Brushing with a mouthwash, fluoride rinse or plain water are all alternatives to using toothpaste. Most studies favor toothpaste, but one study, "Toothpaste May Not Remove More Plaque," found that more plaque was removed with plain water than with toothpaste.
Quite a few toothpastes now come in tubes that stand up for easier storage. If your favorite toothpaste doesn't do this, you can insert it into a reusable stand. For example, "Simply Squeeze" toothpaste tube holders (*est. $3) also help to squeeze out the last bit of toothpaste.
The National Institute of Dental and Craniofacial Research (NIDCR), part of the National Institute of Health, publishes a guide to infant oral care. If drinking water isn't fluoridated, consult a dentist about a fluoride supplement. After baby teeth come in at around age two, the guide recommends using a pea-sized drop of fluoride toothpaste. It's important to supervise a child's brushing till age seven or eight.
Colgate provides an even more detailed guide, "Oral & Dental Health At Any Age."
In 2007, there was widespread alarm over tainted toothpaste imported from China that contained a poisonous chemical, diethylene glycol (DEG) - basically antifreeze. Some were even counterfeit Colgate toothpastes. Most were sold at dollar stores. This led to a series of FDA recalls, and information updates are still posted online at FDA.gov.
On a happier note, chocolate lovers, take heart Â… a Tulane University researcher has found that a cocoa extract may be as effective as fluoride for fighting tooth decay. A chocolate mint toothpaste may not be too far away. See "Chocolate Lovers May Be Able to Brush with Glee."
Kingfisher Natural Toothpaste, a UK brand, is packaged in biodegradable tubes made of cellulose. This toothpaste is approved by the British equivalent of our American Dental Association, but so far, isn't available in the United States.
Issues with fluoride
A small number of people believe that fluoride causes bone cancer and other diseases, but there's not much evidence to support those assertions. The American Dental Association wholly endorses the use of fluoride in toothpaste. Fluoride has been shown to help strengthen tooth enamel, which in turn helps to prevent tooth decay. Dr. Andrew Weil is a popular and respected expert on alternative medicine, but he recommends fluoride for preventing tooth decay in an article on his website.
If an infant or toddler isn't getting enough fluoride, a dentist may prescribe fluoride drops or a fluoride gel. If children drink bottled water, Consumer Reports recommends making sure it has fluoride added, but Global Health objects to this in a brief alert published in July 2002. Overall, experts agree that it's important to find out how much fluoride your child is getting, then check with your pediatrician and dentist for specific advice.
The Center for Disease Control (CDC) publishes guidelines for fluoride use to prevent tooth decay. However, an August 2007 formal complaint, available on FlourideAlert.org, charges that the CDC is not actively disseminating information about the extra susceptibility of some segments of the population to harm from excess fluoride, including kidney patients, diabetics, infants and seniors. Minority and low-income groups also have higher rates of fluorosis than the general population.
Fluoride in drinking water is much more controversial than fluoride toothpaste. You can read some pro-fluoride arguments at the ADA website and at DepletedCranium.com, a science blog, as well as opposing arguments from the Fluoride Action Network.
+There are plenty of great resources out there if you want to learn more about toothpastes and their ingredients.
The American Dental Association (ADA) publishes a list of toothpastes that carry the ADA seal, plus an explanation of what the seal means. The ADA website also contains links to clinical research studies on toothpaste, plus detailed articles on oral health, including how to choose a toothbrush and when to see a dentist.
A chart of toothpaste RDA values (measuring abrasiveness).
Tom's of Maine has developed toothpastes to meet just about every concern about ingredients, so the company's FAQ page has a lot of useful information on each one.
You can also find information on toothpaste ingredients at the U.S. Dept. of Health & Human Services Household Products Database.
The Cosmetics Database published by the Environmental Working Group lists many toothpastes and their ingredients, with ample links to research, at CosmeticsDatabase.com (search for "toothpaste").
Other informative websites include the Academy of General Dentistry and the University of Maryland Medical Center. They offer insights into proper brushing techniques and basic toothpaste and toothbrush terms. These sources do not recommend any brands, but do have general guidelines for oral care. The Raleigh News & Observer has an older, but entertaining, article on the large numbers of toothpastes: "It's tartar-control, whitening, sensitive, minty chaos."
Manufacturers' websites have ingredients lists and other information. Drugstore.com carries a wide variety of toothpastes, listing the ingredients for each.
Toothpaste Manufacturers:
AIM, Arm & Hammer, Mentadent, Close-Up (Church & Dwight)
Aquafresh (GlaxoSmithKline)
Crest (Proctor & Gamble)
Spry (Xlear)
Ultra brite (made by Colgate)
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