Your Child's Oral Health  

Toothpaste, what works?

In several recent articles we have  discussed both toothbrushes and toothbrushing, but haven’t said much about the stuff you put on the brush!  Our previous articles on the topic can be found on our website.
While shopping around in the pharmacy, grocery store, or natural food store, you have likely noticed that toothpaste comes in a variety of different formulations, all touting their benefits.  All of the different kinds have their advantages and disadvantages, but none have ALL of the advantages in one tube.
There is one important thing to understand about toothbrushing: the most important part is the BRUSHING.  What goes on the brush is secondary.  Toothpaste does not work like dish soap; it’s the mechanical action of the bristles physically removing the plaque from the teeth that is very important.  Toothpaste, generally, is a pleasant tasting delivery system for a specific ingredient rather than a “detergent” for cleansing teeth. 
The main beneficial ingredients used in toothpaste are fluoride first and foremost, xylitol in non-fluoride toothpastes, antibacterial agents (eg: triclosan), anti-sensitivity agents in sensitivity toothpastes, and abrasives in whitening pastes.
Fluoride, as has been previously discussed in detail in our articles is the number one recommended ingredient by dentists and practically every dental organization, and does not need much more description.  It’s anti-cavity and remineralization benefits have been clearly demonstrated in scientific research  over the long term.  
Xylitol is a relatively new ingredient in some toothpastes and it has been shown to have  anti-cavity properties.  Xylitol is a non-caloric, natural sugar substitute derived from birch trees that has been found to reduce the ‘stickiness’ of plaque, preventing it from building up.  Xylitol also cannot be metabolized by cavity causing bacteria, thus preventing the buildup of acids that normally occurs with sugar.  The majority of toothpastes containing xylitol do so in an effort to provide an anti-cavity toothpaste alternative for those individuals opposed to the use of fluoride.  
Antibacterial ingredients are aimed at actually reducing the number of cavity causing organisms.  There has been discussion regarding the use of antibacterial agents in toothpastes, similar to those in hand soaps and sanitizers and an increased incidence of antibiotic resistant organisms, however, no evidence to support this concept has arisen to deter their use.
Anti-sensitivity toothpastes have a variety of materials aimed at blocking the tiny exposed tubules in teeth that are porous and through which fluids travel eliciting that sharp pain some of us experience when root surfaces are exposed.   Of note, these sensitivity toothpastes will not reduce discomfort caused by cavities, and dental pain in this form should be assessed by a dental professional.  
Whitening toothpastes will either contain an abrasive agent to mechanically remove surface stains and increase the whiteness of teeth, or, a low concentration bleaching agent to slowly bleach teeth over time.  While abrasive pastes will ‘scrub’ teeth clean and make them look more white, they will also abrade teeth and wear away the enamel much faster than regular toothpastes.  The low concentration bleach containing toothpastes will have minimal effect, and for those searching for whiter teeth, a visit to the dentist to discuss alternatives is recommended.
For children, the best choice is a toothpaste that tastes good to them, contains fluoride, and is used appropriately with regard to frequency and amount. Toothpaste should be used twice per day, ideally morning and before bed. Make sure that toothpaste is kept out of the reach of preschool children, some of whom enjoy eating the paste. Too much of a good thing can be harmful.  
For more information and to decide what is right for you and your family, visit your dental professional.  He or she will be more than happy to point you in the direction right for you and your children.

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About the Author

Dr. Alan Milnes is a pediatric dentist with 35 years of practice experience and 20 years of experience as a full time University Professor at the Universities of Manitoba and Toronto. He has operated a full time pediatric dental practice in Kelowna since 1997, the only pediatric dental office in either the Interior or Northern Health Authorities.

Dr. Terry Farquhar  completed his pediatric dental residency training in Halifax, Nova Scotia and Rochester, New York. Prior to entering Dentistry, Dr. Farquhar  worked as a pediatric nurse at Alberta Children's Hospital in Calgary.

Their pediatric dental specialty practice provides a complete range of dental services for ALL children and teens including treatment in-office using various forms of behaviour guidance, oral, inhalational and intravenous sedation and treatment in hospital under general anesthesia.

"We are dealing with an epidemic of tooth decay in children, a condition called early childhood tooth decay. Many children with dental disease have a poor quality of life because of chronic pain and infection which makes sleeping and eating difficult. Providing information through our column to parents of children in the Interior of BC will be helpful in giving them important tools to prevent dental disease in their children."

Please visit our website for a look at what we do each and every day and our qualifications - www.okanagandentalcareforkids.com; email: [email protected]

The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet does not warrant the contents.

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