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The Right Stuff?

By Robert Griggs, DMD

Choosing the right toothpaste has become a complicated, decision making process.

One walk through the aisles of any chain pharmacy or food store and you quickly realize that you’re “not in Kansas anymore”. On the occasion when I have shopped in these mega toothpaste aisles, I must admit I find some humor in watching the overwhelmed shopper try to make an educated purchase. After several tortuous minutes of watching the unsuspecting consumer face the fear that their purchase will lead to a buyer’s remorse of incalculable proportions and knowing that it could well be a month they must endure the mis-gotten tube of elixir, I step in to offer my help.

So let’s break it down into some simple categories and their differences.

Sensitive vs. all others. Sensitive toothpastes provide the active ingredient potassium nitrate or stannous fluoride. The active ingredient works by clogging the exposed porosity in the root surfaces. In general these products work well to reduce sensitivity but are not as effective at removing stains due to their low abrasiveness. They also cannot be used in combination with other toothpastes as they will render your sensitive brand useless. If you choose to use a sensitive paste, do not alternate. In the case of stannous fluoride pastes they may contribute to mild staining too, but both types do provide needed fluoride protection.

Which brings me to our next choice, All Natural toothpastes? To all my fellow tree huggers out there, be forewarned. There is nothing natural about all natural toothpaste. Last time I checked the tubes were still manufactured in a commercial plant on an assembly line and the paste was not extracted from a toothpaste tree. More importantly is my concern that some of these pastes provide no fluoride protection. (Isn’t fluoride a naturally occurring element?) Sorry for the diversion. Why is fluoride so important? Well it has the unique ability to combine with the calcium ions on your teeth. This type of chemical bond makes your tooth more resistant to the acids the bacteria produce. Its mother nature’s dirty little secret, bacteria go potty too!

To whiten or not to whiten, that is the question. Perhaps Shakespeare’s Hamlet might have been written differently in the 21st century. So really what does this mean? Well to break it down in simpler terms, most whitening toothpastes are simply more abrasive! Yes, all they do is remove stain better. If you feel like you’ve been misled, don’t worry you’re not alone. Typically these toothpastes are gels (translucent in appearance). There are a few toothpastes in this category that truly do help whiten teeth, these toothpastes have the active ingredient of either hydrogen peroxide or carbamide peroxide.

Our last category is the standard paste, this is the type many of us grew up on when there were only 2 choices, imagine that. In this category you can find other subcategories. Some claim to do just about everything, fresh breath, whiter teeth, cavity protection, tartar control and on and on and on. Some for day, some for night, and some for gums and others for re-calcification, I tell you its maddening!

And just when you thought you pulled yourself out of this black hole they throw in baking soda!

Ok, so baking soda may have some merits. One is it increases the pH in your mouth, that’s a good thing. Also if you have a bunch of bonded fillings on your front teeth it’s less abrasive so they will stay pretty longer, that’s good too. The down side is the salty taste with an attempt to mask it with some type of mint flavor and sorbitol sweetener.

So let’s regroup and try to narrow this down for you.

If you have a bunch of gum (gingival) recession and your teeth are sensitive, using a sensitive toothpaste is the way to go. If on the other hand you really want to experience that cold frosty zing, try one of those abrasive, whitening toothpastes for a week or two, then head out to the local ice cream shop! Your kids will be amazed at how you were able to connect so many bad words in one sentence.

Ok, for you heavy smoker, red wine drinking, cigar toting, tea/coffee drinkers out there, consider going no further down the aisle than the whitening toothpaste area and find your favorite flavor. Make sure you keep your dental hygiene appointments.

For the average Joe/Jane and kids a paste works well and provides everything you need in either a squeeze or pump (yes more choices). If you tend to build a lot of tartar (professionally known as calculus) then consider one that incorporates a tartar control. If your dentist tells you that he sees early cavities starting then find one that helps re-calcify teeth.

And to my tree hugger friends, don’t believe that stuff you read on the internet about the hazards of fluoride. When was the last time you read an obituary that stated, “John Doe, died at the ripe old age of 87 from excessive toothpaste use, he left behind family & friends but kept his teeth”? Spend more time on bee colony collapse, it’s important.

Finally for those of you who either have a lot of cavities, bonded fillings or dentures, a paste with baking soda would be a better choice. And for the love of God, ease up on the soda.

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