Dr. Pearl E. Whites
What is the Best Toothpaste to Use?
Updated: Aug 18, 2022
Am I to buy Crest, Colgate, or UltraBrite? Do I get hydroxyapatite toothpaste, charcoal toothpaste, or other fad toothpastes? Are the different types of fluoride on the back of the ingredients any better than the other? Do I just get the most expensive toothpaste?
Two Things You Need to Know
1) The FDA says fluoride is the ONLY ingredient in toothpaste that can prevent cavities and reinforce the enamel tooth structure. No other chemical in toothpaste can say that.
2) NEARLY ALL fluoride toothpastes contain about the same amount of fluoride since the FDA strictly regulates how much goes into toothpaste! That's right. If you're buying toothpaste for the anti cavity properties then it almost does NOT matter if the toothpaste is from the dollar store or in a golden-wrapped container. This includes pediatric to adult, extra strength to regular, multiple benefits vs single action toothpastes.
Don't be confused by the different fluorides in toothpaste
(boring science portion):
There are 3 forms of fluoride accepted by the FDA: 1) stannous fluoride 2) sodium fluoride 3) and sodium monofluorophosphate, If you look at the back of the toothpaste ingredients you will find different measurements among brands. What do they mean?
To compare apples to apples, most dental agencies all over the world are uniform saying for toothpaste to be effective against cavities, a person needs to brush his or her teeth 2x/day with a toothpaste that has at least 1,000+ parts per million (ppm) of fluoride. Regardless of the 3 sources of fluoride in toothpaste among brands, one thing is constant: if an over-the-counter toothpaste in America has fluoride in it (i.e. Crest, Colgate, Aim, etc.) it has a range of 1,000-1,100 ppm of fluoride and is equally effective. All fluoride toothpastes act as a shield that protects your teeth from the acidic onslaught making it harder for cavities to grow.
What's the Difference Between Fluorides?
All 3 types of fluoride are effective anti-cavities ingredients (stannous fluoride, sodium fluoride, and sodium monofluorophosphate). However, stannous fluoride has an antimicrobial property that fights against gum disease whereas the other fluorides don't. The downside to stannous fluoride is over months and years it can leave lightly tan stains on your teeth--remember stannous can stain. If you wanted an extra boost of protection then choose stannous fluoride toothpastes (image below are the main stannous fluorides on the market), but any fluoride toothpastes are sufficient in protecting your teeth.
**Stannous fluorides: Crest Pro-Health (and all the offshoots like Gum Detoxify, Gum Restore, Whitening, Regular), Colgate Renewal Gum, Paradontax, and Sensodyne.
Most natural toothpastes advertise as fluoride free, vegan, gluten free, organic, no sodium lauryl sulfate (gives toothpaste foam), no triclosan (anti gingivitis), etc. Tom's of Maine has a great explanation of fluoride's role and they are a more naturalist company: if you want to prevent cavities you should use a toothpaste with fluoride. We are not entirely anti "natural toothpastes." If you want a toothpaste that does NOT prevents cavities then don't use a fluoride toothpaste and it's a win/win for you and any dental office.
Hydroxyapatite, Charcoal, or Other Fad Ingredients for Toothpaste
Hydroxyapatite is a new trend toothpaste that fortifies and claims to strengthen teeth. Funny thing is this is exactly what fluoride toothpastes do too--in fact, it's more effective when fluoride is involved. Fluoro-hydroxyapatite is formed while using fluoride toothpaste, which shields your teeth from cavity-causing bacteria. This is more of a marketing technique rebranding what fluoride toothpaste already does.
Charcoal toothpastes are very abrasive and do make your teeth whiter. They are also more destructive to enamel and are NOT even in the same arena as fluoride toothpastes since they do NOT prevent cavity formation. We suggest to avoid trendy toothpaste fads and stick with what is reliable--fluoride toothpastes.
Honest Truth of Active/Inactive Ingredients
To differentiate among other toothpaste brands, companies will add "inactive ingredients" but just know that the main function of any toothpaste or mouthwash is largely dependent on the "active ingredients." We delve into those inactive ingredients in a different article.
How Much Fluoride Is Needed?
Kid labeled vs adult toothpaste has the exact same amount of fluoride too. Kids need the same quality amount of fluoride per day--1,000ppm per brush but the quantity is different. According to the ADA they give guidance of how much fluoridated toothpaste is needed:
1st erupted tooth to 3-years old: the size of a grain of rice.
Kids 3-6-years old: need no more than a pea-sized
After 8-years old fluorosis (too much fluoride, which can cause white cloud stains on your teeth) rarely is a threat to teeth and is not as regulated.
If your teeth are at great risk for decay then heavily consider a prescription toothpaste like Prevident 5,000. This is like a cannon vs a rifle when it comes to protection.
Find a toothpaste that you like based on taste preferences. If it has fluoride and that's the only feature you look for in a toothpaste then it does NOT matter which one you choose.
Some toothpastes advertise that they do more than their competitors when both have the exact same ingredients. Don't be dissuaded by the advertising but focus on the active ingredients.
If you want more added benefits to a toothpaste then use stannous fluorides (see list above).
The ADA, CDC, and EPA established how much fluoride you need topically each day to effectively fight cavity-causing bacteria--2,000ppm of fluoride toothpaste, which entails brushing 2x/day.
Nearly every over-the-counter fluoride toothpaste has the same quality amount regardless of the condition the fluoride is in ranging around 1,000ppm.