Which Toothpaste is the Right One for You?

Preparing this blog took much longer than we had anticipated!  At first we thought we knew all there was to know about different kinds of toothpastes and their use and indications but once we started exploring, we realized how little we knew and how hard it is to get some answers from various toothpaste manufacturers.


In choosing a toothpaste most people look for good flavor, thickness (neither too runny nor too hard) and pleasant texture.  People also want their mouth to feel clean after brushing, with sweet breath, and for teeth to look not only unstained, but as white as possible. Dentists, on the other hand, say the best toothpaste is the one that protects teeth from cavities, abrasion.  Plaque If not removed at least every 24 hours, it hardens into tartar, which builds up and makes teeth and gums even more susceptible to decay - resulting in a negative cycle that can cause first gingivitis, then serious periodontal disease. In turn, quite a few experts believe that periodontal disease may cause systemic problems, including but not limited to heart problems.
Let’s start off by familiarizing ourselves with commonly found ingredients in toothpastes:

Basic Ingredients

Fluoride:  is the main active ingredient found in almost all toothpastes.  It wasn't until about 50 years ago that fluoride was first added to toothpastes.  It helps with calcium uptake thereby strengthening the enamel and making it less susceptible to decay. Fluoride only makes up about 0.1%- 0.2% of most toothpaste, although prescription-strength fluoride toothpastes contain more than 1% of fluoride. 

Abrasives:  are added to aid in removal of plaque and daily deposits from the tooth.  Toothpaste is rated on a scale of RDA 1-200, according to its abrasiveness. The American Dental Association (ADA) recommends using a toothpaste with an abrasive index of less than100.  If toothpaste with higher index of abrasiveness is used on a regular basis, irreversible damage may result which includes enamel and root surface wear which may cause tooth sensitivity.  Tooth enamel re-mineralizes daily from the supply of ionic calcium and phosphorus in the saliva.  Scratching the surface of the tooth with an abrasive such as hydrated silica harms the enamel and prevents re-mineralization, much like using sand to clean glass.  Severe wear could eventually occur.

Some examples of abrasives in toothpastes are calcium carbonate, mica, calcium pyrophosphate, dicalcium phosphate, sodium bicarbonate, and hydrated silica.
To find out the abrasive index of some commonly used toothpaste please refer to table 1 at the end of this blog.

Detergents:  are added to prevent the toothpaste from dripping.  They create foam and bubbles.  The main detergent in toothpaste is known as sodium lauryl sulfate (SLS) which is shown to cause oral canker sores in some people.  If you are one of these people who get frequent canker sores you may want to change your toothpaste to one that does not contain SLS.  These toothpastes are usually found in health food stores or on line.  One example of non SLS toothpaste is: Dr. Collins natural toothpaste.

Flavors:  are added to give the toothpaste a pleasant and inviting taste and smell.  They range from mint to cinnamon and fruits etc.  Interestingly enough, they even come in "pickle flavor"!

Moisturizers:  are added to keep the toothpaste moist and prevent it from drying out.  Examples of some commonly used moisturizers are glycerin, sorbitol, and water

Preservatives:  are added to prevent microbes from growing in the toothpaste and spoiling it.  It is for the presence of this ingredient that we don’t have to refrigerate our toothpastes!  Methylparaben is used as a preservative in some toothpaste. Parabens have received some negative attention in recent years for iatrogenic activity - meaning they can add to the risk of some cancers, including breast cancer.

Colors:  are added to give the toothpaste an attractive appearance.  Some toothpastes have glitters added for special effect or have two colors in a stripe.

Sweeteners:  are added to make the experience of brushing a sweet one!  Saccharin, aspartame, or xylitol are some of the common sweeteners used in toothpastes.

Thickeners:  are added to prevent the toothpaste from being too runny.  Carageenan and xanthan gum are common thickeners added to toothpastes.

Other Ingredients

Antibacterial Agents:  Certain toothpastes contain Triclosan, which is an antibacterial and anti-fungal agent.  It is commonly found in antibacterial soaps.  Toothpastes which contain Triclosan are known to prevent plaque from forming around the teeth for up to 12 hours and claim to have a positive effect on the health of the gum by reducing inflammation.

Peroxide:  are added to those toothpastes that have whitening effect.  Peroxide is a whitening agent and is the main ingredient used in most tooth bleaching products. Peroxide can irritate sensitive gums, causing extreme tenderness. 


Desensitizing Compounds:  are added to desensitizing toothpastes to reduce tooth sensitivity.  Two commonly used desensitizing compounds are:  Potassium Nitrate and Strontium Chloride. Both compounds interfere with pain transmission but in different ways.

The root of the tooth contains many dentinal tubules.  These tubules are the pathways from the outside of the tooth to the nerve in the center of the tooth.  The nerve can only transmit the sensation ‘pain’ to the brain.  When there is no gum recession these tubules are covered up and protected by the gum.  But when the root is exposed due to recession, outside factors such as cold, heat, and air stimulate the tubules.  In turn they stimulate the nerve which sends a ‘pain’ signal to the brain.

Potassium nitrate works by traveling down the dentinal tubule, thereby interrupting pain signals to the brain.

Strontium chloride works by physically blocking the dentinal tubules that have become exposed when the gums recede.

It is important to keep in mind that not every pain signal is harmless and should be blocked by desensitizing toothpaste.  Pain signals should be taken seriously as they could indicate more important problems that if masked temporarily would only get worse over time.  So if you have any pain or sensitivity that was not there before, please consult with your oral health care provider prior to using any desensitizing toothpastes.

Baking Soda:  is added to help with stain removal.  Contrary to common belief baking soda itself is not an abrasive agent.  It has been used as a tooth cleanser for more than 150 years.  It not only removes stain but it also helps to whiten teeth. To use it as a stain removing agent simply purchase a yellow box of baking soda from any supermarket. Pour some into a small dish and keep beside your sink or medicine cabinet.  Dip your wet toothbrush into the baking soda until it is well caked and then proceed to brush for 2 minutes.  If you do not like the salty taste simply add a small amount of toothpaste to your brush as well as the baking soda.  This will help to mask the salty taste.  Some of our patients who have tried this on a regular basis have managed to keep their teeth virtually stain free.

Enzymes:  Glucose oxidase, lactoperoxidase and lysozyme are enzymes that are added to reduce the frequency of dry mouth conditions and increase saliva production.  These enzymes are used exclusively in Biotin products which are commonly used by people who suffer from a dry mouth condition.


Now that we have talked about various ingredients in toothpastes I think you all agree with us that choosing the right toothpaste can be quite challenging!  This is how I would approach it:

1. Some individuals with specific needs or conditions may be advised to use a specific type of toothpaste for a short or longer duration of time until desired objectives are achieved, here are some examples:
• Individuals who are at high risk of developing cavities due to systemic or genetic predisposition and individuals who are going through orthodontic treatment, may be advised to use a prescription strength, Fluoridated toothpaste for a specific or indefinite length of time
• Individuals who have some mild, generalized tooth or gum sensitivity may be advised to use toothpaste which contains some "desensitizing agent" for a specific length of time until the sensitivity subsides. Please note that all other adverse factors that could potentially contributing to sensitivity must be ruled out first
• Individuals with periodontal conditions who have already gone through the active phase of treatment and are following a diligent home care dental hygiene routine, with bleeding gum, may benefit from using toothpaste which contains "antibacterial agents". Short term use of these toothpastes may eliminate the residual periodontal inflammation, ultimately resolving the issue of "bleeding gum
2. If you have healthy and well maintained dentition, you may pick from a variety of toothpastes, based on your personal preferences. We do however; only recommend that you choose from those toothpastes which have the abrasive level of under 100. Please refer to table 1 for a list of such toothpastes
3. Some individuals may opt for using toothpastes without Fluoride due to the controversy surrounding Fluoride toxicity. There are not very many toothpastes in the market which are made without Fluoride but manufacturers are responding more to general public concern and more brands are being added to the market
4. If you get recurring canker sores, you may want to try toothpaste without SLS....your painful recurring episodes may just be over
5. If you drink wine or tea frequently and get stain on your teeth, you may want to use either plain baking soda or any toothpaste containing baking soda. Baking soda is the most gentle, least abrasive yet most effective way of removing stain from your teeth in between your dental cleaning visits. Some individuals attempt to deal with the stain issue through the use of very abrasive toothpaste....while this could lead to irreversible damage to enamel and teeth, it barely proves effective in dealing with the stains. We recommend the use of baking soda and baking soda containing toothpaste for mild stain in between professional cleaning visits and use of OTC or custom made trays and bleach material for handling the moderate to severe stains
6. While this blog addresses only adult toothpastes, I would like to take this opportunity and remind all parents to supervise brushing of your youngsters and to remind them not to swallow the toothpaste as frequent ingestion may result in poisoning due the Fluoride toxicity if used in dosages higher than recommended. Please always use children's toothpaste for children and always read the label as well

I hope you find this blog informative and interesting. As always, Dr. Rahbar and her team would be more than happy to discuss any issues or concerns you may have and to answer all your questions and help you with choosing the toothpaste that is right for you!

Please refer to the following table (table 1) for a list of commonly used ingredients in some common brands of toothpaste.

Brands	Fluoride	Detergents	Sweeteners	Antibacterial	Whiteners	Desensitizer	ADA Seal	Stain Removal	RDA
Aloesense Toothpaste	Yes	SLS	Saccharine	No	No	No	Yes	Hydrated Silica
Aquafresh All Tartar Control	Yes	SLS	Saccharin	No	No	No	No	Hydrated Silica	110
Aquafresh Fluoride	Yes	SLS	Saccharin	No	No	No	Yes	Baking Soda & Hydrated Silica	91
Aquafresh Multi Action Whitening	Yes	SLS	Saccharine	No	No	No	No	Hydrated Silica	113
Aquafresh Sensitive	Yes	SLS	Saccharine	No	No	Yes (KNO3)	No	Hydrated Silica	91
Aquafresh Striped Gel Whitening	Yes	SLS	Saccharine	No	No	No	No	Hydrated Silica	119
Aquafresh Triple Protection	Yes	SLS	Saccharine	No	No	No	Yes	Baking Soda & Hydrated Silica	105
Aquafresh Whitening  With Fluoride	Yes	SLS	Saccharine	No	No	No	No	Hydrated Silica	113
Arm & Hammer Dental Care Advance Cleaning  w/Baking Soda	Yes	SLS	Saccharine	No	No	No	Yes	Baking Soda	42
Arm & Hammer Dental Care Whitening	Yes	SLS	Saccharine	No	No	No	No	Baking Soda	168
Arm & Hammer Peroxicare Baking Soda	Yes	SLS	Saccharine	No	Peroxide	No	No	Baking Soda	49
Colgate 2-in-1 paste Mouthwash Whitening	Yes	SLS	Saccharine	No		No	No	Hydrated Silica	200
Colgate Baking Soda & Peroxide w/ Tartar Control	Yes	SLS	Saccharine	No	Peroxide	No	No	Baking Soda & Hydrated Silica	125
Colgate Baking Soda & Peroxide w/ Tartar Control Whitening	Yes	SLS	Saccharine	No	Peroxide	No	No	Baking Soda & Hydrated Silica	145
Colgate Cavity Protection Gel	Yes	SLS	Saccharine	No	No	No	Yes	Hydrated Silica	65
Colgate Cavity Protection Regular	Yes	SLS	Saccharine	No	No	No	Yes	No	65
Colgate Luminous Fluoride Toothpaste	Yes	SLS	Saccharine	No	No	No	Yes	Hydrated Silica	175
Colgate MaxFresh  with Mini Breath Strips	No	No	Saccharine	No	No	No	No	Hydrated Silica	175
Colgate Sensitive Maximum Strength	Yes	SLS	Saccharine	No	No	Yes (KNO3)	No	Hydrated Silica	67
Colgate Simply White Advanced Whitening	Yes	SLS	Saccharine	No	Peroxide	No	No	Hydrated Silica	124
Colgate Tartar Control Whitening Mint	Yes	SLS	Saccharine	No	No	No	No	Hydrated Silica	170
Colgate Toothpaste, Regular	Yes	SLS	Saccharine	No	No	No	No	Hydrated Silica	65
Colgate Total 12-Hour MultiProtection Plus Whitening Gel	Yes	SLS	Saccharine	Yes (Triclosan)	No	No	Yes	Hydrated Silica	213
Colgate Total Clean Mint	Yes	SLS	Saccharine	Yes (Triclosan)	No	No	Yes	Hydrated Silica	70
Colgate Total Advanced Whitening Gel	Yes	SLS	Saccharine	Yes (Triclosan)	No	No	Yes	Hydrated Silica	190
Colgate Total Advanced Whitening Paste	Yes	SLS	Saccharine	Yes (Triclosan)	No	No	Yes	Hydrated Silica	190
Colgate Total Clean Mint Paste	Yes	SLS	Saccharine	Yes (Triclosan)	No	No	Yes	Hydrated Silica	124
Colgate Total Enamel Strength	Yes	SLS	Saccharine	Yes (Triclosan)	No	No	Yes	Hydrated Silica	110
Colgate Total Gum Defense	Yes	SLS	Saccharine	Yes (Triclosan)	No	No	Yes	Hydrated Silica	175
Colgate Total Whitening Gel	Yes	SLS	Saccharine	Yes (Triclosan)	No	No	Yes	Hydrated Silica	175
Colgate Total Whitening Paste	Yes	SLS	Saccharine	Yes (Triclosan)	No	No	Yes	Hydrated Silica	175
Cool Wave Fresh Mint Gel Fluoride Anticavity	Yes	SLS	No	No	No	No	Yes	Hydrated Silica	200
Crest Baking Soda & Peroxide Whitening with Tartar Protection	Yes	SLS	Saccharine	No	Peroxide	No	No	Baking Soda	75
Crest Cavity Protection Cool Mint Gel	Yes	SLS	No	No	No	No	Yes	Hydrated Silica	95
Crest Cavity Protection Paste	Yes	SLS	Saccharine	No	No	No	Yes	Hydrated Silica	95
Crest Extra White Plus Scope	Yes	SLS	Saccharine	Yes (Cetylpyridinum Chloride+ Alcohol)	No	No	No	Hydrated Silica	130
Crest Multi Care	Yes	SLS	Saccharine	No	No	No	No	Baking Soda	144
Crest MultiCare Whitening Fluoride Anticavity	Yes	SLS	Xylitol	No	No	No	No	Baking Soda	144
Crest Nature's Expression, Mint Plus Green Tea Extract	Yes	SLS	Saccharine	No	No	No	No	Hydrated Silica	144
Crest Pro-Health	Yes	SLS	Saccharine	No	No	No	Yes	Hydrated Silica	156
Crest Pro-Health Night Toothpaste	Yes	SLS	Saccharine	No	No	No	Yes	Hydrated Silica	144
Crest Pro-Health Whitening	Yes	SLS	Saccharine	No	No	No	Yes	Hydrated Silica	166
Crest Sensitivity Protection Extra Whitening	Yes	SLS	Sucralose	Yes(Cetylpyridinum Chloride + Alcohol)	No	Yes (KNO3)	No	Hydrated Silica	168
Crest Sensitivity Protection Whitening Plus Scope	Yes	SLS	Sucralose	Yes(Cetylpyridinum Chloride + Alcohol)	No	Yes (KNO3)	No	Hydrated Silica	107
Crest Tartar Control	Yes	SLS	Saccharine	No	No	No	Yes	Hydrated Silica	144
Crest Tartar Protection Fresh Mint Gel	Yes	SLS	Saccharine	No	No	No	Yes	Hydrated Silica	144
Crest Whitening Expressions Anticavity	Yes	SLS	Saccharine	No	No	No	No	Hydrated Silica	144
DTI  Toothpaste/Gel	Yes	SLS	Saccharine	No	No	No	Yes	Hydrated Silica
DTI Paste/Gel - Saccharin Free	Yes	SLS	No	No	No	No	Yes	Hydrated Silica
Gator Paste Fluoride Protection	Yes	SLS	Saccharine	No	No	No	Yes	Hydrated Silica
Ibis Daant Whitening Toothpaste	Yes	SLS	Saccharine	No	No	No	No	Hydrated Silica
Mentadent Advanced Care with Baking Soda & Peroxide	Yes	SLS	Saccharine	Alcohol	Peroxide	No	No	Baking Soda & Hydrated Silica	103
Mentadent Toothpaste Advanced Cleaning	Yes	SLS	Saccharine	Alcohol	Peroxide	No	No	Baking Soda & Hydrated Silica	103
Nature's Gate Herbal Crème De Anise	No	SLS	No	No	No	No	No	Baking Soda
Noles Fluoride Protection	Yes	SLS	Saccharine	No	No	No	Yes	Hydrated Silica
Oraline Fluoride Mint Toothpaste	Yes	SLS	Saccharine	No	No	No	Yes	Hydrated Silica
Oraline Secure Clear Fluoride Mint Toothpaste	Yes	SLS	Saccharine	No	No	No	Yes	Hydrated Silica
Rembrandt Classic Sensitive	Yes		Saccharine	No		Yes (KNO3)	No		53
Rembrandt Extra Gentle Mint	Yes	No	Xylitol	No	AluminumHydroxide	No	No		63
Sensodyne Anticavity  for Sensitive Teeth with Baking Soda	Yes	SLS	Saccharine	No	No	Yes (KNO3)	No	Baking Soda & Hydrated Silica	98
Sensodyne Anticavity for Sensitive Teeth with Fluoride	Yes	SLS	Saccharine	No	No	Yes (KNO3)	No	Hydrated Silica	96
Sensodyne Anticavity Toothpaste for Sensitive Teeth	Yes	SLS	Saccharine	No	No	Yes (KNO3)	No	Hydrated Silica	98
Sensodyne Extra Whitening	Yes	SLS	Saccharine	No	Peroxide	Yes (KNO3)	No	Baking Soda & Hydrated Silica	110
Sensodyne for Sensitive Teeth, Tartar Control Plus Whitening	Yes	SLS	Saccharine	No	No	Yes (KNO3)	No	Hydrated Silica	110
Sensodyne Fresh Impact	Yes	SLS	Saccharine	No	No	Yes (KNO3)	Yes	Hydrated Silica	96
Sensodyne Pronamel	Yes	No	Saccharine	No	No	Yes (KNO3)	No	Hydrated Silica	34
Sheffield Fluoride Toothpaste	Yes	SLS	Saccharine	No	No	No	Yes	Hydrated Silica
Squigle Enamel Saver	Yes	No	Xylitol	Yes (Calcium Propionate)	No	Lactoferrin	No	No	44
Squigle Regular	Yes	No	Xylitol	No	No	Lactoferrin	No	No	55
Squigle Tooth Builder	No	No	Xylitol	Yes (Calcium Propionate)	No	Lactoferrin	No	No	55
The U Fluoride Protection	Yes	SLS	Saccharine	No	No	No	Yes	Hydrated Silica
Tom's of Maine Baking Soda Cavity Protection	Yes	SLS	Xylitol	No	No	No	Yes	Baking Soda	41
Tom's of Maine Clean & Gentle Care	Yes	SLS	Xylitol	No	No	No	Yes	Hydrated Silica	45
Tom's of Maine Fluoride Free Antiplaque + Whitening	No	SLS	Xylitol	No	No	No	No	Baking Soda	41
Tom's of Maine Fluoride Free Clean & Gentle Care	No	SLS	Xylitol	No	No	No	No	No	41
Tom's of Maine Fluoride Free for Sensitive Teeth	No	SLS	Xylitol	No	No	Yes (KNO3)	No	Hydrated Silica	41
Tom's of Maine Fluoride Free with Propolis & Myrrh	No	SLS	Xylitol	No	No	No	No	No	41
Tom's of Maine Max Strength for Sensitive Teeth w/ Fluoride	Yes	SLS	Xylitol	No	No	Yes (KNO3)	No	Hydrated Silica	41
Tom's of Maine Natural Anticavity Fluoride	Yes	SLS	Xylitol	No	No	No	Yes	Hydrated Silica	93
Tom's of Maine Simply White Fluoride	Yes	SLS	Xylitol	No	No	No	Yes	No	41
Tom's of Maine Whole Care Fluoride	Yes	SLS	Xylitol	No	No	No	No	Hydrated Silica	93
Tom's of Maine Wicked Fresh	Yes	SLS	Xylitol	No	No	No	No	Hydrated Silica	93
Topol Whitening Anticavity	Yes	SLS	Saccharine	No	No	No	No	Hydrated Silica
Ultra Brite Advanced Whitening	Yes	SLS	Saccharine	No	No	No	No	Hydrated Silica	145
Ultra Brite Baking Soda	Yes	SLS	Saccharine	No	No	No	No	Baking Soda & Hydrated Silica	145
Ultra Brite Baking Soda & Peroxide Whitening	Yes	SLS	Saccharine	No	Peroxide	No	No	Baking Soda & Hydrated Silica	145
Ultra Brite Gel	Yes	SLS	Saccharine	No	No	No	No	Hydrated Silica	145
Ultra Brite Toothpaste	Yes	SLS	Saccharine	No	No	No	No	Hydrated Silica	145
USO Fluoride Mint Toothpaste	Yes	SLS	Saccharine	No	No	No	Yes	Hydrated Silica
Viadent Advanced Care Fluoride	Yes	SLS	Saccharine	No	No	No	No	Hydrated Silica
Xclear Spry	Yes		Xylitol	No	No	No	No	Unknown
XyliWhite	No	No	Xylitol	Yes   (Tea Tree Oil)	Papain	No	No	Baking Soda & Hydrated Silica