Brushing Up on Toothpaste Knowledge

Maybe I deserve an "F" in Attentive Parenting, but in 16 years of hectoring my kid to brush his teeth, I’ve never stopped to scrutinize the toothpaste label. So I hadn’t considered the implications of such ingredients as sodium lauryl sulfate, FD&C blue No. 1, or hydrated silica.

Do I need to put any of these on my list of things to worry about?

No, says dentist Patrick Emigh of Emigh Dental Care in Long Beach. Sodium lauryl sulfate (SLS) is a detergent that creates the foaming action in toothpaste. “A very small percentage of people who have very sensitive, tender tissue may experience some irritation if they use toothpaste with sodium lauryl sulfate, but this is rare,” Emigh says. If irritation does occur, TheraBreath and Tom’s of Maine make SLS-free toothpaste.

“Some whitening toothpastes may cause some sensitivity too, but this is temporary and not harmful,” says Emigh. If this occurs, you can simply switch to another toothpaste without the whitening action, he suggests.

The hydrated silica in toothpaste is a mild abrasive that removes debris and stains from teeth, according to the American Dental Association (ADA). Other abrasives in toothpaste include hydrated aluminum oxides, magnesium carbonate, phosphate salts and silicates. The ADA evaluates all toothpaste ingredients before issuing its seal of acceptance, says Clifford Whall, director of the ADA acceptance program. In order to earn the ADA seal, a product must be safe and effective when used as directed, he says.

Colgate Total contains triclosan, an antibacterial agent shown to be effective in preventing gingivitis, or inflammation of the gums, according to the Food and Drug Administration. Some animal studies point to hormone disruption from triclosan, so the FDA is reviewing its safety in a joint project with the Environmental Protection Agency. An update from the FDA is expected sometime this winter. In the meantime, the official word from the agency on triclosan is that it “is not known to be hazardous to humans.”

Why the “keep out of the reach of children under 6 years of age” warning on toothpaste? Because it contains fluoride to prevent tooth decay, and fluoride shouldn’t be ingested in large amounts. Children younger than 6 may not catch on right away that they’re supposed to spit out the toothpaste, not swallow it. Use only a pea-sized dab of toothpaste for children until you’re sure they can follow the “spit it out” instruction. Kids learn how to do this at different ages, Dr. Emigh says, so he advises parents to supervise their kids’ brushing.

Jorge Oaxaca, a dentist practicing in Seal Beach, sounds a practical note. If you turn your attention away and your child swallows some toothpaste, “it’s not the end of the world,” he says. Toothpaste manufacturers err on the side of caution and safety, he says.  “They’re not going to put stuff in toothpaste that can do you in.”

Parents who may feed their children healthy foods often don’t read toothpaste labels and are often surprised to learn that saccharin is used to sweeten and flavor many brands, says dentist Harold Katz, who developed the TheraBreath line of toothpaste and mouthwashes. Marketing toothpaste to children with cartoon characters or action figures is like the “Joe Camel approach,” he maintains. (The ADA will not put a seal on any toothpaste that contains sugar or other ingredients that would promote tooth decay.)

If you don’t want to be concerned about any toothpaste ingredient, including dyes and saccharin, you can always brush your teeth with plain old sodium bicarbonate, also known as baking soda, which is free of polysyllabic chemicals and a bargain for around $1.50 a box.

Correction: An earlier version of this story mentioned My First Toothpaste as a low-fluoride alternative. However, that brand isn't sold in the U.S.