Toothpaste is not always paste. It can be a gel, powder, or paste that you brush onto your teeth and gums to help get rid of accumulating plaque and improve your oral health. According to the American Dental Association (ADA), toothpaste is important to oral health because it helps to remove plaque and its bacterial buildup on teeth and fights off periodontal (gum) disease. Most toothpaste also contains fluoride, which bolsters tooth enamel and fights tooth decay.
What's in Toothpaste?
The exact composition of different toothpastes may vary slightly depending on the benefits being touted by the particular brand (such as whitening teeth or reducing gum inflammation). In general, toothpastes include the following ingredients:
- Gentle abrasives, such as magnesium carbonate, dehydrated silica gels, calcium carbonate, hydrated aluminum oxides, and phosphate salts.
- Glycerol, sorbitol, or other so-called “humectants,” substances that keep the toothpaste from drying out.
- Thickeners like seaweed or mineral colloids, synthetic cellulose, or natural gum to give the toothpaste a homogeneous appearance and texture.
- Fluoride to help make tooth enamel stronger and more resistant to decay.
- Flavoring agents that do not cause tooth decay, such as saccharin.
- Detergents, such as sodium lauryl sarcosinate, to make the toothpaste foamy.
With the dizzying array of toothpaste choices in a typical drugstore aisle, it can be daunting to try and find one that's right for you. “One almost needs a PhD degree to weather the dental 'aisle of confusion',” says Richard H. Price, DMD, spokesperson for the ADA, and a former clinical instructor at Boston University Henry M. Goldman School of Dental Medicine.
When choosing a toothpaste, the first order of business is to make sure that the product is safe and will do what it claims. Toothpastes containing fluoride are regulated by the U.S. Food and Drug Administration (FDA) since they make disease-fighting claims. These products will display a standard “drug facts” panel on the packaging listing active ingredients, warnings, and other relevant information. Toothpastes without fluoride are considered cosmetics and, therefore, do not fall under FDA supervision. However, these products should still provide a list of ingredients. To avoid counterfeit and unregulated products, steer away from any toothpaste that doesn’t clearly state ingredient information or is not properly labeled.
Confused toothpaste shoppers can find additional guidance by looking for the ADA seal of approval. This symbol indicates that the manufacturer has participated in a voluntary testing program conducted by the ADA to gauge a product’s safety and effectiveness. Any toothpaste containing sugar, for example, will not get the ADA seal of approval.
“With the ADA seal on it, you know that it will do what it says,” notes Dr. Price, who is retired from a 35-year private group dental practice in Newton, Mass.
The Benefits of Fluoride in Toothpaste
A key ingredient in toothpaste is fluoride. Fluoride has broad benefits for people, both young and old. “Fluoride toothpaste is not just for kids — it is beneficial for us our whole lives,” says Price. “The fluoride in the toothpaste heals and remineralizes microscopic cavities as they form, it hardens the tooth surface, making it more resistant to the acid attack of bacteria, and slows down the action of these acid-producing bacteria.”
Fluoride Safety
Although the FDA requires fluoride toothpaste to carry a warning label urging parents to contact a poison control center if their child accidentally consumes a large quantity of toothpaste, the ADA’s Council on Scientific Affairs takes the position that the FDA warning overstates the risks of ingested fluoride to children. According to the ADA statement, children cannot swallow enough fluoride from toothpaste during normal brushing to cause any serious problems. Nevertheless, to be on the safe side, Price recommends limiting children under age 5 to a pea-sized amount of toothpaste and supervising their brushing since most young children haven’t learned to rinse rather than swallow at the end of brushing.
Toothpaste for Particular Tooth and Gum Conditions
No matter what your personal oral health needs are, there’s likely a toothpaste for you.
If you have sensitive teeth, look for products with ingredients such as potassium nitrate or strontium chloride. To fight gingivitis or tartar buildup, choose a toothpaste that contains pyrophosphates, triclosan, and zinc citrate. In addition, you can find products designed to combat bad breath or formulated with special abrasives to help whiten stained teeth.
“If you have special needs, such as teeth that are sensitive to cold or heat, or problems with tartar buildup, look for toothpastes that address these issues that carry the ADA seal, or speak with your dentist for a recommendation,” Price advises.
Medically reviewed by Cynthia Haines, MD
