Consumer Report

That line is actually the title of a small article in a recent Consumer Reports magazine issue.  But it brings to mind a question that I have been asked over and over in my 34 years of doing dentistry.  One of the most common questions I get from patients is “What is the best toothpaste to use?”

We are bombarded daily with marketing hype about toothpaste as manufacturers battle for their share of the 1.8 BILLION dollars that Americans spend on toothpaste each year (Fun Dental Facts @www.dentalgentlecare.com).  That doesn’t include toothbrushes, floss, mouthwash, etc.- just TOOTHPASTE!

We’ve all seen and heard the hype.  This one whitens teeth better, this one strengthens your enamel better, this one removes stains better, and this one will eliminate your bad breath.  So, if all the hype were true, you’d think there would be some agreement among dentists about which toothpaste is the best.  I don’t think that’s the case.

I’ve never seen any research showing one brand or type of toothpaste is better than another.  In fact, when patients ask me what toothpaste they should use, I tell them “whatever one tastes good to you,  as long as it contains fluoride” and has the seal of approval of  The American Dental Society.   (The ADA Seal of Approval means the manufacturer has submitted the product to rigorous testing for safety by the ADA.)

In fact, some research has shown that patients actually do a better job of brushing their teeth if they use a dry brush (JADA129:614,1998).   Perhaps all the foam interferes with our ability to feel the brush actually touching the gumline.  Or, perhaps, having a mouthful of foam drooling out of our mouths makes us stand with our heads over the sink.  That’s messy, boring, and only covers up what we’re trying to see.

Maybe that’s why the average person only brushes 30- 60 seconds when research (J Dent Hyg 83: 11-116, 2009) says that the brush needs to be in our mouths 120-180 seconds per brushing.  In fact, the same study found that “brushing without toothpaste for 60 seconds removed as much plaque as brushing with toothpaste for 60 seconds.  The toothpaste provides no added benefit for plaque removal.”

What about the ability of toothpaste to whiten our teeth and keep them white?  Well, that’s just some more of the marketer’s hype to get a share of that 1.8 billion dollars.  Almost any dentist or dental hygienist will tell you that the chemicals in toothpaste or whitening gels that cause the whitening have to be in contact with your teeth for at least 30 minutes per day to cause any whitening effect.  And, of course, the bleach in toothpaste can’t be very strong or it would make the toothpaste taste like bleach.

Consumer Reports says, “Think they (whitening toothpastes) make your teeth sparkle?  Don’t start smiling yet.  None of the 41 ‘whitening toothpastes’ we tested did any better to actually whiten teeth than any other toothpastes.”  And my own clinical observations would back this statement up.  I’ve never seen evidence of a patient getting whiter teeth from their toothpaste.  (Properly used bleaching gels, yes!  But not from toothpaste.)

In reality then, the brand or type of toothpaste you use isn’t important.  My recommendation is to start brushing your teeth with a dry brush (soft) on the inside surfaces of the teeth.  Spend 60 seconds just on the inside of the teeth.  Most people tend to neglect the insides so it’s best to start there. Then add whatever toothpaste brand tastes good to you, and spend another 60 seconds brushing the outside of the teeth.

Remember, it’s the amount of time spent with the brush in the mouth and not the toothpaste brand that matters.  It’s like exercise equipment.  It doesn’t matter which brand or type you buy if you don’t put your time in using it.