Common Toothpaste Ingredients

There are so many different types of toothpaste out there, all with different ingredients. Which ones are important? Which ones sometimes cause allergic reactions? Can any cause harm? Let’s find out!

• Toothpaste has a pretty wide range of components. The standard formula includes the following categories in these amounts…
• Abrasives to aid in removing plaque (20-40%)
• Water (20-40%)
• Moisturizing components (20-40%)
• Foaming agents (1-2%)
• Binding agents (2%)
• Flavoring agents (2%)
• Sweetening Agents (2%)
• Therapeutic agents (up to 5%)
• Coloring or preservatives (1%)

Cavity Protection

Fluoride – Using a fluoride toothpaste is one of the single biggest things you can do to help prevent cavities. While, I’m on the fence about fluoride in the water supply, I’m am strongly for using fluoride toothpaste every day. The benefits of this are huge and you don’t get the full body exposure that you get with fluoride in in your drinking water. Most toothpastes come with 0.22% sodium fluoride (1100 parts per million / ppm) or 0.76% sodium monofluorophosphate (1000 ppm). There are some extra strength toothpastes that contain 1500 ppm, which has been shown in studies to be more effective in controlling cavities. Some Crest brand toothpastes (such as Crest Pro Health) contain a slightly different form of fluoride known as stannous fluoride. This type of fluoride helps protect against cavities as well as gingivitis but it does tend to cause significant staining in some people. 1500 ppm is the upper limit for over the counter toothpastes. A 5000 ppm toothpaste is available by prescription from your dentist or physician.

Xylitol – Xylitol is an alternative sweetener that has shown to have some benefits in preventing cavities. It isn’t nearly as effective as fluoride but can be a good adjunct or for young children who can’t use fluoride toothpaste yet.

Plaque and Gingivitis Control

Triclosan – Colgate is the only brand of toothpaste that uses triclosan as they have a patent on this formulation. Triclosan works as an antibacterial agent and reduces the total bacteria load in your mouth. Studies have shown that it helps reduce plaque and tartar build-up more so than other toothpastes that don’t contain it. There have been some concerns about triclosan as a hormone disruptor. To date, no studies have shown any problems arising from it.

Tartar Control

Tetrasodium pyrophosphate – Some people tend to build up tartar at a much higher rate than others and these people are the ones who benefit most from a tartar control toothpaste. Tartar build-up on your teeth is mostly a result of excess calcium and magnesium in your saliva. Tetrasodium pyrophosphate binds to these minerals and makes it so that they can’t be deposited on your teeth.

Abrasiveness and Whitening

Whitening in a toothpaste isn’t so much about specific ingredients, but more about how abrasive the toothpaste is. The more abrasive the toothpaste, the better you’re able to to remove heavy stains on the outside of the tooth (sometimes at the expense of some of your tooth enamel). Common abrasive ingredients in toothpaste are chalk (calcium carbonate) or baking soda. A lot of toothpastes also have silicon or aluminum oxides today. I’ve put together a chart with the estimated abrasiveness ratings of many of the toothpastes currently out there. Higher values mean that the toothpaste is more abrasive. All things else being the same, you’d like a toothpaste that is less abrasive.

Low abrasive toothpastes are usually considered 75 or below.

Medium abrasiveness is 75-100.

Highly abrasive is 100-150.

Extremely abrasive (as in don’t use) is 150+.

The FDA recommends that you never brush with product with an abrasiveness level over 200. I personally think you should use a toothpaste with less than 100.

Combating Sensitivity

Potassium nitrate – Your teeth have millions and millions of tiny tubes running through them. When your teeth become very sensitive, one method to decreasing the sensitivity is to start plugging up those tubes in your teeth. This is what potassium nitrate does if you use it consistently. One thing most people don’t know is that you have to use a sensitivity toothpaste containing potassium nitrate for about two weeks before you get the effects. Some common toothpastes that contain potassium nitrate are Sensodyne, Crest Sensi-relief, or Colgate Sensitive.

Sodium citrate – This works in a similar manner

High fluoride toothpastes – These toothpastes are only available by prescription. The most common brand is known as Prevident 5000 but there are many other generic versions as well. The 5000 stands for 5000 ppm of fluoride in the toothpaste. Standard toothpastes that you can purchase at the store only have 1000-1500 ppm. The higher levels of fluoride help strengthen your enamel and also help plug up the tubes in the teeth in a similar way to potassium nitrate.

Detergents / Foaming Agents

Sodium lauryl sulfate (SLS) – Ever wonder why your toothpaste foams when you brush with it? This ingredient is the reason why. SLS is a surfactant that is used in many products including toothpastes, shampoos, bodywashes, soaps, and detergents. There have been some concerns about SLS and cancer. To date, studies have found no link whatsoever between them. The one problem that SLS products do cause in some people are gum or skin irritation. I have quite a few patients in my dental practice who are mildly allergic to SLS and it causes them to develop mouth sores if they use a toothpaste that contains it. If you’re one of these people, look for a SLS free toothpaste. They can be more difficult to find but they are out there. Tom’s of Maine is my favorite SLS free toothpaste.

Flavorings and Other Miscellaneous Ingredients

Sweeteners – Obviously, sugar in toothpaste is a bad idea, although early formulations of toothpaste did contain honey and sugar products! The most common sweeteners currently in toothpaste include saccharin, sorbitol, and mannitol, and xylitol.

Polyethylene plastic beads – Some toothpastes have used colored plastic beads just to make the toothpaste more cosmetically appealing. These beads have a tendency to get stuck under the gumline causing a little bit of discoloration and occasionally irritation. I see them on a somewhat regular basis in patients in my dental practice. Most companies are phasing these out now due to several negative articles that have come out about them.

Cinnamon flavorings – These types of flavorings also have a tendency to cause some gum irritation in a small percentage of people. If you’re consistently getting mouth ulcers and you use anything cinnamon flavored, try using something else to see if it helps.