You have just successfully navigated the wall of toothbrushes.
Now for the wall of toothpaste – just as complicated, with added bonus of remarkable, if not extraordinary, marketing claims. If half of those claims were true I would be out of a job. The fact that I am not ought to tell you something . . .
I often ask people what tooth paste they use. Then I ask ‘why that one’? At this point most people look a bit bewildered and say ‘I don’t know, I just always pick that one because its easiest’.
The first question, before exploring how to pick a good one, is to consider what is the purpose of toothpaste – why do we need it at all?
Toothpaste is a product that helps break up the biofilm*,the layer of bacteria that grows over and between the teeth, and around the gums. It helps the toothbrush to do its job thoroughly. It also adds minerals such as calcium and fluoride to help strengthen tooth structure and a flavour to make the breath fresh.
Without toothpaste the very stubborn, sticky and harming biofilm could not be removed.
The key ingredients in toothpaste are:
Abrasive – Toothpaste needs a very mild grittiness to work, because biofilm* is very tenacious,
Detergent – A very mild detergent helps breakdown the matrix in the biofilm that bacteria have built, and it binds up the loose bacteria so they can be rinsed away,
Mineralising agent – Most toothpastes contain fluoride. Some use calcium or other minerals such as strontium,
Flavour – This is purely to make the breath feel fresh and clean.
So how do you choose a toothpaste when confronted by the wall?
Keep it very simple. Multiple ingredients are not better. Plain ones work just as well as the ones with ‘special’ additives.
Don’t fall for marketing hype, or extravagant claims.
Look beyond the market dominators – this means you will need to bend your knees to see below the ‘magic, big sales’ zone.
If you find a toothpaste that feels lovely and tastes pleasant you will be more likely to use it. Try it out for a week, and buy more if you love it.
Talk to your dentist, just make sure they are unbiased.
And don’t automatically fall for the samples we dentists give out. We get them delivered to us (for free) in truckloads and have to get rid of them. Ask your dentist if they back the sample 100%, and why. . .
There are many possible toothpaste options. Here is a run-down of their value:
Whitening toothpastes. How well do these work? I have never seen anyone ‘whiten’ their teeth with whitening toothpaste alone. They might help sustain your tooth whitening results. . . but no better than if you just cut back on the quantity of coffee, tea and red wine you drink 😳😬😁.
Desensitising toothpaste. Some are very effective, but quite a few of them are a waste of time and money. The most effective ones contain some form of stannous fluoride or a strontium-based additive. Ask your dentist for specific guidance on the one you need. And take your glasses to read the ingredients list.
Antibacterial toothpaste. Not needed. Detergent is a very effective antibacterial because it wraps up their surface and makes it impossible for them to stick back onto the teeth and gums. Anything else runs to risk of breeding resistant bacteria, as has already happened. Triclosan should be avoided.
Baking soda toothpaste. Too abrasive for long term use. This should be used occasionally, when teeth are feeling extra sticky.
Charcoal toothpaste for removal of stains. Too abrasive for long term use. The use of charcoal is unstudied and unproven to have any benefits. Risks are unknown.
Smokers toothpaste. This stuff should come with a warning. These products are incredibly abrasive and harming. I have seen tooth enamel abraded away with their use.
Fluoride free toothpaste. I use a fluoride free toothpaste, but I also have a very low sugar diet. If you want to use these toothpastes, reduce your sugar intake.
Herbal, homeopathic toothpastes. A low sugar diet is essential.
Anti-tartar toothpaste. Never seen it work. They can make teeth sensitive.
Toothpaste has an important role to play in cleaning teeth, but it is not the miracle product that marketing makes it out to be.
What makes toothpaste work is not a list of ‘super’ ingredients, it is how well you brush with it and how much time and awareness you dedicate to your brushing.
Get your dental healthcare professional to show you how to brush. Brush in that way, and you will maximise your toothpaste to its full potential.
*Biofilm was called ‘plaque’ in the old days.