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Dentists Debate Toothpastes

In a dentist’s ideal world, you wouldn’t only brush your teeth twice a day — you’d be doing the job well, brushing for the full two minutes and choosing the right toothpaste. Yet with all the toothpastes on shelves to choose from, it can be difficult to figure out which one to use. 

People live busy lives full of eating, drinking and sleeping. Toothpaste helps clear away food debris and protects teeth against decay with a special recipe of antibacterial and cleansing agents. Your typical toothpaste is made of fluoride, which helps strengthen your tooth enamel against cavities; sodium lauryl sulphate, the ingredient that creates a nice foaming effect; and triclosan, an antibacterial agent that helps prevent gum disease. Toothpaste also contains some level of abrasive ingredients, commonly derived from chalk or silica, to gently scrub stains and debris off your teeth. 

While toothpaste can come with any or all of these ingredients, which one you choose depends on your needs and preferences. We spoke with five dentists about the most popular types of toothpaste on the market and whether they really do what they claim. 

Kids’ toothpaste

What type of toothpaste you should use for your kid — and how much — depends on their age. According to the American Dental Association, caregivers should use no more than a smear of fluoride toothpaste on children under the age of 3.

For kids ages 3 to 6, caregivers shouldn’t dispense more than a pea-sized drop of fluoride toothpaste. “Children’s toothpaste generally contains flavors that are approachable for kids, fun marketing and tube sizes that are easier for children to hold,” says Dr. Kate Zoumboukos of SW Austin Dental in Texas.

Whitening toothpaste

Whitening toothpaste usually contains more of those abrasive ingredients, which makes it better at scrubbing stains from the surface of the teeth. Chicago-based Dr. Alexander Alemis says he doesn’t see any issues with whitening toothpaste and encourages people to try different products to see what they like. 

Dr. Rob Raimondi of One Manhattan Dental, on the other hand, isn’t a fan of whitening pastes. He says the abrasive ingredients can thin the enamel on your teeth and cause more damage in the long run; he recommends whitening strips over whitening paste. “Getting regular cleanings can remove stains in a healthy way,” says Raimondi, “but if a tooth polished at the dentist isn’t white enough, you can chemically whiten your teeth with strips at home or with an in-office procedure.” 

Sensitive toothpaste

These formulas can benefit people who have receding gum lines that expose teeth’s roots, experience sensitivity to heat or cold when eating or find brushing painful for another reason. Dr. Ryan Dulde, of Eagle Dental in Eagle, Wisconsin, says this type of paste is usually free of ingredients that could irritate, like the strong abrasives or hydrogen peroxide sometimes used for whitening. 

Sensitive toothpaste also contains more fluoride than standard varieties, which Dulde says can help “plug the pores of the teeth so the nerve endings are less sensitive and don’t perceive temperature or rubbing.” Another trick to prevent irritation while brushing is to use your nondominant hand to brush. “You don’t need a heavy hand to do a good job,” Dulde says.

Before making the jump to a new toothpaste, Zoumboukos says it’s important to talk to your dentist about any increased sensitivity. Your provider may want to address issues contributing to sensitivity, like worn tooth enamel or exposed roots.

Prescription toothpaste

A toothpaste that’s prescription-grade contains even more fluoride than sensitive toothpaste, which makes it a good option for people with extra-sensitive mouths. It’s also commonly prescribed for people who don’t have enough saliva in their mouths due to medical procedures, like radiation for head or neck cancer. “Saliva has anti-cavity characteristics, so if you have less saliva, you may be more prone to cavities,” Alemis says. Fluoride creates an extra barrier on your teeth that’s hard for acids created by bacteria to penetrate. 

Extra fluoride is safe as long as you don’t swallow it, but Zoumboukos says it’s important to keep your prescription toothpaste away from kids and pets who could get into it. 

Charcoal toothpaste

You’ve likely seen more dental products advertising charcoal, whether as an ingredient or as a component of a brush. Charcoal is absorbent, so doctors sometimes give it to patients who have ingested poison. “Someone had the idea to put it in toothpaste to absorb toxins in your mouth,” says Raimondi. “Then they realized how abrasive it is, so it makes your teeth look really white.” 

Raimondi generally doesn’t recommend charcoal-based products as a primary toothpaste, as that level of abrasion can damage your teeth and gums. Dr. Jonelle Anamelechi, a Children’s Choice Pediatric Dentistry and Orthodontics dentist based in Washington, D.C., agrees. The key point for her is that the effectiveness of charcoal toothpastes haven’t been proven in clinical research. Many brands or lines of charcoal toothpaste also don’t contain ingredients that make toothpaste effective, like fluoride. 

Baking soda toothpaste

Many store-bought toothpastes also contain baking soda, which Dulde says is gently abrasive and can lift stains and polish teeth. If you’re looking at a standard toothpaste that happens to contain baking soda, he doesn’t have a problem with it. But if the paste’s only active ingredient is baking soda, you might be missing out on beneficial ingredients. “Baking soda could be a beneficial ingredient,” he says, “but brushing with baking soda alone wouldn’t be my first choice.” 

Standard fluoride toothpaste

Finally, you have the most basic — and possibly beneficial — toothpaste out there: run-of-the-mill fluoride toothpaste. “Fluoride is a safe, cheap, effective ingredient and has many benefits for public health,” says Dulde. “It strengthens enamel and makes teeth more resistant to cavity damage.”

In general, Anamelechi says, fluoride toothpaste is a good baseline. Once you’ve confirmed that it’s present, choose a product based on any other needs, such as whitening or sensitivity. Although there’s plenty of research to support the use of fluoride toothpaste, some people are concerned about its effects. (Excessive fluoride intake can cause nausea or an upset stomach, and long-term excessive intake is associated with bone disease. Neither is likely unless you’re eating tubes of toothpaste on the daily.) 

Rinsing extra after you brush can ensure you don’t swallow too much of it, says Raimondi. Some manufacturers also opt for other active ingredients, such as xylitol, a natural sweetener purported to avoid tooth decay. (So far, studies are unclear about that claim.)

Don’t rely on your toothpaste to fix all your oral and dental health issues, of course. “Toothpaste is helpful, but we believe the brush is more important, because it does the mechanical action of cleaning your teeth,” says Dulde.

Alemis suggests using a generic soft-bristled toothbrush (yes, like the kind you get from your dentist) and replacing it every few months. “As you brush, go back and forth, with half the bristles on your gums and half on the teeth,” he says. There’s no hard-and-fast rule, but Raimondi suggests aiming for two or three minutes. 

If you still need help with your brushing routine or choosing a toothpaste? Check in with your dentist or dental hygienist before you brave the dental care aisle — and while you’re at it, maybe schedule that cleaning you’ve probably been putting off too.

Ready to book a doctor’s appointment? Visit Zocdoc.

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