Fluoride, Whitening, Sensitivity: Which toothpaste is right for you?

Fluoride, Whitening, Sensitivity: Which toothpaste is right for you?

Hi everyone, I am writing this blog today to help you understand what to pay attention to when buying a toothpaste and I am using this evidence based, literature review research that was published in 2012. You always need to ask your dentist what is the best option for you, e.g. Toothpaste: Whitening, Fluoride, Sensitivity, and as your dentist, I want to be sure you can make an informed decision when it comes to your oral health.

The first thing you need to pay attention to is what you want to achieve with your toothpaste. Are you preventing or stopping decay? Are you trying to take care of your gums? Are you trying to whiten your teeth? Do you have sensitivity and want a toothpaste that helps you with that? After you answer that question you can start paying attention to what is actually inside of that toothpaste.

Toothpastes for caries prevention and remineralization:

Fluoride is the most important active formula in the toothpaste that inhibits the incipient caries (early enamel demineralization) from developing by remineralization and prevents carious lesions to appear by strengthening enamel of the tooth (19-27% reduction of caries).  On order for you to treat incipient lesions, Dr. Mahi recommends that you reduce sugar intake and remove plaque and the bacterial biofilm from the surface of your teeth efficiently, and second, use a toothpaste with increased fluoride concentration. Although Fluoride has been proven to be safe and effective, it can cause fluorosis if it is ingested in early childhood especially between the ages 4 to 6.

So now, you may ask, what is the best Fluoride concentration?

It has been shown that children between the ages 2 to 5  swallow 30 to 50 percent of the toothpaste and toothpastes containing fluoride concentration of 500-550 ppm was later recommended for children to prevent fluorosis. It has been shown that the use of “pea size”  amount of toothpastes containing 400 ppm or 1450 ppm fluoride from age 1 would be safe. In general, if you are prone to decay and have higher rate of cavities, you will need a toothpaste with higher concentration of Fluoride. Toothpaste with 1000 to 1500 ppm concentrations is the most effective.

Higher concentrations in toothpastes  (2500 to 5000 ppm) offer up to 36% reduction of cavities and also are more effective in remineralization. Those need to be prescribed by your dentist.

So what compound of fluoride is the most effective? In vitro studies show that aminofluorides, sodium fluoride (NaF) and sodium monofluorophosphate (NaMFP) are the most effective compounds respectively.

xylitol is another ingredients that is used to fight cavities because of its antibacterial impact especially on Streptococcus Mutans. It also stimulates the salivary glands to secrete more saliva.

Other ingredients include enzymes known as lysozyme, lactoperoxidase and glycosil oxidase which fight the bacteria in your mouth known as  Streptococcus mutant.

Toothpastes for treating gum disease:

To prevent and treat gum disease you need to mechanically clean the teeth and also prevent bacterial growth. You need antiseptic and antibacterial agents added to toothpaste such as triclosan, chlorhexidine, hydrogen peroxide, baking soda, Povidone Iodine, zinc citrate, etc…

The other option is natural essential oils and vitamins.The pure essential oils of lavender and eucalyptus are proven to have soothing and healing properties and are key elements of the toothpastes made by Dental Herb Company. These toothpastes have similar antibacterial effectiveness as chlorhexidine containing toothpastes. Also topical use of antioxidants may prevent the destructive effects of gum disease caused by bacteria and immune system response to bacteria.

Synthetic antiseptic or antibacterial substances such as triclosan also  help with gingivitis . Copolymer is used to strengthen the effect of triclosan.  Chlorhexidine is very a effective antibacterial agent but it can cause pigmentation of teeth and composite restoration, dry mouth, temporary taste changes,  potential allergic reactions, and can increase calculus formation.

Toothpastes for sensitivity:

Toothpaste containing 5% or 10% potassium nitrate are reported to decrease tooth sensitivity for up to 4 weeks. Fluoride compounds such stannous fluoride also increases dentin resistance against acids and reduces sensitivity. Calcium and phosphate ion also can be added to increase fluoride efficiency in preventing sensitivity. Cleaning teeth with distilled water is also a good idea. Srontium acetate and arginine are the other elements that can be used to reduce sensitivity.

Whitening toothpastes are mentioned most often in literature. Their main purpose is the removal of plaque, either mechanically or chemically [2]. How- ever, in some dentifrices there are added chemicals that provide a bleaching effect, therefore in this toothpaste class there are two definite subclasses – whitening toothpastes and bleaching toothpastes.

Whitening toothpastes:

Some Whitening toothpastes use abrasive substances such as silica dioxide, hydrated silica dioxide, calcium carbonate, calcium phosphate di-hydrate, calcium pyrophosphate, alumina oxide, perlite (70-75% silica dioxide) and sodium bicarbonate, to remove stains from the surface of the teeth. Thosedo not change the color of the teeth.

Some enzymes such as protease and papaine also can be used for whitening . Sodium pyrophosphate, sodium tripolyphosphate and other pyrophosphates are also used to remove tartar and staining.

Bleaching toothpastes contain hydrogen peroxide or calcium peroxide that penetrate the enamel and have a bleaching effect. The concentration of these agents is usually  small (1% hydrogen peroxide or 0.5-0.7% calcium peroxide)  with a short exposure time. There is not enough evidence that these toothpastes can lighten the internal tooth color.

We are proud to be given the chance to teach you more about toothpastes.  Our ultimate goal is to become your number one go-to dental office in Lincoln Park area by providing high quality dental services.


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