we get in our toothpaste. Something else to stay away from is glycerine. It's very, very common in toothpaste and is just not needed. Glycerine coats the teeth and actually can prevent them from being remineralized.
So what are some good things to look for in a toothpaste? Well, number one, highest on my list is something called sodium bicarbonate, or good old baking soda. It's a very, very mild abrasive, and it keeps the oral environment very alkaline, i.e., not acidic. Essential oils like organic coconut oil or peppermint oil are also great additives to a toothpaste. Also look for xylitol as a sweetener, as it has antibacterial properties naturally.
A word on demineralization.
What is that? Well, enamel demineralization takes place when the teeth are exposed to acidic conditions, i.e., when the pH falls below 5.5, and this occurs when we drink things like sports drinks or have highly processed diets. Calcium and phosphate at that point are dissolved out of the tooth and eventually can cause decay with the help of certain bacteria. Calcium, phosphate, and fluoride help to remineralize the tooth under the right conditions. Saliva contains calcium, phosphate, and bicarbonate, and healthy saliva has a pH of around 6.8 to 7.4, the point at which teeth can actually heal themselves.
So what are the brands of toothpaste that I like?
Well, I like a lot of Arm and Hammer brands because they have a large component of that sodium bicarbonate. Another brand that I like is something call Earth Paste (but it's brown). It contains a lot of organic, natural compounds that are healthy for the teeth. Unfortunately, it's brown which many people don't like the look of that. Another paste is called Xyli White, and this actually has a large component of that compound that I recommended earlier called xylitol. And that helps, again, for a lot of the bacteria that are in your mouth.
Here's how to figure out if you are using the right toothpaste!
There are so many toothpastes on the market today, it's hard to decide which products to use. Before you reach for that whitening toothpaste you need to know that the abrasivity of these products can be damaging to your teeth. In fact, recent studies show that it's NOT the strength of the toothbrush bristles (hard vs. soft) that causes the damage and recession at the gum line. Rather, the cause may be the abrasive particles in everyday whitening toothpastes. You also want to choose a toothpaste that isn't too abrasive. The abrasiveness in toothpaste can scratch porcelain restorations and even natural enamel. This natural enamel is almost impossible to get back once it is gone so it is imperative that you keep it healthy. The lower the number the less abrasive the toothpaste is. The lowest level of abrasiveness runs from 0-70. 71-100 is medium abrasiveness and 101-150 is highly abrasive. You want to avoid using toothpastes altogether that run in the 151-250 mark as those are considered harmful! To be safe, choose the baking-soda toothpastes like Arm & Hammer. Plain baking soda is the least abrasive stain remover.
But it's not just stains you should be worried about. It is also important to choose products that prevent (perhaps even reverse) decay. The best products for preventing cavities are those that help strengthen and remineralize (regrow) enamel. CariFree products have a high pH, so they neutralize the acids that dissolve your enamel (which makes the teeth soft and susceptible to decay). CariFree Neutralizing Gel also contains tiny enamel-building crystals which your teeth essentially soak up and regrow enamel. These products actually strengthen "soft teeth." Your Atlanta Dental Spa team of doctors recommend the combination of a gentle stain-removing toothpaste along with enamel-strengthening products like CariFree. Using these products everyday will help to ensure stronger, healthier teeth and a brighter smile.
As always, check with your dentist to see what the best toothpaste is for you! Everyone's mouth is different and therefore every patient is going to need something different to give them optimal oral health.
Abrasivity of common toothpastes:
RDA – Dentifrice brand and variety
04 ADA reference toothbrush and plain water
07 plain baking soda
08 Arm & Hammer Tooth Powder
30 Elmex Sensitive Plus
35 Arm & Hammer Dental Care
42 Arm & Hammer Advance White Baking Soda Peroxide
44 Squigle Enamel Saver
48 Arm & Hammer Dental Care Sensitive
49 Arm & Hammer Peroxicare Tartar Control
49 Tom’s of Maine Sensitive (given as 40′s)
52 Arm & Hammer Peroxicare Regular
53 Rembrandt Original (“RDA”)
54 Arm & Hammer Dental Care PM Bold Mint
57 Tom’s of Maine Children’s, Wintermint (given as mid-50′s)
62 Supersmile 63 Rembrandt Mint (“Hefferren RDA”)
68 Colgate Regular
70 Colgate Total
70 Arm & Hammer Advance White Sensitive
70 Colgate 2-in-1 Fresh Mint (given as 50-70)
79 Sensodyne 80 AIM
83 Colgate Sensitive Maximum Strength
91 Aquafresh Sensitive
93 Tom’s of Maine Regular (given as high 80′s low 90′s)
94 Rembrandt Plus
94 Plus White
95 Crest Regular (possibly 99)
101 Natural White
103 Arm & Hammer Sensation
104 Sensodyne Extra Whitening
106 Colgate Platinum
106 Arm & Hammer Advance White Paste
107 Crest Sensitivity Protection
110 Colgate Herbal
110 Amway Glister (given as upper bound)
113 Aquafresh Whitening
117 Arm & Hammer Advance White Gel
117 Arm & Hammer Sensation Tartar Control
120 Close-Up with Baking Soda (canadian)
124 Colgate Whitening
130 Crest Extra Whitening
133 Ultra brite
144 Crest MultiCare Whitening
145 Ultra brite Advanced Whitening Formula
150 Pepsodent (given as upper bound)
165 Colgate Tartar Control (given as 155-165)
168 Arm & Hammer Dental Care PM Fresh Mint
175 Colgate Luminous (given as 150-200)
200 Colgate 2-in-1 Tartar Control/Whitening or Icy Blast/Whitening (given as 190-200)
200 FDA recommended limit 250 ADA recommended limit