Most people know that brushing with toothpaste should be part of their daily hygiene routine… but have you ever wondered what all those ingredients in your dentifrice are and how they work? It can be a challenge to sort through the mind boggling array of choices on the shelf at the local supermarket, but knowing some basics can help consumers make more informed choices about the toothpaste that will best meet their needs.
Choosing the right product to use begins with understanding the oral environment, which harbors a thriving community of over 500 species of bacteria, some of which make their home in a sticky substance called “plaque” that adheres to the teeth. The bacteria in the plaque produce acids which lead to cavities, toxins that cause gum disease and sulfur compounds that create breath odor.
A dentifrice, derived from the Latin words “dens” (tooth) and “fricare” (to rub) is any toothpaste, gel, or powder used to remove the harmful plaque and debris from the teeth in one of two main ways:
Abrasive Action: Abrasive ingredients physically scrub away the plaque and solid particles, and polish stains from the teeth. 
A polished tooth surface is more resistant to plaque accumulation, but the too much abrasion can also make the teeth sensitive. Since the roots of teeth are softer than the enamel, people who have gum recession should be very cautious about the abrasiveness of the toothpaste they use. All abrasive ingredients are not created equal. The American Dental Association has created the RDA scale, which rates abrasiveness from zero (lowest) to 250 (highest). As a general rule, baking soda (sodium bicarbonate) toothpaste is at the low end of the scale and many whitening and tartar control toothpastes are at the high end.
Antimicrobial Action: Toothpaste may contain one or more ingredients that kill or slow the growth of bacteria. Cavities, gingivitis and periodontal disease can’t occur unless certain bacteria are present in the mouth, so antimicrobial ingredients are very helpful for people who have a high risk for these conditions.
Generally, a dentifrice is classified as either cosmetic, therapeutic or both depending on its unique properties but all of them have several ingredients in common:
• Water (15-50%),
• Abrasive agent (20-60%),
• Humectants (20-40%) which prevent hardening of the toothpaste when exposed to air. Common ones include glycerin, mannitol and sorbitol.
• Surfactant or detergent (1-2%), usually sodium laurel sulfate which creates the foaming action that helps loosen plaque and food particles,
• Binders (1-2%) such as cellulose gum prevent separation of the solid and liquid ingredients,
• Flavoring agents (1%) such as peppermint or cinnamon essential oil mask the unpleasant flavor of the other ingredients,
• Sweeteners such as sodium saccharin or Xylitol,
• Colorants
Most dentifrices also contain an “active ingredient” that makes them useful for a specific purpose:
• Do you have red, sore or bleeding gums? Triclosan is a very effective antibacterial product found in many soaps, deodorants and other products, but Colgate TOTAL is the only dentifrice that contains this ingredient. Look for other antimicrobial ingredients like Xylitol, Zinc Citrate, Peroxide, Lacoperoxidase and baking soda (sodium bicarbonate) to help control gingivitis.
• Do you build up tartar quickly? The tartar control ingredient Pyrophosphate might help keep it from forming, but be careful because it can cause gum and tooth sensitivity too!
• Are your teeth Sensitive? Potassium nitrate and Stannous fluoride are helpful. Be aware that stannous fluoride can cause temporary stain on the teeth.
• Do you want a brighter, whiter smile?: Abrasive agents and peroxide remove surface stains but don’t really change the natural color of the teeth. For that, you would need to consider a bleaching procedure.
• Is your mouth dry?: Lactoperoxidase is an enzyme that helps with this problem. Fortunately, it also reduces gingivitis since they often occur together. Dry mouth is a serious problem with many causes, and it is important to speak to your doctor or dentist if you suffer from this symptom.
• Cavity protection: Fluoride is an active ingredient in most toothpaste. It is absorbed into the tooth structure, replacing tooth structure that has been weakened by plaque and making teeth harder and more resistant to decay. Xylitol is a natural sweetener that has been shown to slow the growth of bacteria in the mouth, preventing both cavities and gingivitis.
Next time you’re shopping for a dentifrice, read the label… you might be surprised! 
The Food and Drug Administration (FDA) has issued a caution to consumers to carefully examine labels and avoid purchasing toothpastes imported from China (usually found at Dollar and discount stores). Some have been found to be counterfeit, containing no fluoride and harmful substances like Diethelene Glycol (antifreeze).
Toothpaste and a good brush are the first lines of defense against cavities and gum disease, so talk to your oral health providers about the best product to meet your needs. They can help you navigate the options and avoid unwanted side effects. When in doubt, a good rule of thumb is to choose a product that has the American Dental Association Seal of Acceptance. That’s a consumer’s best assurance that a product is safe and effective.
