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Do I Really Need a Tartar-Control, Desensitizing Toothpaste with Baking Soda and Gel in a Stand-Up Tube to Clean My Teeth and Prevent Tooth Decay?KINDS OF TOOTHPASTES


A Primer on Pastes

Okay, so you know that you're supposed to brush your teeth with an ADA-accepted fluoride toothpaste. But lately you've been seeing a lot of toothpastes on the shelf that have other ingredients. Here's a helpful guide to some toothpaste ingredients and what they do:

Tartar-Control Toothpastes -- These toothpastes help prevent tartar (hardened plaque that may cause gum disease) from forming. The active ingredient in tartar-control toothpastes is usually pyrophosphate.  But, these toothpastes do not remove tartar... Only a professional tooth cleaning can do that.

First- It only reduces tartar buildup above the gumline, where your toothbrushing technique should be preventing tartar formation in the first place. It doesn’t have any effect on tartar formation below the gumline; to prevent that, you still need to brush and floss, to mechanically remove bacteria before they solidify into tartar.

bulletIt may cause unexplained sensitivity to hot and/or cold in some or all of their teeth. The sensitivity disappeared after you stop using tartar control toothpaste. If you want a good moderately-priced toothpaste with antibacterial action, we recommend Colgate Total. Stay away from anything with sodium pyrophosphate, the tartar-control ingredient that my cause tooth sensitivity.*

Baking Soda -- This mild abrasive has a mythology dating back to the early 20th century that makes it popular today. Many people think it helps fight gum disease and cleans teeth. The reality: it hasn't been shown to have any effect on periodontal disease. Why use a toothpaste with baking soda, then? If you like the taste or feel of toothpastes with baking soda, you're more likely to brush regularly, thus improving your oral health. 
( 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.)

Susceptible to decay?  Is your mouth very dry because of medications you take?  Are your teeth unusually sensitive to hot or cold?  You could benefit from a high-fluoride toothpaste.  Colgate’s Prevident 5000+ (by prescription only) and its generic version Fluoridex contain five times as much fluoride as ordinary toothpastes..  These toothpastes can save you many times what they cost by reducing decay. 

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Hydrogen Peroxide -- One of two proven ingredients that whiten teeth (H.P.'s whitening cousin is carbamide peroxide), hydrogen peroxide is found in bleaching systems that dentists prescribe and some over-the-counter bleaching kits. While the efficacy of products that contain either hydrogen peroxide or carbamide peroxide has been well proven, some people may have adverse reactions to products that contain these whitening agents. Furthermore, the ADA is concerned about unsupervised use of some OTC kits. Still other kits might contain harmful acids. Also, not everyone is a good candidate for a bleaching procedure. Good candidates are people with coffee or food stains. Poorer candidates are those who have gray teeth or teeth stained from taking tetracycline. 
(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.)

You can now choose a toothpaste based on your own persoanl needs

Desensitizing Toothpastes -- The ADA recognizes two ingredients as effective in reducing discomfort associated with sensitive teeth: strontium chloride and potassium nitrate. Both are effective in blocking the tube-like channels that pass through teeth and connect to nerves. When these tubes are exposed, hot, cold and acidic foods stimulate nerves causing hypersensitivity.  Desensitizing toothpastes with strontium chloride or potassium nitrate block the tubes or reduce the ability of the nerves to transmit pain and can be found in Crest or AquaFresh for Sensitive Teeth and Sensodyne. Don't expect these toothpastes to work overnight, though. Most people won't notice any improvement for 4-6 weeks.

For preventing and treating gingivitis (gum inflammation), Colgate Total is excellent.  It contains the anti-bacterial ingredient Triclosan, and comes in several varieties.  This is also an excellent all-around toothpaste for decay prevention

Abrasives -- All ADA-Accepted toothpastes contain a mild abrasive that works with your toothbrush to remove plaque. Generally, these abrasives take the form of silica. It is a myth that abrasives in toothpaste cause enamel to wear away. More likely, enamel erosion occurs as a result of over-vigorous brushing. 

Whiter teeth: Don’t waste your money on “whitening” toothpastes.  Study after study shows that they don’t work.  These toothpastes remove surface stains on teeth (all toothpastes are designed to do this) but have absolutely no effect on the color of the teeth themselves.  If you want whiter teeth, ask us about tooth-whitening we have one-visit in-office bleaching.

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Denture Pastes -- While it's true that more people are keeping their teeth, those who use full or partial dentures need to keep them clean. What to use? Not surprisingly, there are ADA-accepted denture cleansers that safely and effectively clean dentures. These products contain a mild abrasive and detergent plus a flavoring agent. If you run out of denture paste, the ADA recommends using soft hand soap or mild dishwashing liquid to clean dentures.

Natural Toothpastes--some "natural" brands may contain vitamin C, which increases the levels of acidity in your mouth and erodes enamel. And there is no evidence proving that natural toothpastes containing ingredients such as baking soda instead of fluoride will prevent tooth decay. While natural oral care product makers play on people's fears concerning alcohol and fluoride, there really is no reason to worry. It's all a ploy to get consumers to spend three times more on the "natural" brands than they would on tubes of the common brand- name toothpastes.* Most natural toothpastes are missing fluoride, with the exception of Tom's of Maine's Natural Fluoride Toothpaste.  Research has shown that fluoride is the most effective way to stop tooth decay, so it is an important ingredient to have included in your toothpaste. 

There are other, more exotic ingredients such as aloe vera and sanguinaria that can be found in commercially available toothpastes. However, let your dentist and the ADA Seal of Acceptance be your guides in deciding whether to purchase products with these ingredients.

Years ago, dental literature was filled with articles researching the effective-ness of a particular new toothbrush compared to a standard brush.  I don’t see much of this research today.  It seems that manufacturers produce new designs that look nifty,  colorful, or high-tech but do not have proven effectiveness.  In the office, we give out the Crest Complete soft or extra-soft brush because of the research showing its effectiveness.  We also highly recommend the Braun Oral B and the Sonicare electric toothbrushes for the same reason.  Good products, well researched.

Primer on Toothpaste.  Click here to learn more about tartar-control, baking soda, hydrogen peroxide, desensitizing, abrasive and denture toothpaste: Toothpaste Primer by ADA

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Sodium Bicarbonate and Hydrogen Peroxide: The Effect on the Growth of Streptococcus mutans

 This  experiment studied the effects of sodium bicarbonate and hydrogen peroxide on the cariogenic bacteria Streptococcus mutans through analysis with a spectrophotometer. The growth of S. mutans was analyzed using seven different environments. Twelve wells in each of the seven rows of a multi-well plate were used to incubate the test materials. In combinations of 10 µl distilled water, 100 µl broth, 10 µl 10% sucrose, 10 µl S. mutans, 10 µl 10% sodium bicarbonate, and 10 µl 3% hydrogen peroxide, seven different environments were created for testing. Environments had either sodium bicarbonate or hydrogen peroxide with S. mutans, or a
combination of sodium bicarbonate and hydrogen peroxide with S. mutans. The plate was incubated at 37°C and measured at 0, 18, 20, 22, 24, 26, 28, 30, and 42 hours by optical density with a spectrophotometer.

Results showed bacterial growth was prevented by sodium bicarbonate, hydrogen peroxide, and the combination of sodium bicarbonate and hydrogen peroxide. Although hydrogen peroxide is bacteriocidal and sodium bicarbonate is bacteriostatic, there were no significant differences among the three treatment groups in spectrophotometer readings at any of the nine readings over 42 hours.

There was no significant difference among the effects of hydrogen peroxide, sodium bicarbonate, or the sodium bicarbonate and hydrogen peroxide combination, as measured by optical density. The hydrogen peroxide, sodium bicarbonate, and the sodium bicarbonate and hydrogen peroxide combination prevented bacterial growth of S. mutans. The results show that products containing these agents have
the ability to stop the growth of S. mutans. Products containing sodium bicarbonate and/or hydrogen peroxide may be useful to caries- prone patients. More studies are needed to confirm these results on patients.

Author(s): Kelly J Silhacek RDH, BS ; Kristin R Taake RDH, BS Source: Journal of Dental Hygiene      Volume: 79 Number: 4 Page: 7
Publisher: American Dental Hygienists' Association

*Karen L. Schneider is a research intern at the American Council on Science and Health. June 2002
** Dr Waterston Newsletter, 2/03.

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February 06, 2008

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