Do you know that feeling of being overwhelmed? You stand in front of a seemingly endless wall of colourful tubes: “Extra White,” “Total Care,” “Sensitive,” “Organic,” “Herbal.” Marketing promises miracles – but from a medical perspective, only a few details on the back of the package actually matter.
Toothpaste is far more than a breath freshener. It is a pharmacologically active vehicle designed to deliver active ingredients to the tooth surface while mechanically removing biofilm—without damaging tooth structure. Here is your medical guide to what truly counts on the ingredients list.
1. The Gold Standard: Fluoride
Let’s start with the most important factor. Scientifically, there is no debate: fluoride is the most effective agent for preventing tooth decay. Brushing without fluoride means giving up the natural “repair mode” for your teeth.
What fluoride actually does:
- Remineralisation: Acids produced by bacteria and sugar constantly remove minerals from enamel. Fluoride promotes the reintegration of calcium and phosphate into the tooth structure.
- Acid resistance: Fluoridated enamel is chemically more stable and dissolves only at lower pH levels than untreated enamel.
- Bacterial inhibition: Fluoride interferes with the metabolism of decay-causing bacteria, reducing their ability to multiply.
The correct dosage (updated guidelines): Recommendations have changed in recent years based on new evidence. Always check the ppm (parts per million) value on the tube:
- Adults & adolescents: The standard is 1,450 ppm. Anything below this does not provide adequate protection for permanent teeth.
- Children (0–6 years): This is where guidelines have evolved. Instead of the formerly common 500 ppm, professional societies now often recommend 1,000 ppm children’s toothpaste – with strict dosage control:
- From the first tooth: a rice-grain-sized amount (1,000 ppm)
- From age 2: a pea-sized amount (1,000 ppm)
2. The “Abrasive Factor” (RDA Value)
Toothpaste contains fine cleaning particles (abrasives) to mechanically remove deposits. Their abrasiveness is measured by the RDA value (Relative Dentin Abrasivity).
- Low (RDA < 50): Ideal for sensitive teeth or exposed tooth necks.
- Medium (RDA 50–80): The standard for healthy teeth—effective cleaning with minimal wear.
- High (RDA > 100): Caution with many “whitening” toothpastes. While they remove stains from coffee or tea, long-term use can also wear away healthy enamel. Patients with sensitive teeth should avoid these products.
3. Foaming Agents (Surfactants)
Foam gives the sensation of cleanliness. This effect is created by surfactants such as sodium lauryl sulfate (SLS).
- Medical note: If you frequently suffer from painful mouth ulcers (aphthae) or very dry oral mucosa, consider choosing a toothpaste without SLS. This ingredient can further irritate sensitive tissues.
4. Additives: Useful or just marketing?
- Zinc: A genuinely useful ingredient. Zinc compounds have antibacterial properties, help slow the formation of tartar and reduce bad breath. (Note: zinc is generally not recommended in children’s toothpaste.)
- Chlorhexidine: Found only in specialised medical toothpastes. It can be helpful for short-term management of acute gum inflammation, but is not suitable for long-term use due to the risk of tooth staining.
Conclusion: Do not be distracted by terms like “pearl extract” or “herbal complex.” Turn the tube around and look at the facts: 1,450 ppm fluoride for adults and a medium RDA value are the best choice for maintaining healthy teeth. Do you have specific concerns, such as tooth sensitivity? Speak to us at your next appointment—we will help you find the toothpaste that best suits your individual risk profile.