Dental Health Matters

The following excerpts on toothpastes and preventing tooth decay are from How To Save Your Teeth: Toxic-Free Preventive Dentistry, by David Kennedy, Doctor of Dental Surgery. Many thanks to Dr. Kennedy for giving us permission to share this valuable information with our readers.

Toothpastes: Do They Help?

In general, toothpastes are often just a cosmetic product with limited decay-preventive value. If you stain your teeth with smoke or tea, then a toothpaste may help reduce the staining. Pleasant flavored toothpastes seem to help motivate children and adults to brush. However, kids may be tempted to swallow the good-tasting stuff, and if it contains preservatives, saccharin, lead, colorings, or fluoride, they will receive a dose of a questionable or toxic substance. The fact that a tube of toothpaste contains a lethal dose of fluoride for a small child has been discreetly obscured from the general public’s knowledge.

And remember when toothpaste tubes stayed rolled up? Many of those tubes contain lead which the toothpaste absorbed and thus gave you an additional daily dose of lead every time you brushed. Until manufacturers furnish complete evidence that their products are effective and harmless, I refuse to recommend them.

Many dermatologists are aware that some of the additives in toothpaste can cause a rash or sores inside the mouth. Fluoride is particularly notorious in this respect. One patient came to me after going to see a dermatologist about an irritation at the corners of her mouth. She had always had beautiful skin, but for the previous several months, she had a persistent rash. The doctor correctly identified her toothpaste as the culprit, and as soon as she switched to a non-fluoride brand, her problem cleared up.

The abrasiveness of toothpaste can help polish teeth, but too much abrasion will wear away the enamel and especially the root. Many of the gritty products sold as smokers’ toothpastes are overly abrasive. In time, they may actually cause yellowing of the teeth by wearing down the enamel. Gritty toothpaste should not be used around the root surfaces, since even the mildly abrasive products can damage this area. That does not mean you should not brush around the gums. I’d rather see a root worn down by brushing than rotted away by neglect. Wear is usually a minor problem but root decay can destroy teeth quickly. Baking soda should not wear away enamel, but if it is improperly applied, it can scratch the gums.

Other toothpastes contain bleaching agents that are supposed to whiten your teeth. Teeth can be whitened through the use of a mouth guard which holds the whitener against the tooth surface for several hours, but the topical application of a paste has only little effect on the brightness of teeth.

Several companies have advertised new toothpastes designed to prevent the buildup of tartar in the hopes that they will reduce gum disease. These tartar-control toothpastes apparently interfere with the remineralization of the teeth. Several of my patients have reported increased root sensitivity after using tartar-control toothpaste. There is little evidence at this time that the tartar itself is the cause of gum disease. It is but one of several factors that contribute to the spread of disease. Since I am concerned about the long-term effects of demineralization, I do not recommend the use of tartar-control toothpastes. Where root sensitivity is a problem, there are toothpastes designed to help remineralize root surfaces. These pastes are best applied after brushing just before bed. That way they will stay on the tooth longer. Just dab a spot on the sensitive root and go to bed. It usually takes six weeks to feel the improvement.

Why haven’t any reliable scientific studies been carried out to determine the comparative safety and effectiveness of the different toothpastes? Maybe because there is no money to be made from such a study. Maybe because large toothpaste manufacturers don’t want you to know that fluoride-containing toothpastes cause allergic-type reactions and gum damage and that a family-sized tube of fluoridated toothpaste contains enough fluoride to kill a small child.

Many believe the pronouncements and recommendations made by the American Dental Association and leading consumer magazines, but few realize that these organizations have not done the scientific research necessary to show safety. In fact, in many cases, just the opposite has been found – the products they have recommended have been shown to be unsafe!

For now, the most reliable approach is to use the common, time-tested agents: baking soda and salt, or a mixture of both with hydrogen peroxide. Other natural products and options are listed in the chapter on gum disease.

Toothpaste is good to the extent that it encourages kids to brush. It is bad if it discourages dry brushing anywhere and anytime. Only a few commercial toothpastes are helpful in controlling tooth decay or gum disease. Feel free to brush without toothpaste; don’t get fixated on the idea that you must have it in order to clean your teeth.

To prevent tooth decay, Dr. Kennedy recommends the following three-step approach:

1. The first step is nutritional. The amount of decay is proportional to the length of time the teeth are in contact with sugar. Diet is very important. I can recall the surprise on a very health-conscious mother’s face when she found out that apple juice is a common cause of children’s tooth decay. “But it is natural,” she protested. Decay germs grow faster and produce more acid to damage teeth if sugar is present. Any kind of sugar will do, even the sugar found in dried fruit such as raisins.

2. The second step is easy. I call it antibacterial. The germs that eat teeth are removed by baking soda. They can be washed away after soda is applied. The soda also helps neutralize any acid present.

3. The third step may be the most important. The weak grooves in a child’s permanent molar teeth can be completely protected. By sealing them with a bonding material, tooth decay can be sealed out before it begins. If left unsealed, more than 50% of these grooves will decay within just a few years. The twelve permanent molars erupt four at a time at ages 6, 12, and 18. Other permanent teeth may have a significant groove defect that may need sealants but the six and twelve year molars are the critical ones.

Dr. David Kennedy practiced preventive dentistry for over 25 years in San Diego, California. He holds a bachelor’s degree in Comparative Biochemistry and Physiology from the University of Kansas and a Doctor of Dental Surgery from the University of Missouri at Kansas City. He served for two years in the United States Navy Dental Corps. He has lectured internationally to dentists and professionals on preventive and restorative dentistry and on the hazards of mercury and fluoride. He is a past President of the International Academy of Oral Medicine and Toxicology.