First the official definition of toothpaste – Toothpaste is a paste or gel dentifrice used with a toothbrush as an accessory to clean and maintain the aesthetics and health of teeth. Toothpaste is used to promote oral hygiene: it serves as an abrasive that aids in removing the dental plaque and food from the teeth, assists in suppressing halitosis, and delivers active ingredients such as fluoride or xylitol to help prevent tooth and gum disease (gingivitis). Most of the cleaning is achieved by the mechanical action of the toothbrush, and not by the toothpaste.

Salt and Baking soda are among materials that can be substituted for commercial toothpaste. Toothpaste is not intended to be swallowed. Tooth powders were the first noticeable advance from just using a “toothbrush”, and were made up of elements like powdered charcoal, powdered bark and some flavoring agents. This would be applied to teeth using a simple stick. “Toothpowder” was first available in Britain in the late eighteenth century. It came in a ceramic pot and was available either as a powder or paste.

The rich applied it with brushes and the poor with their fingers. Modern toothpastes were developed in the 1800s. A dentist called Peabody was the first to add soap to toothpaste in 1824. Chalk was first added to toothpaste by John Harris in the 1850s. In 1873, toothpaste was first mass-produced into nice smelling toothpaste in a jar. In 1892, Dr. Washington Sheffield of Connecticut was the first to put toothpaste into a collapsible tube. Sheffield’s toothpaste was called Dr. Sheffield’s Crème Dentifrice.

Advancements in synthetic detergents (after World War II) replaced the soap used in toothpaste with emulsifying agents such as Sodium Lauryl Sulphate and Sodium Ricinoleate. The 1960’s saw the introduction of fluoride into toothpaste. This development was followed in the 1980’s with the addition of soluble calcium fluoride to fluoride toothpastes. It is therefore within the last thirty years that toothpastes contain the two ingredients – calcium and fluoride. While there are controversial views on the effectiveness and safety of fluoride toothpaste, the scientific research does not generally support those position. For those who are concerned about fluoride, there are natural toothpastes which might be a more comfortable choice for you.

How toothpaste works — our mouth contains one or more of 500 types of micro-organisms. Some of these, mainly streptococcus mutans, create sticky plaque from food residue in your mouth. Micro-organisms in our mouth feed on left over food to create acid and particles called volatile sulfur molecules. The acid eats into tooth enamel to produce cavities while volatile sulfur molecules give breath its foul odor. Toothpaste works with toothbrush to clean teeth and fight plaque bacteria. Toothpaste contains abrasives which physically scrub away plaque. In addition, toothpaste abrasives help remove food stains from teeth and polish tooth surfaces. Some toothpaste contain ingredients which chemically hinder the growth of plaque bacteria. These include ingredients like natural Xylitol and artificial triclosan.

There are some toothpastes that will address specific needs. Toothpastes are available for sensitive teeth (work pretty well), for people who build up a lot of tartar (does not stop the tartar, but does make it easier to get off at cleanings), or for those who have dry mouth (success here is limited at best).

So which toothpaste is the best one to use? Unless you have a specific need, the harsh reality is that the bulk of the action that you get from brushing your teeth comes from your “elbow grease”, or basically the action of the brush against the teeth, so while the toothpaste marketers would all have you believe that theirs is the best, the real best one is simply the one you will use! If any particular toothpaste will result in your teeth being brushed a little longer, then use that one. We do recommend using fluoride toothpastes, particularly for children (make sure they don’t swallow it), because we have the positive results of this seen first hand.

Dr. Craig Ajmo, of Mountain Dental Associates in Ellijay, is a Graduate of Emory University School of Dentistry. He is also heavily involved in Practice Based Research, and is a board Member of the Network for Practice Based Research of the International Association for Dental Research.