Toothpaste or dentifrice refers to a substance, such as a paste, gel or powder, used for cleaning and polishing teeth. Dentifrice is the most commonly used consumer product for maintaining the aesthetics and health of teeth in children and adults (1, 4). It has multiple functions, including removing plaque, limiting halitosis and applying fluoride to the tooth structure.
Certain active ingredients in toothpaste also impede tooth disease and gingivitis (1, 4). Used in conjunction with a toothbrush, toothpaste enhances the mechanics of brushing, cleaning and polishing with a toothbrush and enables it to reach accessible teeth surfaces (1, 4).
The History of Toothpaste
Research suggests the ancient Egyptians began using toothpaste for oral hygiene around 5000 BC. At nearly the same time, Roman and Greek residents started using toothpaste. Around 500 BC, the populace occupying the regions of India and China also gravitated to the practice of using dentifrice. Like modern humankind, these people used the earliest forms of toothpastes for cleaning their teeth and gums, and eliminating halitosis.
The ingredients in early toothpastes differ from culture to culture. The Egyptians used a combination of ingredients, including burnt eggshells, ox hooves’ ashes and water. Various powdered mixtures prevailed up to the early 1800s. The modern era of toothpastes began when soap was added to the product, giving it a paste form.
In the 1850s, consumers could buy toothpaste packaged in jars; Colgate started this method of packaging its product in 1873. In the 1890s, Colgate transitioned to selling toothpaste in tin/lead tubes– similar to the toothpaste dispensers used today.
In 1914, manufacturers started adding fluoride to toothpaste. During World War II, a shortage of lead/tin, and leakage of the metal alloy into toothpaste, caused a switch to plastic tubes. Soap remained an ingredient in toothpaste up to 1945. Subsequently, it was replaced with sodium lauryl sulfate.
For the next 50 years, toothpaste manufacturers focused their research and development on improving toothpastes, adding ingredients to combat tooth sensitivity and disease prevention (2, 3).
The Main Ingredients of Toothpaste
The basic composition of toothpaste consists of a wide range of ingredients. Regardless of the type of toothpaste, most products contain the following six ingredients:
Abrasives ―Toothpaste contains about 20 percent abrasives, which primarily assist in extricating bacteria, plaque and food from the teeth without harming the tooth enamel. These rough particles also help remove some stains. Common abrasive agents include compounds, such as calcium carbonate, baking soda and silicates.
Thickeners―Thickening or binding agents give toothpastes the appropriate texture and help maintain its consistency. Toothpaste manufacturers use gums and seaweed molecules in most products (13, 16).
Humectants ― Seventy-five percent of the constituent of toothpaste has humectants and water for aiding moisture retention. Manufacturers add glycerol and other substances to gel and paste toothpastes to keep products from prematurely drying out (13, 16).
Flavoring ― Toothpaste manufacturers add flavoring agents to mask the taste of some of the other ingredients, which make dentifrice palatable to the taste buds. Flavoring agents include menthol, artificial sweeteners or aromatic oils (13, 16).
Fluorides― Fluorides, in the form of sodium monofluorophosphate or sodium fluoride, constitute 0.24 percent of the ingredients contained in toothpastes. It works to prevent cavities by acting as an antibacterial agent. It also removes plaque, cleans teeth and hardens tooth enamel. The U.S. Food and Drug Administration or FDA classifies fluoride as a drug because of its therapeutic attributes (13, 16). TheraBreath makes a non-fluoride toothpaste available for consumers who prefer that option.
Detergents ―To help the distribution of abrasives, fluorides and other agents throughout the mouth, toothpaste manufacturers add detergents like sodium N-lauroyl sarcosinate or sodium lauryl sulfate to their products. The foaming action facilitates the loosening of food, plaque and other debris from the tooth surface and between teeth (13, 16).
A percentage of consumers have problems with the development of oral ulcerations or canker sores inside the mouth. Studies have shown sodium lauryl sulfate, listed above as a common ingredient in most dentifrices, irritates the delicate tissue lining of the mouth (14, 15).
TheraBreath toothpaste does not contain sodium lauryl sulfate. In addition, the product is free of alcohol, saccharin, benzalkonium chloride, colors or artificial flavors.
Types of Toothpaste & Benefits
Today’s marketplace offers consumers a broad range of toothpaste products. To address a variety of oral hygiene concerns, such as plaque, calculus, halitosis and teeth whitening, toothpaste manufacturers began adding certain active agents to discern between dentifrices designed to address specific oral hygiene issues.
Some of the more common types of toothpaste currently marketed to consumers include the following:
- Fluoride – Soil food and water contain fluoride. Mineral deposits such as fluorite and fluorapatite also contain fluoride. The ADA considers fluoride as the most important ingredient for toothpaste (1, 4). Foods and drinks release sugar and starches, which mix with bacteria and may compromise oral hygiene and health. Fluoride toothpaste removes plaque, strengthens tooth enamel and prevents tooth decay (1, 4, and 5).
- Tartar Control – Tatar control toothpaste removes tartar from teeth. Bacteria, left unresolved, harden into plaque, which accumulates on the teeth and under the gums. Tartar is a derivative of plaque. Tartar prevention toothpastes contain a variety of chemical compounds, including pyrophosphates and zinc citrate. These chemical compounds prevent plaque and gingivitis (4, 10).
- Sensitive Teeth - Toothpastes formulated for sensitive teeth or exposed dentine may contain any one or a combination of chemical compounds, such as formaldehyde, arginine, potassium nitrate, strontium chloride or calcium carbonate. The toothpaste works by prohibiting irritants, such as hot or cold liquids or foods, from entering the pathway leading to the nerve endings (4).
- Whitening – Consumers have demanded tooth whitening toothpaste and these have become popular as consumers seek faster, convenient, effective and less intrusive methods of brightening their teeth. Whitening toothpastes do not contain peroxide-based bleaching, prevalent in many teeth whitening products. These specially formulated toothpastes rely on chemicals or abrasive particles.
Some whitening toothpastes polish teeth. Other products bind to stains—lifting them off the tooth surface. One such product contains silica, which studies have shown successfully whitens teeth (4, 11, and 12). Manufacturers have also created toothpaste products designed for children and fresh breath. TheraBreath toothpaste eliminates bacteria and food odors and Bad Breath. Clinical studies have proven the product reverses the condition known as Dry Mouth. TheraBreath toothpaste is recommended for people with Diabetes.
How to Use Toothpaste
The Columbia College of Dental Medicine recommends the following techniques when using toothpaste for oral hygiene:
Apply a pea-size dab of toothpaste on the head of a toothbrush. Use a toothbrush outfitted with soft bristles. Hold the toothbrush at a 45-degree angle to the gum line so that the bristles reach between the teeth. Use a circular motion, moving the toothbrush one-half tooth length at a time, but do not press too hard. Brush the inside and outside, as well as the top and bottom of each tooth.
To clean the back of the upper and lower front teeth, hold the toothbrush in a vertical position and use the bristles on the tip of the toothbrush. Clean the crevices on the teeth chewing surfaces by using a back and forth motion (15). TheraBreath reminds you to brush not only your teeth, but the roof of our mouth, the interior of your cheeks and your tongue.
Consumers tend to have a certain preference for the toothpaste they choose for their family– paste or gel, tartar control or teeth whitening. Dental care professionals should work with each patient to understand their needs and concerns. Discuss the available toothpaste options, taking into account the patient’s oral hygiene needs and other concerns the person may express.
- 1 Toothpaste – Defined by the American Dental Association. Available at: http://www.ada.org/1322.aspx Accessed November 29, 2008.
- 2 Colgate, Oral and Dental Health Research Center: History of Toothbrushes and Toothpastes. Available at: http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Oral-Hygiene/Brushing-and-Flossing/article/History-of-Toothbrushes-and-Toothpastes.cvsp. Accessed November 29, 2008.
- 3 The History of Toothpaste: From 5000 BC to the Present, Huffington Post, Thomas P. Connelly, D.D.S. Available at: http://www.huffingtonpost.com/thomas-p-connelly-dds/mouth-health-the-history-_b_702332.html, September 2, 2010. Accessed November 30, 2011.
- 4 Medicine Net, Weighing Your Toothpaste Options. Available at: http://www.medicinenet.com/choosing_a_toothpaste/article.htm#basics. Accessed November 30, 2011.
- 5 Medical News Today, What Is Fluoride? What Does Fluoride Do? http://www.medicalnewstoday.com/articles/154164.php. Accessed November 30, 2011.
- 6 Newby CS, Rowland JL, Lynch RJ, Bradshaw DJ, Whitworth D, Bosma ML, Benefits of a silica-based fluoride toothpaste containing o-cymen-5-ol, zinc chloride and sodium fluoride. http://www.ncbi.nlm.nih.gov/pubmed/21762159 . Int Dent J. 2011 Aug. Accessed November 30, 2011 Pub Med
- 7 Wong MC, Clarkson J, Glenny AM, Lo EC, Marinho VC, Tsang BW, Walsh T, Worthington HV, Cochrane reviews on the benefits/risks of fluoride toothpastes. Available at: http://www.ncbi.nlm.nih.gov/pubmed/21248357. J Dent Res. 2011 May;90(5):573-9.Accessed November 30, 2011 Pub Med
- 8 A meta-analysis of six-month studies of antiplaque and antigingivitis agents. Available at: http://www.ncbi.nlm.nih.gov/pubmed/17138709 Pub Med
- 9 Gunsolley JC, A meta-analysis of six-month studies of antiplaque and antigingivitis agents. Available at: http://www.ncbi.nlm.nih.gov/pubmed?term=A%20meta-analysis%20of%20six-month%20studies%20of%20antiplaque%20and%20antigingivitis%20agents.%20J%20Amer%20Dent%20Assoc. Accessed November 30, 2011 Pub Med
- 10 A silica toothpaste containing blue covarine: a new technological breakthrough in whitening. Joiner A. Instant tooth whitening from a silica toothpaste containing blue covarine. Available
at: http://www.ncbi.nlm.nih.gov/pubmed?term=A%20silica%20toothpaste%20containing%20blue%20covarine%3A%20a%20new%20technological%20breakthrough%20in%20whitening. Int Dent J. 2009 Oct; 59(5):284-8. Pub Med
- 11 Pub Med Collins LZ, Naeeni M, Platten SM.. Instant tooth whitening from a silica toothpaste containing blue covarine. Available at: http://www.ncbi.nlm.nih.gov/pubmed?term=A%20silica%20toothpaste%20containing%20blue%20covarine%3A%20a%20new%20technological%20breakthrough%20in%20whitening. J Dent. 2008;36 Suppl 1:S21-5. Accessed on November 30 2011 Pub Med
- 12 Refuat Hapeh Vehashinayim, Toothpastes: ingredients, brands, categories and their utilization. Available at: http://www.ncbi.nlm.nih.gov/pubmed/21250403 2010 Apr;27(2):19-27, 61 Accessed on November 30 2011 Pub Med
- 13 Healy CM, Paterson M, Joyston-Bechal S, Williams DM, Thornhill MH. The effect of a sodium lauryl sulfate-free dentifrice on patients with recurrent oral ulceration. http://www.ncbi.nlm.nih.gov/pubmed/10218040. Oral Dis. 1999 Jan;5(1):39-43. Pub Med
- 14 Medicine Net, Canker Sores Available at: http://www.medicinenet.com/canker_sores/page3.htm. Accessed November 30, 2011.
- 15 The Ohio State University Medical Center – Brushing and Toothpaste. Available at: http://medicalcenter.osu.edu/patientcare/healthcare_services/dental_care/brushing_toothpaste/Pages/index.aspx Accessed on November 30 2011
- 16 Columbia University College of Dental Medicine, Brushing and Flossing. Available at: http://www.simplestepsdental.com/SS/ihtSSPrint/r.WSIHW000/st.31843/t.31879/pr.3/c.308427.htmAccessed
Accessed on November 30 2011