It’s a basic necessity. Brushing your teeth several times daily helps keep them clean, free of plaque-forming bacteria, and freshens the breath. In the UK, we spend £217 million a year just on toothpaste.
Brushing, like most daily tasks, can be boring, so manufacturers now advertise toothpaste so as to suggest it’s a beauty or luxury product rather than a matter of personal hygiene. This encourages consumers to buy more and at a higher price, and also draws attention away from ingredients. What’s actually in toothpaste is not something most people concern themselves with though perhaps they should.
Dental decay and gum disease affect more than just the mouth. Periodontal disease is linked with other than for risk factors like smoking and high cholesterol (J Am Dent Assoc, 1998; 129:
301-11). Poor oral health is also related to stroke, peripheral vascular disease, diabetes and preterm pregnancy.
However, toothpaste is not actually necessary for clean teeth. Dry-brushing is just as effective. Abrasives in toothpaste, such as chalk or silica, help but, essentially, the function of toothpaste is to deliver ‘active ingredients’ like fluoride, and anti-bacterials like triclosan, to the teeth and gums. That’s why modern toothpastes contain glue-like agents such as PVM/MA co-polymer to keep the active ingredients in contact with the teeth after rinsing.
For beauty and health, we rely on the active ingredients; yet, many of these may be doing more harm than good.
Fluoride myths
Many consumers buy toothpastes with fluoride believing it protects teeth. But there’s little convincing evidence of this. Unlike true nutrients, such as calcium and magnesium, no human disease-including tooth decay-will result from a fluoride `deficiency’.
In fact, fluoride is a systemic poison, and there is enough in the average family toothpaste to kill a small child if ingested (J Public Health Dent, 1997; 57: 150-8). The US and Sweden-but not the UK-require that fluoride toothpaste be labelled with a special poison warning.
Fluoride can cause sensitivity/allergy- type reactions and is now suspected in a host of illnesses, including gastric reflux, bone disorders, diabetes, thyroid dysfunction and mental impairment. Fluoride from toothpaste, tablets and water before age six is also a major risk factor for fluorosis, which mottles and discolours teeth (Pediatr Dent, 2000; 22: 269-77).
Both animal and human studies show a clear relationship between oral cancer and fluoride (Townsend Left Docs, 1990; 89: 864-5; Yiamouyiannis J, Fluoride: The Aging Factor, Delaware, OH: Health Action Press, 1993).
More recently, fluoride has been found to activate and interfere with G-proteins, chemical messengers vital to hormone and neurotransmitter function.
Foaming mad
Other ingredients in standard toothpastes are also worrying. Many contain the synthetic industrial-strength detergent sodium lauryl sulphate (SLS), a suspected GI or liver toxicant. SLS is also associated with mouth ulcers (Compend Contin Educ Dent. 1997: 18: 1238-40), and can irritate the mucous lining of the mouth-relevant given the fluoride/cancer link. It may even increase uptake of other, more harmful substances in the mouth (int J Occup Med,2000: 6: 138-42, 143-7).
Triclosan, a common antibacterial in toothpaste, is sometimes added to counteract SLS (Scand J Dent Res, 1993; 101: 192-5), yet the two combined can become an even more powerful irritant (Toxicol Lett. 1997; 91: 189-96). Triclosan is also associated with the rise in resistant ’superbugs’. Used in antibacterial/antiplaque formulas, triclosan can reduce plaque buildup (Am J Dent, 1989; 2: 231-7) but, although tartar-control formulas may prevent 40-50 per cent of new tartar buildup, they can do nothing for plaque that is already present.
Abrasives are also potentially harmful. Case reports show that fine granules of silica and other abrasives can collect beneath the gums to form granulomas - small nodules of inflamed tissue (Dermatology,2001; 203: 177-9; Ann Periodontol, 1999; 4:20-31). These lesions can mimic gingivitis, and may also leave the gums more vulnerable to infection.
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