Milnes & Farquhar: Brushing is what’s key

In several recent columns we have discussed both toothbrushes and toothbrushing, but we haven’t said much about the stuff you put on the brush.

In several recent columns we have discussed both toothbrushes and toothbrushing, but we haven’t said much about the stuff you put on the brush.

While shopping around in the pharmacy, grocery store or natural food store, you have likely noticed that toothpaste comes in a variety of different formulations, all touting their benefits.

All of the different toothpaste brands have their advantages and disadvantages, but none have all of the advantages in one tube.

But there is one important thing to understand about toothbrushing—the most important part is the brushing.

What goes on the brush is secondary.

Toothpaste does not work like dish soap. It’s the mechanical action of the bristles physically removing the plaque from the teeth that is very important.

Generally, toothpaste,  is a pleasant tasting delivery system for a specific ingredient rather than a “detergent” for cleansing teeth.

The main beneficial ingredients used in toothpaste are fluoride, xylitol in non-fluoride toothpastes, antibacterial agents (such as triclosan), anti-sensitivity agents in sensitivity toothpastes, and abrasives in whitening pastes.

Fluoride, as we have discussed in previous columns, is the number one recommended toothpaste ingredient by dentists and practically every dental organization.

Its anti-cavity and remineralization benefits have been clearly demonstrated in scientific research over the long term.

Xylitol is a relatively new ingredient in some toothpastes as it has been shown to have anti-cavity properties.

Xylitol is a non-caloric, natural sugar substitute derived from birch trees that has been found to reduce the stickiness of plaque, preventing it from building up.

Xylitol also can’t be metabolized by cavity causing bacteria, thus preventing the buildup of acids that normally occurs with sugar.

The majority of toothpastes that contain xylitol do so in an effort to provide an anti-cavity toothpaste alternative for those individuals opposed to the use of fluoride.

Antibacterial ingredients are aimed at actually reducing the number of cavity causing organisms.

There has been discussion regarding the use of antibacterial agents in toothpastes, similar to those in hand soaps and sanitizers, coupled with an increased incidence of antibiotic resistant organisms. However, no evidence to support this concept has arisen to deter their use.

Anti-sensitivity toothpastes have a variety of materials aimed at blocking the tiny exposed tubules in teeth that are porous and through which fluids travel eliciting that sharp pain some of us experience when root surfaces are exposed.

Of note, these sensitivity toothpastes will not reduce discomfort caused by cavities, as dental pain in this form should be assessed by a dental professional.

Whitening toothpastes will either contain an abrasive agent to mechanically remove surface stains and increase the whiteness of teeth, or a low concentration bleaching agent to slowly bleach teeth over time.

While abrasive pastes will “scrub” teeth clean and make them look more white, they will also abrade teeth and wear away the enamel much faster than regular toothpastes.

The low concentration bleach containing toothpastes will have minimal effect. Again, for those searching for whiter teeth, a visit to the dentist to discuss alternatives is recommended.

For children, the best choice is a toothpaste that tastes good to them, contains fluoride, and is used appropriately with regard to frequency and amount.

Toothpaste should be used twice per day, ideally in the morning and before bed.

Make sure that toothpaste is kept out of the reach of preschool children, some of whom enjoy eating the paste. Too much of a good thing can be harmful.

For more information and to decide what is right for you and your family, visit your dental professional.

He or she will be more than happy to point you in the direction right for you and your children.


Alan Milnes and

Terry Farquhar are

certified specialists in

pediatric dentistry at 101-180 Cooper Rd.





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