Second Opinion: Is toothpaste necessary?

2016 10 12 14 41 06 881 Dr B Second Opinion 400

The first commercially produced toothpaste was launched in 1873 and sold in a jar. Today, more than 1,400 different types of toothpastes are available online and in stores. But, my patients ask, is toothpaste even necessary?

As with most things, there is controversy about toothpaste. Dental companies frequently advertise their products in misleading and confusing ways. The general public becomes the victim of this misinformation.

Cleaning teeth

Alvin Danenberg, DDS.Alvin Danenberg, DDS.

First of all, when I am asked, I tell my patients that they don't need toothpaste to clean their teeth. The mechanical removal of unhealthy dental plaque using just a toothbrush, floss, and tiny brushes that clean between teeth are all that are necessary. No toothpaste is necessary to remove unhealthy clumps of bacteria and food debris.

The next fact is that toothbrushing would not be so critical if they were eating a nutrient-dense diet that was anti-inflammatory. A study from BMC Oral Health (July 26, 2016) showed that a healthy diet would decrease the signs and symptoms of active gum disease without the rigors of cleaning between the teeth.

However, don't get me wrong. It is important to remove unhealthy dental plaque from around the tooth. Brushing and flossing will help. And, toothpaste can offer a pleasant way to clean your teeth. Unfortunately, patients can be taken in by marketing claims that may be misleading, confusing, or even downright false.

Chemicals in toothpaste

Most conventional toothpastes in the marketplace include chemicals that are harsh to the teeth and gums. While these chemicals may make a toothpaste "feel smooth," "taste good," "help to whiten teeth," or "coat the teeth to prevent decay," these chemicals are unhealthy overall. Toothpaste companies will not share the truth of these potentially harmful chemicals with you.

In addition, several of these chemicals may be toxic to the body when they get into the systemic circulation.

Here are some chemicals that might be in your toothpaste:

“Toothbrushing would not be so critical if they were eating a nutrient-dense diet that was anti-inflammatory.”
  • Aluminum hydroxide
  • Aspartame
  • Carrageenan
  • Diethanolamine (DEA)
  • Flavorings
  • Fluoride
  • Food coloring
  • Formaldehyde-releasing preservatives
  • Parabens
  • Potassium sorbate
  • Propylene glycol
  • Sodium benzoate
  • Sodium lauryl sulfate
  • Sodium saccharin
  • Titanium dioxide
  • Triclosan

Claims by manufacturers

Most commercial toothpaste companies make claims that their toothpastes are necessary if you wanted to clean your teeth effectively. The ads suggest that you would not be able to clean your teeth and your mouth if you were not using their products. These statements are false. Toothpaste is not necessary to make your mouth clean or healthy.

Also, some manufacturers suggest that their toothpaste is organic. In August 2016, a well-known dental manufacturer was ordered to remove false claims from its website that stated one of its toothpaste brands was "organic" and that the U.S. Department of Agriculture (USDA) "did not have standards for toothpastes regarding the word organic." In fact, the USDA does have strict regulations regarding the use of the word "organic" on toothpaste products.

The bottom line

Toothpaste is not necessary to clean teeth. The mechanical cleaning with dental floss and various sized brushes will do so adequately. But more important, anyone's mouth would be healthier if we ate foods that were nutrient-dense and anti-inflammatory.

I tell my patients that if they want to use toothpaste, they need to be aware of the ingredients on the label.

There are a few brands that can state they are "Made with Organic Ingredients," which means that 70% of their ingredients are certified organic, excluding water and salt. There are very few toothpastes that may claim they are organic and would be allowed to use the USDA Organic Seal, which means that 95% of their ingredients are certified organic, excluding water and salt.

I looked and, as of May 2017, I could not find any brand that was 100% organic, which would mean that every ingredient in the toothpaste was certified organic, excluding water and salt.

A version of this column first ran on Dr. Danenberg's blog. appreciates the opportunity to reprint it. His book Crazy-Good Living is available on July 15, 2017, by Elektra Press.

Alvin Danenberg, DDS, practices at the Bluffton Center for Dentistry in Bluffton, SC. He is also on the faculty of the College of Integrative Medicine and created its integrative periodontal teaching module. He also spent two years as chief of periodontics at Charleston Air Force Base earlier in his career. His website is

The comments and observations expressed herein do not necessarily reflect the opinions of, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.

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