Toothpaste and Mouthwash Used for Fighting Gingivitis and Dental Plaque: Health Risks Plus False Claims
© 2017 Health Realizations, Inc. Update

When you go to your local market and take a look at all the toothpastes on the shelves, the choices can be overwhelming. You can choose from tartar control, whitening, sensitivity reduction or total control formulas. Many of these brands are simply cosmetic, while some of the others have been clinically approved by the American Dental Association to improve oral hygiene by reducing plaque, which is one of the major causes of periodontitis.

Quite simply, there is an abundance of dental products available to consumers today and many of them claim to do amazing things to improve your oral health – but can you really trust their claims? And more importantly, are the ingredients really safe?

What's Behind Oral Care Product Claims?

Toothpaste and mouthwash manufacturers who post claims that their dental products prevent plaque or any other related oral conditions must submit scientific data supporting their claims to the Food and Drug Administration (FDA). Each product must have been clinically tested in humans, and manufacturers are required to conduct intensive studies showing the amount of fluoride available, the amount of fluoride released in one minute and the amount of fluoride absorption in normal and abnormal enamel. If the FDA finds that the data is false or does not support their claims, the manufacturers are then required to drop the unsupported claims from their advertising campaigns.

Dental plaque is a thin film of food debris and other material that forms on the surface of the teeth. This provides the perfect environment for bacteria to grow. Scientific studies have proven that plaque is directly linked to cavities and gingivitis, which is a painful inflammation of the gingival tissue. According to toothpaste and mouthwash manufacturers, their products typically contain abrasives that can provide enough mechanical movement during brushing or rinsing to remove plaque from your teeth. Mouthwash manufacturers also typically claim that their rinses are able to remove plaque by using antimicrobial and chemical ingredients.

Dental tartar is a hard, yellow deposit that can be found on your teeth. This tartar is made of mineral salts, food and other bacterial debris. Over time, these deposits harden and cannot be brushed off the teeth. Tartar has a rough surface that attracts more debris and food to it. This causes additional tartar to form on a consistent basis.

Consumers are presented with statements on the toothpaste or mouthwash labels stating such things as "for the reduction or prevention of plaque, tartar, calculus, film, sticky deposits, bacterial build-up, and gingivitis" or that the product offers the "reduction, prevention or treatment of gum disease, inflamed gums, swollen gums, bleeding gums, pyorrhea, trench mouth, periodontal disease or tooth-destroying acids."

Toothpaste: The Down and Dirty

Toothpaste is essential to your daily dental routine to help remove the film of plaque on your teeth and gum tissue. It also improves the cleaning that a toothbrush can provide. So what are the ingredients in most toothpaste? The typical ingredients are:

• Mild abrasives that can remove debris and some surface stains. Examples of these abrasives are calcium carbonate, dehydrated silica gels, hydrated aluminum oxides, magnesium carbonate, phosphate salts and silicates.
• Fluoride that supposedly strengthens tooth enamel and prevents tooth decay, although this is heavily debated. Each toothpaste that is approved by the ADA contains fluoride.
• Humectants prevent water loss in the toothpaste. Examples of humectants are glycerol, propylene, glycol and sorbitol.
• Flavoring agents, like saccharin or other sweeteners provide the taste of the toothpaste.
• Thickening agents stabilize the toothpaste formula. These agents include mineral colloids, natural gums, seaweed colloids or synthetic cellulose.
• Detergents create the foaming action that consumers expect when brushing. These detergents are such ingredients as sodium lauryl sulfate, sodium N-Lauryl sarcosinate.

In addition, some toothpaste includes ingredients like potassium nitrate or strontium chloride to prevent tooth sensitivity. Stannous fluoride or triclosan are also added to help reduce gingivitis. Modified silica enzymes are added to help whiten teeth by physically removing surface stains on enamel surfaces.

Most studies suggest that tartar control toothpastes do not remove tartar. They only help to prevent tartar from forming. The active ingredient in tartar control toothpaste is pyrophosphate. Some clinical studies on this ingredient show that it may reduce tartar as much as 36%, but it does not reduce tartar forming below the gum line. The problem with this is that the tartar under the gingival margin is where the most damage is done!

For this reason, it is very important for you to receive a professional cleaning twice a year at your dentist’s office. Due to the wording and advertising of some toothpastes, many consumers incorrectly assume that using a tartar control toothpaste will prevent them from experiencing any problems with gingivitis or tartar, but this is not accurate.

Mouthwashes: What are They Really?

Many mouthwash brands provide results that are purely cosmetic, while others have a positive impact on oral hygiene by reducing the amount of plaque present in your mouth. The cosmetic mouthwashes are the over-the-counter products that help to remove debris before/after brushing, suppress bad breath and bacteria and freshen your mouth. Therapeutic mouthwashes have the same benefits of cosmetic mouthwashes, but they also contain an ingredient to help fight some oral diseases.

These therapeutic mouthwashes are regulated by the FDA and are approved by the American Dental Association. Using mouthwash prior to brushing your teeth, however, does little to reduce any plaque buildup. If you were to use mouthwash as the only method of dental care, it would be detrimental to the state of your oral hygiene.

There are two basic mouthwash formulations: chlorhexidine and essential oils. Clinical studies have shown chlorhexidine preparations have a marginal advantage over the essential oil preparations when it comes to the reduction of plaque. The problems with chlorhexidine mouthwash are that the preparation can stain your teeth and alter your taste perception for several hours after using the preparation. For these reasons, chlorhexidine mouthwash is usually indicated for short-term use.

In addition to reducing plaque, mouthwash is also used to reduce bad breath. The incidence of bad breath can have many different origins, but one of the most prevalent causes is bacterial plaque that builds up on your tongue or in saliva. Clinical studies have shown that both chlorhexidine and essential oil mouthwash preparations are useful in reducing bad breath. In addition, both chlorhexidine and essential oil preparations are used to promote the health of gingival tissues surrounding dental implants and appliances.

Potentially Harmful Ingredients in Your Everyday Oral Care Staples ...

It is a well-known fact the body can absorb things very rapidly through the tissues present in your mouth. For example, many different medications are given under the tongue due to the quick absorption rate. Because of this potential, it is important to be aware of any potentially hazardous or toxic ingredients found in your toothpaste or mouthwash. Some of those ingredients are:

• Fluoride – You will find the following FDA warning label on each toothpaste/mouthwash that contains fluoride: "WARNING, keep out of reach of children under the age of 6. If more than used for normal brushing is swallowed, contact your physician or local Poison Control Center immediately." Ingesting even a small amount of toothpaste with fluoride can become toxic and even cause death, particularly in children. There is also evidence that suggests consuming fluoride, such as in fluoridated water, may impact your thyroid, leading to hypothyroidism, as well as reduce IQ and lead to brittle bones and skeletal fluorosis. For this reason, some choose to avoid fluoride in their toothpaste entirely.

• Triclosan - This is an antibiotic and antimicrobial agent used in many toothpastes and mouthwashes. It is advertised as an ingredient that combats bad breath. Studies conducted in 2006 and 2009 showed that triclosan exposure had a significant impact on levels of thyroid hormones. The Center for Disease Control and Prevention reported that the frequent use of antibiotics and antimicrobials, such as triclosan, could lead to an overgrowth of bacteria resistant to antibiotics. Canada health officials have requested that triclosan be banned due to this problem of bacterial resistance.

• Abrasives – Toothpaste with abrasives in the preparation are known to cause tooth sensitivity. Many different types of toothpaste, including those that whiten teeth and control tartar, contain stronger abrasives. Unfortunately, it is almost impossible for the consumer to know if their toothpaste contains these stronger abrasives, so you may want to ask your dentist for a recommendation if you struggle with sensitivity.

• Botanicals – Many herbs are now being used in toothpaste and mouthwash preparations. Herbal preparations are often advertised to provide benefits that may be untrue or unfounded. It is important to take the initiative to find the truth about herbal ingredients and any potentially harmful side effects. This is especially important for pregnant women and children using preparations that include botanical ingredients.

• Sodium lauryl sulfate – This is a detergent ingredient found in most toothpastes, dishwashing soaps and body wash. It is thought that sodium lauryl sulfate dries out the mucous lining found inside the mouth. This drying effect leaves the tissues vulnerable to the many irritants that form canker sores. Using toothpaste without sodium lauryl sulfate may lead to a reduction in the incidence of canker sores, which is another good reason to choose Periobiotic toothpaste for your dental hygiene. The Silvercillin liquid and/or gel actually improves healing time of canker sores when applied to the sore.

Dental health is very important and there are more product choices available to consumers today than ever before. While some products can have a positive impact on your mouth, there are also those that have the potential to do some damage. If you have questions or concerns about a toothpaste or mouthwash preparation, read the label and do some research on your own or talk to your dentist to find the safest and most effective products for you and your family.

Sources

LiveStrong.com All About Toothpaste

American Dental Association: Toothpaste

Oral Health Care Drug Products for Over-the-Counter Human Use; Antigingivitis/Antiplaque Drug Products; Establishment of a Monograph

A Comparison of the Antibacterial Effectiveness of Mouthwashes

The Journal of the American Dental Association vol. 128 no. 9 1220