Which Toothpaste Should I Use?

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This is a question I get asked a lot. And no wonder! Take a casual stroll down the dental aisle and its down right overwhelming. There are shelves and shelves of toothpastes all promising to be the next great thing that will save your teeth! Words like, tartar control, whitening, gum care, and other slogans are thrown at consumers with no background information on what ingredients are used and what that means for your overall health. 

The two major toothpaste brands are Crest and Colgate and each have their loyal fan bases. Both have dozens of different toothpastes within their lines so it’s hard to discuss all the different variations. Regular Crest and Colgate are just that- the same formulation we’ve been using since the 1950s. And honestly, these are my favorites. Everything we’ve added in toothpastes since then have a lot of pros and cons, and it gets complicated. 

One of the big changes in more modern toothpastes is the kind of fluoride we use. In the dental industry the number one type of fluoride used has been Sodium Fluoride. Its readily absorbed by the teeth and has little to no side effects orally. Recently many toothpastes have switched to Stannous Fluoride which has been hailed as having great benefits for your teeth. Research shows it can help with sensitivity, reduce risk for cavities, and last longer in the tooth. Sadly it has one major downside. In a larger portion of the population it can cause a lot of staining and even increase production of calculus (tartar). Now both of those things are removable by your hygienist at your regular hygiene visits but often the staining comes on quickly and you’ll be left with dark brown stains on your teeth until you can get to your hygienist. So, personally, I don’t love toothpastes that use stannous fluoride- but if you’re lucky enough to be part of the population that isn’t affected by the side effects- great! Brush away! But it is still very important to use a toothpaste with fluoride in it- if you are looking for fluoride alternatives you can always talk to your hygienist and dentist about what is best for you. 

Another important ingredient that doesn’t get talked about much but is very important is Sodium Lauryl Sulfate or SLS. SLS is not an active ingredient so you have to drive deep into the label to check for it. But I’ll save you some trouble- almost ALL toothpastes have it. What SLS does is it gives your the foaming of the toothpaste- creates the bubbles. People like that feeling. Unfortunately, more and more people are becoming very sensitive to this ingredient- even allergic to it. I have many patients report to me that suddenly their mouth just feels raw, red, irritated- even break out in sores and ulcers. Very often the solution is easy switch to an SLS free toothpaste- and viola! It’s all better. A sensitivity or allergy can start out of nowhere too. You could have been using the same toothpaste for years and suddenly develop symptoms. Now as I stated above almost all toothpastes have SLS in them so finding one that doesn’t have it can be tricky- in fact some newer toothpastes like Crest’s Gum Detoxify and Sensodyne’s Parodontax have DOUBLED the amount of SLS. They both advertise that the extra foaminess allows the toothpaste to reach deep under the gumline which is beneficial for patients with gum disease. And a lot of people really like it. But, I caution you to monitor for any signs of a reaction in your tissues when using it. Thankfully a few brands are catching on to this sensitivity and are offering alternatives, Sensodyne, Toms of Maine, and Hello, all offer SLS free products.

Let’s talk whitening. Everyone wants whiter teeth and most of toothpaste marketing is geared towards praying on this.  Tons are commercials and advertising promise “2 shades whiter!” or “2x the whitening power!” The reality is toothpastes can only work on exterior stains on your teeth. So if you are a coffee, tea or red wine drinker they will help reduce staining from the things you eat and drink. But they aren’t going to do anything to change the internal color of your teeth and most whitening toothpastes use very abrasive materials to help you with outside stains and that’s what is really doing the whitening. We dental professionals don’t like this very much. You only have so much enamel- once it’s gone, it’s gone. It’s why we don’t prefer to drill on teeth if we don’t have to. Using a very abrasive toothpaste everyday can lead to long term wear and increase sensitivity. Unfortunately at this time toothpaste companies are not required to label what abrasivity each toothpaste is. You can find this information if you look hard online but we also have a lovely chart of some major brands in office if you would like to see it at your next visit. Generally, Arm and Hammer, Sensodyne and that good old basic Crest and Colgate come in being less abrasive. 

So what’s the magic toothpaste? Which toothpaste should you use? Most of the time my answer is going to be – Use what you like and what you’re going to use. Until I see something that makes me suggest you change or your have concerns about something in particular- then we are happy to guide through that overwhelming aisle.