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Brushing Up on Toothpaste Knowledge

Experts analyze the safety of various ingredients.

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.

Emily Knell February 13, 2012 at 04:43 PM
"fluoride shouldn’t be ingested in large amounts. Children younger than 6..." But it's OK for them to drink tap water in any quantity with Flouride in it?
Denise Oleary February 13, 2012 at 06:18 PM
tap water isn't healthy for many reasons
Chris McLaughlin February 13, 2012 at 07:04 PM
Treacy, do you have more information on fluoride in toothpaste and tap water?? That does seem to be a glaring contradiction that many municipalities fluoridate their water but your article says it's not safe to ingest in large quantities. What are the short and long-term effects of drinking a lot of tap water??
Treacy Colbert February 14, 2012 at 01:38 AM
Emily, The amount of fluoride in tap water is regulated by the U.S. Department of Health & Human Services. This California Department of Public Health has good info about the amount of fluoride in water in different California communities. http://www.cdph.ca.gov/certlic/drinkingwater/Pages/Fluoridation.aspx
Treacy Colbert February 14, 2012 at 01:39 AM
Chris, This link from the California Department of Public Health has a good explanation of the whys and hows of water fluoridation, and the amount in tap water in different communities. http://www.cdph.ca.gov/certlic/drinkingwater/Pages/Fluoridation.aspx
nyscof February 14, 2012 at 11:54 AM
This article highlights how little dentists know about fluoride. Fluoride gets absorbed into the bloodstream even when it isn't swallowed. The visible signs that your small child swallowed too much fluoride is when the permanent teeth come in with white spotted, yellow, brown and/or pitted teeth. This dental fluorosis now afflicts about 50% of US adolescents, according to the CDC We can't see what it's doing to the child's bones and other organs. The EPA regulates fluoride in water as a contaminant because fluoride can also cause skeletal fluorosis - bone and joint damage. The FDA regulates fluoridated toothpaste as a drug and only tested it as a tooth-decay preventive without looking at what it might do to the rest of the body. Like all drugs, fluoride has side effects. See http://www.FluorideAction.Net/health The FDA never safety tested fluoride supplements, either.
Treacy Colbert February 14, 2012 at 02:51 PM
nyscof, I don't see the 50% stat on dental fluorosis in the CDC data. Where did you find it?
Treacy Colbert February 14, 2012 at 02:59 PM
Correction to this article, and thanks to Dr. Cliff Whall of the American Dental Association for pointing this out. My First Toothpaste by Colgate, which is labeled as "low-fluoride," is not sold in the U.S.
Roy Rivenburg February 14, 2012 at 05:54 PM
Here's what the CDC says about fluoridated water: "The safety and effectiveness of fluoride at levels used in community water fluoridation has been thoroughly documented by scientific and public health organizations using scientific reviews and expert panels. These expert panels consist of scientists from the United States and other countries with expertise in various health and scientific disciplines, including oral health, medicine, biophysics, chemistry, toxicological pathology, and epidemiology. Experts have weighed the findings and the quality of the available evidence and found that the weight of peer-reviewed scientific evidence does not support an association between water fluoridation and any adverse health effect or systemic disorders."
Kel8856 February 14, 2012 at 07:42 PM
SLS is a cancer causing ingredient that is in EVERYTHING. All soaps, lotions, etc. That and Sodium Benzoate - I do not buy products with these items in it.... Don't even get me started on cancerous sunblock...
A. M. King February 15, 2012 at 06:01 AM
The best tooth paste I have ever used is not a paste but an oil. It's a blend of peppermint, spearmint, and almond oils. It's called 'Glacial Blue'. It will light you up but your teeth will never be cleaner or your breath fresher. it's good stuff.
A. M. King February 15, 2012 at 06:03 AM
Don't blame you a bit!!!

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