Toothpaste is a paste or gel dentifrice used with a toothbrush to clean and maintain the aesthetics and health of teeth. Toothpaste is used to promote oral hygiene: it can aid in the removal of dental plaque and food from the teeth, aid in the elimination and/or masking of halitosis and deliver active ingredients such as fluoride or xylitol to prevent tooth and gum disease (gingivitis). Some dentist recommendations include brushing your teeth at least 2 times a day, if not more. In most or all developed countries, usage after each meal is encouraged by dentists. However when cleaning teeth with a toothbrush with toothpaste, the essential cleaning is done by the mechanical brushing, and not by the active toothpaste chemicals. Most toothpaste contains trace amounts of chemicals which are toxic when ingested, and is not intended to be swallowed.
Active ingredients
Fluoride in various forms is the most popular active ingredient in toothpaste to prevent cavities. Although it occurs in small amounts in plants, animals, and some natural water sources, and has effects on the formation of dental enamel and bones, it is not considered to be a dietary essential and no deficiency signs are known. Sodium fluoride (NaF) is the most common form; some brands use sodium monofluorophosphate (Na2PO3F). Much of the toothpaste sold in the United States has 1000 to 1100 parts per million fluoride ion from one of these active ingredients, in the UK the fluoride content is often higher, a NaF of 0.32% w/w (1,450 ppm fluoride) is not uncommon. This consistency leads some to conclude that cheap toothpaste is just as good as expensive toothpaste. When the magazine Consumer Reports rated toothpastes in 1998, 30 of the 38 were judged excellent. Application of fluoride also prevents moisture build-up in some surfaces.[citation needed] Other ingredients are less commonly used, including Hydroxyapatite nanocrystals and calcium phosphate for remineralization,[6] and strontium chloride or potassium nitrate to reduce sensitivity.
Other ingredients
In addition to fluoride, the other fundamental ingredient in most toothpastes is an abrasive.[citation needed] Studies have shown that abrasives in toothpaste reduce the time needed to remove plaque from the teeth by approximately 50%. Abrasives, like the dental polishing agents used in dentist's offices, also cause a small amount of enamel erosion which is termed "polishing" action. Some brands contain powdered white mica which acts as a mild abrasive, and also adds a cosmetically-pleasing glittery shimmer to the paste. Many may contain frustules of dead diatoms as a mild abrasive. The removal of plaque and calculus prevents caries and periodontal disease. The polishing of teeth removes stains from tooth surfaces, but has not been shown to improve dental health over and above the effects of the removal of plaque and calculus.
Many, though not all, toothpastes contain sodium lauryl sulfate (SLS) or another of the sulfate family. SLS is found in other personal care products as well, such as shampoo, and is largely a foaming agent although it also acts as a powerful antimicrobial. Due to the anionic charge of SLS, mouthwashes containing cetylpyridinium chloride (which has a cationic charge and thus neutralises SLS) should not be used straight after brushing. SLS may cause a greater frequency of mouth ulcers in some people as it can dry out the protective layer of oral tissues causing the underlying tissues to become damaged[1].
Ingredients such as baking soda, enzymes, vitamins, herbs, calcium, calcium sodium phosphosilicate, mouthwash, and/or hydrogen peroxide are often combined into base mixes and marketed as being beneficial. Some manufacturers add antibacterial agents, for example triclosan or zinc chloride, to prevent gingivitis. Triclosan is a common ingredient in the UK. Bases such as sodium hydroxide are also used to neutralize acids.
Toothpaste comes in a variety of colorings, and flavors. The more usual flavorings are some variation on mint (spearmint, peppermint, regular mint, etc). Other more exotic flavors include: anise, apricot, bubblegum, cinnamon, fennel, lavender, neem, ginger, vanilla, lemon, orange, pine. More unusual are flavors include peanut butter, iced tea, and even whisky. Unflavored toothpaste does exist, however, most are flavored and sweetened. Because sugar promotes growth of bacteria that cause tooth decay, artificial sweeteners such as sorbitol or saccharin are generally used instead. The inclusion of sweet-tasting but toxic diethylene glycol in Chinese-made toothpaste led to a multi-nation and multi-brand toothpaste recall in 2007.
Toxicity
With the exception of toothpaste intended to be used on pets such as dogs and cats, and toothpaste used by astronauts, most toothpaste is not intended to be swallowed, and doing so may cause nausea or diarrhea; fluoride toothpaste can be toxic if swallowed in large amounts. If a large amount of toothpaste is swallowed, Poison Control should be contacted immediately.[7] Extended consumption while the teeth are forming can result in fluorosis. This is why young children should not use fluoride toothpaste except under close supervision. There are several non-fluoride toothpaste options available in the market for those who choose not to use fluoride. Natural toothpaste can contain peppermint oil, myrrh, plant extract(strawberry extract), special oils and cleansing agents. Case reports of plasma cell gingivitis have been reported with the use of herbal toothpaste containing cinnamon (Cinnamomun zeylanicum).[8]
