Toothpaste
This question has no answer because toothpaste cannot do everything you want. It depends on what problem is being targeted. Most toothpaste on the market promote decay prevention and fresh breath. Toothpastes come in paste, gel, and powder, and a variety of containers.
Here are some helpful categories of toothpaste to help you decide which one would work best for you:
1. Tartar control - Usually a pyrophosphate formulation that retards the formation of hard calculus on teeth. It does not remove existing calculus on the teeth. (Aim, Aqua-fresh, Close-up, Colgate, Crest, Dental Care, Pearl Drops)
2. Anti-stain - Either an abrasive or a chemical that removes surface stain from the enamel. It does not change the internal natural color of the tooth, and often contains harsher abrasives than regular formulations. (Read our separate handout on toothpaste abrasiveness) (Caffree, Pearl Drops, Rembrandt, Topol, Ultra Brite, Zact)
3. Teeth sensitive to hot, cold, and touch - Usually contains potassium nitrate, which desensitizes the exposed root surface with regular use. (Aqua-fresh, Crest, Denquel, Oral-B, Promise, Protect, Rembrandt, Sensodyne, Thermodent)
4. Anti-cavity - Contains fluoride, usually monofluorophosphate or sodium fluoride, which makes the enamel resistant to bacterial acids. NOTES: The use of fluoride is another controversial issue in dentistry, but for this discussion, let's assume that it is safe and effective. The ideal concentration of fluoride in drinking water is considered to be 1 part/million. In most fluoride toothpastes, the concentration is 1000 parts/million. Extra-strength formulations contain up to 50% more fluoride (1500 parts/million), which may not be any more effective. Therefore, be cautious with young children who like the taste of toothpaste and may swallow or eat it causing a toxicity reaction. A new formulation containing xylitol, which has been shown to prevent and even, stop the decay process. (Epic)
5. Non-fluoridated - (Denti-Care, First-Teeth, Homeodent, Oxygene, Radiance, Real Purity, Retardent, Tom's, Tooth & Gum, and many natural formulas)
6. Anti-bacterial - Contains herbs and essential oils that reduce the bacteria in the mouth, thereby reducing the influence of bacteria in decay, gum disease, and mouth odor. (Tooth & Gum)
7. Baking Soda formulations - Contains baking soda which has an antibacterial action that is proportional to its concentration. Be aware that the commercial products vary in its baking soda concentration from 1% to 65%, so some brands are more effective than others. (Colgate, Crest, Dental Care, Mentadent, Peak, Pearl Drops, Perigel, Rite-Aide, Tom's, Vademecum)
8. Non-sodium lauryl sulfate - It has reported that sodium lauryl sulfate, a common ingredient in most toothpaste, can induce canker sores. (Biotene, Denti-Care, First-Teeth, Perigel, Radiance, Real Purity, Rembrandt Natural, Retardent, Tooth & Gum)
9. Whitening formulations - Special ingredients that are intended to lighten teeth that have gotten darker with age. Not as effective as a bleaching procedure which utilizes mouth appliances. (Dazzling White)
10. Dry mouth formulation - A formulation to make the mouth more comfortable that has low saliva flow from age, drug side effect, radiation therapy, Sjogren's syndrome, etc. (Biotene)
11. Natural - Uses natural ingredients, commonly herbs. Often avoids saccharin, artificial colorings, preservatives, and fluoride. Many different brands of natural toothpastes can be found in health food or nutrition stores.
12. Kid's formula - Usually means the flavor is less intense than adult toothpastes, and often has a gimmick associated with it to make it fun and attractive. (Aqua-fresh, Colgate, Crest, Oral-B).
13. ADA approved - Means all required data has been submitted to the American Dental Association, and has met the ADA's standards for effectiveness and safety. The seal of approval will be on the box or container. NOTE: There are effective products that have not submitted data because of expense or philosophy.
14. Non-mint formula - Contains no mint flavoring, which is believed to antidote homeopathic medicines in sensitive individuals, also for those who dislike mint. Most toothpaste contains a mint flavoring. (Crest, Homeodent, Oral -B)
15. Mouth odors - Most mask odors with mint, but chlorine dioxide helps eliminates mouth odor. (Oxygene)
16. Denture formula - A formulation that is too harsh for natural teeth and gums, intended for cleaning acrylic and porcelain. (Complete, Dentu-creme, Efferdent, Fresh 'n Brite, Rembrandt)
Toothpaste Abrasiveness
Toothpaste may be wearing away the enamel and dentin on your teeth, especially at the gum line. The use of “grit” in toothpaste is not unlike the use of grit on sandpaper. The more grit, the more the toothpaste is effective at removing stain and plaque. Unfortunately, a significant downside is the destruction of tooth structure. There is an abrasive index for toothpastes called the RDA Index.
The higher the value, the more abrasive it is. At or below 45 may be an acceptable balance between benefits and risks if you must use toothpaste. Over 45 is a matter of how quickly the loss of tooth structure can occur based on the RDA, frequency of use, type of toothbrush, and brushing technique. The most ideal approach would be to NOT use toothpaste but rather dip your brush into a mouthwash. The next best alternative would be to use only toothpowders or gels, which are typically less abrasive. If you don’t know the RDA of your toothpaste, you can find out by using the consumer contact information on the package or container.