Brush Up on Toothpaste

Selecting toothpaste can be confusing. With different brands promising everything from whiter smiles and fresher breath to fewer bacteria and less tartar, how do you know which one is best for you?

Choices in toothpaste have expanded, with manufacturers adding new detergents, abrasives, and other ingredients to enhance products, according to the American Dental Association (ADA).

Selecting a toothpaste is largely a matter of personal preference, but all adults should use a brand with fluoride, an ingredient known to make teeth stronger, the ADA says. Look for the ADA Seal of Acceptance. While the Food and Drug Administration (FDA) requires that toothpastes meet certain requirements, it does not test for compliance. The ADA Seal means the toothpaste has undergone extensive laboratory testing to ensure it meets safety and effectiveness standards. The ADA also determines the toothpaste's fluoride content, how it is released, and the product's effect on tooth enamel. 

What to consider

So, what should you take into consideration when choosing a toothpaste? The key is in the flavor, the mouth feel, and the ingredients, the ADA says.

The next step in selecting toothpaste is to determine if your teeth have special needs because of sensitivity, staining or gum disease. If so, these are your possible choices:

• Desensitizing toothpastes. These help reduce pain when teeth encounter hot, cold, sweet, or sour substances. They work with the help of potassium nitrate, which deadens tooth nerve endings, or strontium chloride or stannous fluoride, which make teeth less porous. If you don't experience relief in four to six weeks, the ADA says, that could signal a larger problem, such as a tooth fracture.

• Tartar control toothpastes. They target hard yellow deposits on your teeth, commonly called tartar buildup. But such toothpastes only work after a professional dental cleaning, the only way to remove existing tartar deposits. After a professional cleaning, tartar control toothpastes can cut new buildup up to 36 percent, the ADA says. Tartar control toothpastes only control tartar buildup above the gum line. They don't remove tartar below the gum line, which can lead to gum diseases.

• Anti-gingivitis toothpastes. Gingivitis is a gum disease that causes red, tender gums and possible bleeding. Left untreated, gingivitis can lead to tooth loss. Anti-gingivitis toothpastes are most effective when they contain the anti-bacterial agent triclosan and a co-polymer that lengthens the time triclosan stays in the mouth.

• Whitening toothpastes. Available for those with stained teeth, these toothpastes may contain abrasives, forms of peroxide, enzymes, and stronger detergents. In some cases, ingredients such as baking soda and peroxide may be included in such small amounts that they don't necessarily have clinical benefits.

Fluoride and your kids

Though fluoride is considered essential in toothpaste for adults, it can cause permanent tooth discoloration in children who absorb too much.

The ADA says that children under age 2 or children who can’t spit out the toothpaste shouldn't use fluoridated toothpaste unless advised to do so by their dentist or pediatrician. In addition, parents should monitor the tooth-brushing skills of children ages 2 to 6, and teach the child to spit out, rather than swallow, the toothpaste. 

A pea-sized dab of toothpaste offers plenty of fluoride protection, says the American Academy of Pediatric Dentistry. Children can absorb too much fluoride if they swallow the toothpaste.

To ensure your child gets the right amount of fluoride, ask your dentist or local water supplier how much fluoride is in the water your child drinks.