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Putting the squeeze on dentifrice. Why is brushing with toothpaste important?

Looks what is in your toothpaste

Toothpaste Update:

Bacterial survival rate on tooth and interdental brushes can be a worry yet a new study revealed that toothpaste detergents decrease the survival rate of bacteria on a toothbrush and can thus limit the risk for bacterial relocation.*

Brushing with toothpaste (also called a "dentifrice") is important for several reasons. 


A toothpaste and a correct brushing action work to remove plaque, a sticky, harmful film of bacteria that grows on your teeth that causes caries, gum disease, and eventual tooth loss if not controlled. 


The toothpaste containing fluoride makes the entire tooth structure more resistant to decay and promotes remineralization, which aids in repairing early decay before the damage can even be seen. 


Special ingredients in the dentifrice help to clean and polish the teeth and remove stains over time. 


Toothpastes help freshen breath and leave your mouth with a clean feeling.

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What type of toothpaste should I use?
As long as your toothpaste contains fluoride, the brand you buy really does not matter, whether or not it is in paste, gel, or even powder form, or containing a certain flavor. All fluoride dentifrices work effectively to fight plaque and cavities and clean and polish tooth enamel. 

Your dentifrice brand should also bear the ADA (American Dental Association) seal of approval on the container, which means that adequate evidence of safety and efficacy have been demonstrated in controlled, clinical trials.

If your teeth are hypersensitive to hot or cold, consider trying a dentifrice designed for sensitive teeth

Dentifrices containing baking soda and/or hydrogen peroxide (which are both good cleansing agents) give the teeth and mouth a clean, fresh, pleasant feeling that can offer an incentive to brush more, but fluoride is the true active ingredient at work protecting your teeth. 

Some prefer a tartar control toothpaste containing pyrophosphates to prevent the buildup of soft calculus deposits on their teeth. New pastes offer advanced whitening formulas aimed at safely removing stains to make teeth brighter and shinier, although they can't nearly match the effectiveness of a professional bleaching formula administered or prescribed by a dentist.

We don't recommend tartar control toothpastes because they only prevent tartar above the gumline which does nothing to prevent tartar under the gumline which you can not see and can cause much bigger problems to your dental health. Tarter control tooth also contains the ingredient sodium pyrophosphate which can make normal teeth hypersensitive and sensitive teeth extremely sensitive to hot and cold liquids.   


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You only need a pea size amount of toothpaste when you brush

How much should I use?
Contrary to what toothpaste commercials show, the amount of paste or gel needed on your brush for effective cleaning does not have to be a heaping amount. Simply squeeze on a pea-sized dab of paste on the top half of your brush. If you brush correctly holding the toothbrush at a 45-degree angle and brush inside, outside and between your teeth, the paste should foam enough to cover all of your teeth.

Children under 6, however, should only be given a very small, baby pea-sized dab of dentifrice on their brush.

Is brushing with toothpaste enough to fight cavities and gum disease?
No. Although brushing thoroughly after each meal helps, flossing your teeth every day to remove plaque and food particles between teeth and at the gumline is just as important. Studies show that plaque will regrow on teeth that are completely clean within 3 to 4 hours of brushing.

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An Experimental Gingivitis Study to Evaluate the Clinical Effects of
a Stannous Fluoride Dentifrice

A double blind, controlled, parallel group trial utilizing the experimental gingivitis model was performed on thirty young adults to evaluate the clinical effects of a 0.45% stannous fluoride dentifrice used as a slurry on dental biofilm formation and the development of gingivitis. Following a thorough examination and oral prophylaxis
procedures, subjects were randomly assigned to apply one of the  following dentifrices twice daily over a three-week period: A) dentifrice slurry without active ingredients; B) 0.45% stannous fluoride gel; and C) Colgate® Total dentifrice slurry (0.30% triclosan, 0.24% sodium fluoride, 2% copolymer). After three weeks, the stannous fluoride dentifrice significantly (p < 0.05) reduced gingivitis compared with the Colgate® Total group by 39.7%. Gingivalbleeding was also reduced relative to the Colgate® Total group.  The results of this clinical trial demonstrated that,over a three-week period, the application of a 0.45% SnF2 gel significantly inhibited the onset of gingivitis compared to Triclosan/sodium fluoride/copolymer (Colgate® Total).
However, neither stannous fluoride nor Triclosan/sodium fluoride/copolymer (Colgate® Total) possessed sufficient antimicrobial activity to suppress biofilm formation in the absence of regular oral hygiene practices.
Lang, Niklaus P./Anton, Elena/Gabriel, Yvonne/Pjetursson, Bjarni E./Winston, Leslie J./He, TaoOral Health Prev Dent 4/2004 Page 369-376

Colgate Total toothpaste  is a good toothpaste because it contains the anti-bacterial ingredient Triclosan.   It has a germ-fighting ability that lasts for up to 12 hours after you brush. Colgate Total has also become the first toothpaste accepted by the American Dental Association for the prevention and reduction of bad breath. It has been shown to reduce bad breath up to 51% for 12 hours after brushing.

Toothpaste that contains sodium pyrophosphate which is the most commonly-used tartar control agent in toothpastes, only limits tartar above the gumline.   It has no effect on the development of tartar below the gumline.  Tartar below the gumline is a far more serious problem.  It  provides an excellent hiding place for the kind of bacteria that can cause periodontal disease.  In addition, it is not uncommon for people using tartar-control toothpaste to develop tooth hypersensitivity.  Your teeth can become very sensitive to temperature extremes, especially cold.

Crest  makes Pro-Health toothpaste which contains a special stabilized stannous fluoride  to fight decay and bacteria, and a “different” anti-tartar ingredient, sodium hexametaphosphate.  Crest claims that this toothpaste reduces tooth sensitivity but a survey  of about 1500 dentists who had used Crest Pro-Health once developed immediate tooth hypersensitivity because sodium hexameta-phosphate has lots of pyrophosphate groups attached to it. 

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Fluoride Toothpaste Significantly Reduces Childhood Cavities

A review of 50 years of clinical trails (74 studies involving more than 42,000 children under the age of 16)  firmly establishes that in children brushing with toothpaste containing fluoride results in 24% less cavities than does brushing with non fluoridated toothpaste.  This study conferred:


greater cavity reduction by brushing twice a day or more with fluorided toothpaste than only once a day.


brushing with toothpaste containing a higher concentration of fluoride is associated with greater reduction in cavities.


fluorided toothpaste with give greater benefits in  those with higher levels of decayed, missing and filled teeth.


brushing with fluoride toothpaste provides additional reduction of cavities even if children live in areas with fluoridated water

Fluoride Toothpaste Significantly Reduces Childhood Cavities, pg 44, Dentistry Today 2/03

This update if from a man who engineers toothpaste tubes for a living.
Some interesting facts........
When the economy is good the tube exit has one size...when the economy is bad the exit is larger so you tend to use more.
The amount of force necessary to open the tube is less than 4 gms/ the people with arthritis can open the tube.
The reason tubes no longer stay folded is so you always see the logo.+


All sonic toothbrushes should not be used with baking soda and/or peroxide toothpastes.  These toothpaste products should be avoided as they contribute to cracks in the upper portion of the handle.

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+ Roy, IDF April 2002.

Sources: Consumers smile on Unilever s Mentadent, Laura Bird, Wall Street Journal, May 31, 1994; Comprehensive Dental Hygiene Care, edited by Irene Woodall, Mosby-Year Book, Inc., 1993; Fluoride helps prevent tooth decay, American Dental Association, 1993; Dentifrice use among preschool children, by Steven M. Levy, DDS, et. al., JADA, Sept. 1993; Clinical and Biological Aspects of Dentifrices, edited by G. Embery and G. Rolla, Oxford University Press, 1992.

This article is provided by: Academy of General Dentistry

*Quirynen, Marc, de Soete, Marc, Pauwels, Martine, Goossens, Kitty,teughels, Wim, van Eldere, Johan & van Steenberghe, Daniel. Bacterial survival rate on tooth and interdental brushes in relation to the use
of toothpaste.  Journal Of Clinical   Periodontology 28 (12), 1106-1114

February 06, 2008

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