My sister sent me a note recently asking about toothpaste. She saw our recent Facebook post showing a typical “wall of toothpaste” from a local grocery store. She asks, “I’ve often wondered which paste is best to choose, and since there are so many, I almost always choose the cheapest one that has whitening. Thanks for taking the time to share and let me know the differences!” There are countless types of toothpastes available over the counter/off the web and, with that in mind, I’d like to break them down into several categories to keep things simple. For simplicity’s sake, most of what you’ll find over the counter contains fluoride at a therapeutic dose, but there are numerous non-fluoridated options available online and through health food stores or dental practices which accomplish similar goals.
The first is your obvious generic toothpastes – Crest, Colgate, Tom’s of Maine, Rembrandt, Arm & Hammer, and Aquafresh all produce a standard run of the mill toothpaste and most have very similar ingredients and flavors to help the toothbrush debride plaque and food debris away from teeth. I caution patients that toothpastes with baking soda or aggressive abrasives in them can accelerate gum loss/recession and erosion of tooth structure.
WHITEN YOUR SMILE
The second is whitening toothpaste. Again the same manufacturers all have whitening toothpaste products, but not all whitening toothpastes are created equal. The goal of a whitening toothpaste in general is to produce a product which can overcome and remove the surface stains our teeth are subject to form due to our western diet. These products, as well as most ‘homemade’ whitening toothpastes, do a fantastic job of whitening simply by stain removal, but they do not penetrate the tooth adequately to whiten the underlying dentin which is naturally a darker yellow shade. Sustained application of a whitening agent is necessary to whiten the underlying dentin. I caution patients to carefully read the ingredients list of any whitening toothpaste, as the chemistry involved can be irritating to the gums, and we have also found examples which contain phosphoric acid which is known to demineralize tooth structure.
Speaking of demineralization, the third category are products designed to remineralize or strengthen teeth. Colgate, Sensodyne, Crest, and many others have recently introduced these products which previously were only available through a dental office or prescription. Many of these toothpastes will have “enamel health” in some way, shape, or form on the labeling. These products contain calcium and phosphate ions in a delivery system designed to help ‘bathe’ the tooth resulting in remineralization over time. These are best used at night time as the very last product (including water) consumed or used orally. I firmly believe these pastes to be a game-changer in the quest to reduce cavities and prolong the lifespan of dental restorations.
For people who accumulate plaque and calculus rapidly, most of the major manufacturers have developed tartar control toothpastes. One of my favorite comedians, Mitch Headberg, used to say “I use tartar control toothpaste. I still have tartar, but that stuff is under control!” These toothpastes are designed to reduce tartar formation AFTER the teeth have been thoroughly cleaned. Once it’s there, it’s not coming off with toothpaste alone. Like whitening toothpastes, these products can have abrasives and chemistry in them designed to reduce the ability for tartar to attach to teeth.
Lastly, we have our desensitizing toothpastes. Almost everyone is making a desensitizing toothpaste, but the king of the hill remains Sensodyne after decades of successful application. Sensodyne has released a full line of toothpastes now and has something for everyone, including whitening toothpastes. The methodology behind a whitening paste is to essentially block the microscopic tubules (think pores) present in teeth which allow the outside environment to be communicated to the nerve inside the tooth. Proper use can reduce or even eliminate most run-of-the-mill sensitivity if applied similarly to remineralizing product.
Which paste is right for you? Spend a little bit of time and look at the products available but ignore the price. When in doubt, go for a total care type paste which incorporates several benefits in one tube. And don’t forget to floss.