Monthly Archives: February 2011

Xylitol: The Magic Bullet

Have you ever wished for a miracle product that cures everything? Xylitol just might be as close as we have come to that “magic bullet”… It doesn’t really cure everything, but this natural sugar alcohol is a truly amazing health discovery with a multitude of benefits!

Where does Xylitol come from?

Xylitol isn’t new. The product was first discovered by a German chemist in the late 19th century, and was popularized in Europe as a safe sweetener for people with diabetes that would not impact insulin levels. During World War II, when Europe was experiencing an acute sugar shortage, Finnish scientists searched for an alternative – and re-discovered Xylitol, the low-calorie sugar alcohol found in fibrous vegetables, fruit, berries, corn cobs and various hardwood trees like birch. The name, in fact is derived from a Latin word meaning “wood sugar”. This natural substance is produced by certain microorganisms; and it even forms in the human body as a result of normal glucose metabolism. We actually make up to 15 grams daily!

Sugar alcohols like Xylitol are commonly used in sugarless products; you will recognize them by names such as such as mannitol and sorbitol. Equal in sweetness and volume to sugar, Xylitol has 40 per cent fewer calories and 75 per cent fewer carbohydrates and the granular form of can be used in many of the ways that sugar is used, including to sweeten cereals and hot beverages and for baking.

The Many Health Benefits of Xylitol

Among the greatest benefits of Xylitol is that it prevents tooth decay by inhibiting the growth of the bacteria that cause cavities. These bacteria (Streptococcus mutans) use sugar to grow and reproduce generating acid as a by-product, which causes the tooth enamel to break down and a cavity to form. Streptococcus mutans cannot use Xylitol the same way so over time, the type of bacteria in the mouth changes- fewer and fewer decay-causing bacteria survive on tooth surfaces, so less plaque forms and the amount tooth-dissolving acid is decreased.

Studies show that Streptococcus mutans is passed from parents (usually mothers) to their newborn children. Regular use of Xylitol by expectant and new mothers has been demonstrated to reduce this bacterial transmission by up to 80% during the first two years of life, resulting in fewer cavities for the child.

Xylitol has been evaluated and recommended by the American Dental Association for the prevention of tooth decay, but studies have demonstrated that it has some other potentially promising medical benefits which deserve further exploration. Xylitol can:

  • Prevent ear infections (Xylitol chewing gum)
  • Prevent upper respiratory infections or “colds” (Xylitol nasal spray)
  • Helps with glycemic (blood sugar) control in diabetics
  • Increase the activity the white blood cells involved in fighting bacteria (neutrophils).
  • Help control oral infections of Candida yeast
  • Help prevent periodontal disease, gastric and duodenal ulcers.
  • Improve bone density and show potential as a treatment for osteoporosis.

The effectiveness of Xylitol is depends on using an optimal dose each day – about 5 grams, or the amount found in gum or mints used 3-5 times daily, is usually adequate. The frequency and duration of exposure is important, so chew Xylitol gum for approximately 5 minutes and mints should be allowed to dissolve. Xylitol was approved for safety the U.S. Food and Drug Administration in 1963 and has no known toxic levels for humans, although it can be rapidly fatal if accidently ingested by dogs (who frequently have a bit of a sweet tooth!). Large amounts of Xylitol can have a laxative effect, however the dose suggested for cavity prevention is much lower than what typically produces this unwelcome side effect. Most people build a tolerance to the product when used over time in recommended doses, and eventually the laxative effect decreases or disappears entirely.

Xylitol is found most often in chewing gum and mints, but toothpaste and mouth rinses are also available. Health food stores and several internet companies offer are often a good resource for Xylitol products, including bulk packaged. Generally, for the amount of Xylitol to be at decay-preventing levels it must be listed as one of the first three ingredients on the product label.

People at moderate to high risk for tooth decay are most likely to benefit from using Xylitol, especially if it is used as part of an overall strategy that includes a healthy diet and good oral care at home. Ask your doctor, dentist or dental hygienist how using Xylitol may be of benefit to you or your family- you may find that it is the “magic bullet” you have been searching for!

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Is Whitening Really Safe … and Is It Right For Me?

Nothing conveys youth and confidence like flashing a bright white smile, and it seems everyone from teens to seniors want to know more about whitening options… and why not? There are a wide variety of products available commercially and through the dental office that make it is easier, safer and more affordable than you might think for virtually everyone to perk up their pearly-whites.

Whitening is a term that is used to cover a broad range of products and procedures, but there are some important terminology distinctions to be made. According to the Food and Drug Administration (FDA), the term “bleaching” is may only be used for products which whiten the teeth beyond their natural color. This applies strictly to products that contain bleaching agent – most often hydrogen peroxide or carbamide peroxide. The term “whitening,” on the other hand, refers to restoring a tooth’s natural color by removing surface stain and debris, so any product that cleans (such as toothpaste) can be considered a whitener. Understanding these differences is the first step in choosing the right product and procedure to meet your needs.

Skeptics often wonder if whitening and bleaching is too good to be true… the results look great, but is it really safe? The answer is, “absolutely!” The Food and Drug Administration only approves products for use in the mouth if they are shown safe and effective when used according to manufacturer’s recommendations. That said, there is a right and wrong way to use any product and you can always have too much of a good thing. Consumers should be aware that they are taking risks if they use whitening services outside the dental office, such as at a salon. Recently, the American Dental Association asked the FDA to regulate these services for the safety of the public. All whitening and bleaching products are not created equal; get the best possible result and avoid complications or disappointment by asking yourself what your expectations are. Choose the right product, and be sure you understand the limitations of your choice; it will differ depending upon the product and a variety of individual factors including your dental and periodontal (gum) health, and any fillings or crowns you may have.

Bleaching

Are you hoping for a dramatic change in your appearance or something more subtle? Those seeking a dramatic impact may wish to consider one of two types of bleaching procedures performed in the dental office; the material used in both of these methods is more concentrated than what is available over the counter. A typical one-hour whitening procedure uses a light activated bleaching material and typically has the most dramatic, long lasting effect. Most people touch up their new smile periodically with an at-home product after this procedure. Alternatively, the dentist may make a model of your teeth and create custom fitted plastic trays that are filled with bleaching material and worn over the teeth at home. The tray method takes about two weeks of repeated application and requires touch-ups periodically.

Over the counter white strips are an effective low cost choice for those who may not be looking for a show-stopping impact, those who don’t want to replace fillings, or if you are just unsure whether your teeth will be too sensitive to tolerate a procedure that uses a stronger bleach concentration. After using an over the counter product, you can always upgrade to an in office procedure later.

Whitening

Whitening toothpastes are generally abrasive and they work by polishing off surface stain; for people who build up stain quickly these can be an inexpensive smile pick-me-up. Use these products in conjunction with bleaching products, or instead of them if your main concern is daily stain from tobacco or foods. Watch for tooth or gum sensitivity, and consider alternating use with standard fluoride toothpaste to resolve the problem.

Mouth rinses that claim to whiten work because they help keep stain causing substances from sticking to the surface of teeth. The effect of these rinses in minimal; they don’t contain bleach and they don’t change the color of teeth. However, they are safe and may be a little added “boost” for those who already have a nice white smile and don’t need much change.

Things to think about

White fillings and crowns don’t change color when teeth are bleached, but that doesn’t mean that whitening isn’t an option! Often, the dentist will recommend bleaching the teeth to the ideal shade and then replacing older fillings or crowns to match. This will leave you with a beautiful, uniform appearance. The roots of teeth are always slightly darker than the enamel; so if you have receding gums, be prepared for the likelihood that the exposed roots will whiten differently than the rest of the tooth.

Keep in mind that regardless of cost no whitening or bleaching procedure is permanent; how long the effect lasts depends heavily on dietary habits and smoking. Avoid coffee, tea, dark sodas, red wine and foods that have strong pigment. Drinking through a straw will help, as will through brushing and flossing to remove stain causing substances. Regardless of the procedure you choose, touch ups should be expected over time.

A major consideration when deciding whether whitening your teeth is right for you is your general oral health. Cavities or gum disease are present can make a bleaching painful, so be sure that you have a dental examination and complete any recommended treatment before beginning a cosmetic whitening procedure. Bleaching can cause sensitivity even in a healthy mouth, but the good news is that it is temporary. Use desensitizing toothpaste before, during and after the procedure; and you may need to give your teeth a longer rest between applications of home products.

Don’t be misled by advertising! Teeth are naturally yellowish, and as we age, it is normal for teeth to darken. No matter how much you bleach them, they will never be truly white and the end result depends on how dark they were when you started. Don’t over use products striving for an unnatural color; too much bleaching will make the teeth sensitive. Imperfections in the enamel can sometimes cause unevenness in the whitening result too, but most of the time the overall change is stunning and any minor imperfections are noticeable only to you – up close in the mirror.

Almost everyone can significantly improve their smile – safely and simply – with a professional or over the counter bleaching procedure or a whitening product. Ask your oral health professional which products would best suit your needs and above all, be realistic about your expectations.


Childhood Dental Emergencies: What Every Parent Needs To Know

Childhood Dental Emergencies: What Every Parent Needs To Know

Childhood injuries are frightening, and certainly no one wants to see a child having pain; but in the heat of the moment it is sometimes hard to know what constitutes a dental emergency and what can wait until Monday. The truth is that it is often a judgment call, but having some guidelines can alleviate anxiety, help with on-the-spot decision making and may prevent a manageable problem from becoming a big one.

A head injury can be life-threatening and it may have resulted in a jaw or facial fracture. Both situations require immediate medical attention. Never leave a person unattended if they have suffered a head injury, and remember that the emergency medical team can often reach you faster than you can get to the hospital.

Soft-tissue injuries of the tongue, cheeks, gums, and lips are very common and they result in bleeding which is often very profuse- and very frightening – both to parents and to the injured person, making it difficult to tell how severe an injury actually is. The most important first step is to control it:

    • Rinse the mouth with a mild, warm (not hot) salt-water solution.
    • Use a moist piece of gauze or tea bag to apply pressure to the bleeding site. Hold in place for 15 to 20 minutes.
    • Hold a cold compress to the outside of the mouth or cheek in the injured area for 5 to 10 minutes. This will control bleeding and reduce pain.
    • Call your dentist right away for an evaluation; but don’t wait for an appointment if the bleeding doesn’t stop – go the hospital emergency room. Continue to apply pressure on the bleeding site with the gauze until you can be seen and treated.

Facial swelling is usually a sign that infection may be present and it is a true dental emergency. An abscessed tooth or other oral infection can become life threatening if left untreated. Call the dentist immediately and use a cold compress (ice or ice-pack wrapped in a cloth) on the area of swelling. Because the cold may helps keep the infection from spreading.

Toothaches have many different causes. They are not necessarily emergencies, but could easily develop into one so call your dentist as soon as possible if your child complains of pain. Over the counter pain medications that are given according to the manufacturer’s instructions may provide some temporary relief but it is important to realize that pain relief from home remedies may be masking a serious underlying problem. Never apply an aspirin or other tablet directly to the painful area because this can cause severe burns to the tissue.

A permanent tooth that is knocked out is a true dental emergency, because the faster the tooth is replaced, the better the chances that the tooth can be saved. Try to find the tooth and rinse it off gently without scrubbing any debris off of it, which can damage the surface. Never use soap or any cleaner for that matter; even mouthwash or toothpaste can be damaging! The ideal place to transport the tooth is in the mouth where it is in contact with saliva, but this may be impractical, especially if the child is likely to swallow it. Place the tooth in cold milk – never water – and get to the dentist’s office (or emergency room) immediately. Permanent teeth that are placed back in the socket within an hour have the best chance of survival.

When a baby tooth is knocked out, contact the dentist as soon as possible. Baby teeth are not reimplanted because here is a potential to damage the permanent tooth developing under it. However, the dentist may feel that it is wise to place a small device to hold the space for the permanent tooth. Furthermore, it is very important to examine the child for any fractures or oral injury that may have resulted from the trauma.

A tooth that is chipped or fractured may be an emergency, especially if the nerve has been exposed. It is a good idea to call the dentist immediately. Rinse the mouth with cool clean water and apply a cold compress to the mouth and lip if it was injured. A fracture leaves the tooth extremely sensitive to temperature change, so avoid placing ice directly on the broken tooth.

Broken braces or wires are fairly common. They seldom represent dental emergencies, but should be addressed as quickly as possible to avoid delays in treatment progress. As always, bleeding or pain is a signal to seek immediate attention. Broken wire or brackets that are irritating the cheeks, lips or tongue, should be covered with a piece of cotton or wax to protect the tissue until the orthodontist repair them. Never try to cut or remove brackets or wires, because doing so creates a risk of swallowing or inhaling these sharp objects.

Lost fillings or crowns are not usually an emergency, but you should call the dentist for an appointment as soon as possible because they can cause sensitivity. More importantly, the newly exposed tooth is particularly vulnerable to decay.

While waiting for your appointment, a loose crown can usually be slipped back over the tooth. Cement it in place using temporary dental cement (available over the counter at the drug store) which will help prevent swallowing it. Cover a lost filling with a piece of cotton gauze to alleviate sensitivity, but severe pain is a signal that there is something else going on that may require more urgent attention.

Of course, it is often said that prevention is the best medicine. Most dental emergencies can be minimized by following a few simple suggestions:

  • Schedule regular dental check-ups to prevent or treat cavities early, before they cause an emergency.
  • Protective gear, including a mouth guard should always be when children and teens participate in sports, and it is particularly important for children who wear braces. A custom fitted mouth guard made in the dental office provides the best protection and a new one is usually required each season because the child’s jaws are still growing and new teeth may be erupting which changes the fit.
  • Always use an age appropriate car restraint – a car seat for young children and seat belts for everyone else.
  • Child-proof your home to prevent falls.

When the unavoidable happens, don’t panic. Examine the child’s mouth and teeth as best you can before calling the dentist or doctor, and be prepared to answer some key questions that may be asked of you: Is there any bleeding and can you tell where it is coming from? Are there any broken or shifted teeth? Are they baby teeth or permanent teeth? Does the jaw seem to move normally when opening and closing? Tell the dentist if you are unsure of the answers to these questions so he has as many details as possible when giving a recommendation.

A good rule of thumb for both children and adults is that when in doubt, or when pain, bleeding or facial swelling are present, it is best to seek the advice of the dentist or physician right away. These are usually signs of a problem that is not likely to go away by itself; the right decisions can mean the difference between saving or losing a tooth … or even a life.


Baby Teeth are Not Just for Kids!

Parents commonly ask whether it is necessary to fill a cavity in a child’s baby tooth since they are temporary. The simple answer is YES! Baby teeth are only around for a couple of years, but they not expendable. Keeping them healthy and intact until they fall out naturally has a major impact on a child’s health and the correct positioning of permanent teeth.

A child has twenty primary (baby) teeth which form in the jaw before birth and begin to appear in the mouth at about four or five months of age… just about the time he is ready to begin tasting solid foods. These first teeth are not only important for chewing and nutrition, but for proper development of facial muscles and speech. As you might imagine, losing baby teeth too early can have long term effects, lasting well into adulthood.

Baby teeth are also space holders for the permanent teeth which are developing under the gums. When a permanent tooth is sufficiently developed, the roots of the baby tooth it will replace begin to dissolve, causing it to loosen. Gradually, the permanent tooth pushes the primary tooth out and takes its place. Occasionally a child may have a baby tooth that never develops, in which case there will usually be no permanent tooth under it either. More commonly, a baby tooth may be present but no permanent tooth has developed under it; when this occurs, many times the baby tooth roots never dissolve and the tooth is never lost. These conditions are called “hypodontia” and they rarely present major dental problems, especially when a dentist detects them early and is able to help parents plan ahead.

When a primary tooth is lost too soon, the permanent tooth has no guide to follow. To complicate matters, when there is nothing to fill the space left by a missing baby tooth, the space may begin to close causing the permanent replacement to erupt into the wrong position. The result can be crowded permanent teeth which may lead to speech disturbances and and bite problems that may require braces (orthodontics) to correct. A dentist can often prevent these complications by placing a small device called a space maintainer in the child’s mouth until the permanent tooth begins to erupt.

Sometimes, when a cavity in a primary tooth is small and the tooth is likely to be lost naturally before it causes any pain, the dentist will recommend simply “keeping an eye on it” to spare the child any discomfort from the filling procedure. Occasionally early tooth decay can even be completely repaired by just using fluoride on a regular basis. Advanced cavities must be addressed more aggressively because can be very painful for kids, just as they are for adults – they can even cause severe, life threatening infections.

Regular dental checkups are important and they can help detect small cavities early when they can be most easily repaired. Baby teeth are usually a nice, bright white color when they are healthy; so parents should be on the lookout for suspicious brown spots or other discolorations on their child’s pearly whites and be alert to signs that the child might be experiencing mouth discomfort.

The American Dental Association recommends that children have their first “well baby” dental visit before their first birthday…because preventing cavities and trauma is the best way to ensure that a child will keep his baby teeth intact until the tooth fairy is ready to claim them (rumor has it that she isn’t paying out that well these days anyway!).


February is Children’s Dental Health Month!

National Children’s Dental Health Month is sponsored every February by the American Dental Association (ADA) to raise awareness about the importance of developing good habits at an early age and scheduling regular dental visits to help ensure a lifetime of good oral health.

Whether you have kids or just love kids, there is no doubt that it can be a challenge to keep up with them. Parents understandably have many questions about caring for their children’s teeth, and with the many conflicting messages in the media it’s hard to know what’s best. Your dental health professional can help sort out all the information, but there are some important guidelines to bear in mind:

Taking care of your child’s oral health actually begins even before pregnancy!

Expectant parents should meet with their dentist and pediatrician to discuss nutritional guidelines for pregnant mothers and children, as well as important developmental milestones. Every child is different, but in general you can expect that:

  • 6 weeks after conception the early tooth “bud” forms.
  • 3 to 4 months gestation the hard tissue that surrounds the teeth is formed,
  • Beginning 4-6 months after birth, the first baby teeth begin to erupt – often sooner for girls than for boys, and permanent teeth are already forming under the gums.
  • Beginning at about age 6, the first permanent molar erupts behind the last baby tooth and soon after, the front baby teeth begin to fall out to make room for the permanent ones.

The American Academy of Pediatric Dentistry recommends that a child have their first dental office visit before age 1.

While this might seem surprising, one in four children develops a cavity before they are four years old. Your child’s oral health is influenced by many factors including the oral health and habits of the parents and siblings, genetics and diet. It’s a good idea meet with dental professionals early on to discuss potential problems before they start, and to establish a care plan for your child that includes:

  • Caring for an infant’s or toddler’s mouth at home and at school
  • Decisions about using fluoride
  • How to manage oral habits like pacifier, finger or thumb sucking
  • How to prevent and manage trauma and emergencies
  • Teething and developmental milestones
  • Diet and oral health

Plan ahead for bottle battles and sippy-cup strategies

Milk, formula, juice, and other drinks such as soda all have sugar in them. The more time the teeth are bathed in these liquids, the greater the risk of getting cavities. Most parents will agree that weaning children from bottles and sippy cups is easier said than done; but from an oral health perspective, it’s smart to eliminate them completely around one year- or as soon as possible after tooth eruption. The National Institute of Health suggests other strategies for minimizing risk, including:

  • Don’t put children to bed with a bottle containing anything but water.
  • Don’t let baby have a bottle or sippy cup to carry around between feedings.
  • Don’t dip baby’s pacifier in anything sweet.

Brushing and flossing is important, but it’s not as easy as it looks!

Seasoned parents know that once children start asserting their independence, it can be difficult to convince them to cooperate with someone trying to brush their teeth. Teach children to accept help – and someone else’s hands in their mouth- from infancy. Even before the first tooth appears, it’s a good practice to remove sugars and bacteria by gently wiping the gums with a soft damp cloth after feeding. Introduce an age-appropriate toothbrush (the right size and shape) once several baby teeth have come in. Use a fluoride free toothpaste until the child can be trusted not to swallow it- and use only a pea sized drop on the brush.

It’s encouraging when a child enjoys brushing and does it often, but most children don’t have the motor skills and manual dexterity to brush by themselves until they are at least eight or nine. Until that time, they will need help and supervision. Every child is different, so talk to your dental provider to find out how your child is doing and what you can do to help.

Let’s face it- flossing is hard to do, even for grown-ups. Children have an extra hard time, because they lack the coordination to do it until they are teens. Disposable hand held floss “picks” can help, but it’s easy to misuse them and cause an injury to the gums. Let children begin practicing once their permanent front teeth erupt around age 7. Before that, and for all of the back teeth, give them a hand!

X-rays are essential. If the dentist can’t see a cavity, chances are you can’t either.

It is very common for parents to say, “My child doesn’t need x-rays. He doesn’t have any problems”, but cavities often begin between the teeth where they can’t be seen, and where the toothbrush doesn’t reach. By the time pain is felt the cavity is often big enough to require a large filling, a root canal or an extraction.

Sometimes, a dentist will recommend taking X-rays on a very young child if they are at high risk for cavities; but more often than not, children can’t hold the x-ray film or sensor in their mouth without help until they are somewhat older. This is generally not a problem, because baby teeth usually have plenty of space between them to allow the dentist to visually check for cavities.

Once the first permanent molar erupts at about age 6, spaces begin to get tighter and it’s important to take x-rays to check for cavities between the teeth. Sometimes, fluoride can heal early cavities so they don’t have to be drilled.

Furthermore, some children never develop one or more of their permanent teeth. This is rarely a major problem but it is important to know about it in advance to plan ahead for braces (orthodontics) if necessary. When no permanent tooth exists, the baby tooth doesn’t always loosen and fall out by itself. In fact, it’s very possible to keep the baby tooth in place for many years as long as it is well cared for, thereby avoiding a variety of potential complications.

Modern Dental X-rays are extremely safe, and without them your dentist has an incomplete picture of your child’s oral health. Knowing in advance what is developing under the gums and between the teeth can help avoid long term problems.

Fluoride

Fluoride is safe, effective and has been recommended by the American Dental Association for 50 years for the prevention of cavities. The dental provider may apply it during checkups in a gel, foam, rinse or varnish; and a variety of prescription and over the counter products containing fluoride are available for home use. The dentist or hygienist will provide you with individualized recommendations for your child.

The American Dental Association advises against using fluoridated water for mixing infant formula because it can damage developing tooth enamel; the local health department can provide information about water fluoridation. Parents should keep fluoride products, including toothpaste out of children’s reach and be alert for signs of fluoride overdose (abdominal pain, vomiting, and diarrhea) if they suspect a child has ingested a large amount of these products.

Sealants

Permanent molars (and sometimes premolars) develop with deep narrow grooves in them. Bacteria that cause cavities become trapped in the grooves, but toothbrush bristles are too large to clean them. A sealant is a plastic coating that is painted on to the chewing surface of to fill in the grooves and create an easily cleanable surface. The sealant can’t be applied once an obvious cavity has developed, so the dentist may recommend sealants as soon as the first permanent molars begin to erupt around age 6.

Children’s oral health is a team effort… and it’s all about prevention.

Armed with the right information and a good oral health team, teachers, parents and caregivers can help establish the foundation necessary for life-long oral health. It’s a team effort that requires a variety of different strategies from good nutrition to regular professional care.

It’s probably no surprise to hear that despite our best efforts to intervene, kids don’t always brush very well; and to make matters worse they probably (at least occasionally) eat and drink things that they shouldn’t. They fall down, they have accidents, and they are sometimes faced with oral health issues that no one can prevent or predict.

The key to a lifetime of healthy smiles in spite of it all is to have a plan in place to compensate for kids being… well, kids.


How Toothpaste Works

Most people know that brushing with toothpaste should be part of their daily hygiene routine… but have you ever wondered what all those ingredients in your dentifrice are and how they work? It can be a challenge to sort through the mind boggling array of choices on the shelf at the local supermarket, but knowing some basics can help consumers make more informed choices about the toothpaste that will best meet their needs.
Choosing the right product to use begins with understanding the oral environment, which harbors a thriving community of over 500 species of bacteria, some of which make their home in a sticky substance called “plaque” that adheres to the teeth. The bacteria in the plaque produce acids which lead to cavities, toxins that cause gum disease and sulfur compounds that create breath odor.
A dentifrice, derived from the Latin words “dens” (tooth) and “fricare” (to rub) is any toothpaste, gel, or powder used to remove the harmful plaque and debris from the teeth in one of two main ways:
Abrasive Action: Abrasive ingredients physically scrub away the plaque and solid particles, and polish stains from the teeth. A polished tooth surface is more resistant to plaque accumulation, but the too much abrasion can also make the teeth sensitive. Since the roots of teeth are softer than the enamel, people who have gum recession should be very cautious about the abrasiveness of the toothpaste they use. All abrasive ingredients are not created equal. The American Dental Association has created the RDA scale, which rates abrasiveness from zero (lowest) to 250 (highest). As a general rule, baking soda (sodium bicarbonate) toothpaste is at the low end of the scale and many whitening and tartar control toothpastes are at the high end.
Antimicrobial Action: Toothpaste may contain one or more ingredients that kill or slow the growth of bacteria. Cavities, gingivitis and periodontal disease can’t occur unless certain bacteria are present in the mouth, so antimicrobial ingredients are very helpful for people who have a high risk for these conditions.
Generally, a dentifrice is classified as either cosmetic, therapeutic or both depending on its unique properties but all of them have several ingredients in common:
• Water (15-50%),
• Abrasive agent (20-60%),
• Humectants (20-40%) which prevent hardening of the toothpaste when exposed to air. Common ones include glycerin, mannitol and sorbitol.
• Surfactant or detergent (1-2%), usually sodium laurel sulfate which creates the foaming action that helps loosen plaque and food particles,
• Binders (1-2%) such as cellulose gum prevent separation of the solid and liquid ingredients,
• Flavoring agents (1%) such as peppermint or cinnamon essential oil mask the unpleasant flavor of the other ingredients,
• Sweeteners such as sodium saccharin or Xylitol,
• Colorants
Most dentifrices also contain an “active ingredient” that makes them useful for a specific purpose:
• Do you have red, sore or bleeding gums? Triclosan is a very effective antibacterial product found in many soaps, deodorants and other products, but Colgate TOTAL is the only dentifrice that contains this ingredient. Look for other antimicrobial ingredients like Xylitol, Zinc Citrate, Peroxide, Lacoperoxidase and baking soda (sodium bicarbonate) to help control gingivitis.
• Do you build up tartar quickly? The tartar control ingredient Pyrophosphate might help keep it from forming, but be careful because it can cause gum and tooth sensitivity too!
• Are your teeth Sensitive? Potassium nitrate and Stannous fluoride are helpful. Be aware that stannous fluoride can cause temporary stain on the teeth.
• Do you want a brighter, whiter smile?: Abrasive agents and peroxide remove surface stains but don’t really change the natural color of the teeth. For that, you would need to consider a bleaching procedure.
• Is your mouth dry?: Lactoperoxidase is an enzyme that helps with this problem. Fortunately, it also reduces gingivitis since they often occur together. Dry mouth is a serious problem with many causes, and it is important to speak to your doctor or dentist if you suffer from this symptom.
• Cavity protection: Fluoride is an active ingredient in most toothpaste. It is absorbed into the tooth structure, replacing tooth structure that has been weakened by plaque and making teeth harder and more resistant to decay. Xylitol is a natural sweetener that has been shown to slow the growth of bacteria in the mouth, preventing both cavities and gingivitis.

Next time you’re shopping for a dentifrice, read the label… you might be surprised! The Food and Drug Administration (FDA) has issued a caution to consumers to carefully examine labels and avoid purchasing toothpastes imported from China (usually found at Dollar and discount stores). Some have been found to be counterfeit, containing no fluoride and harmful substances like Diethelene Glycol (antifreeze).
Toothpaste and a good brush are the first lines of defense against cavities and gum disease, so talk to your oral health providers about the best product to meet your needs. They can help you navigate the options and avoid unwanted side effects. When in doubt, a good rule of thumb is to choose a product that has the American Dental Association Seal of Acceptance. That’s a consumer’s best assurance that a product is safe and effective.