Thursday, July 28, 2011

Toothpaste or not toothpaste? That is the question.

I visited my dentist this past week for my regular 6-month check up.  The oral hygienist cleaned my teeth and declared (as she usually does), "Your teeth look great!  There's hardly any plaque!"

Once she had said this (with no prompting from me), I ventured to tell her, "By the way, I stopped using toothpaste a year ago."  She nodded, continued cleaning my teeth, and then she tentatively added, "So, actually . . . we recommend that our patients use toothpaste."

I had read in the Tightwad Gazette (not the final authority on dental health, I know) that the physical act of brushing is the most important part of cleaning teeth.  Toothpaste adds some fluoride and a bit of abrasive powder to that act.  Over the years I've been using toothpaste less-and-less frequently, curious to see what would happen.  I've flossed regularly, and I've brushed very carefully and thoroughly.  So far, even my dentist seems to see no change in my teeth.
Where's the toothpaste?
I asked the oral hygienist WHY she recommends toothpaste.  "Fluoride" was her answer.  Isn't the fact that I drink city water -- which is fluoridated -- enough, I asked?  She said that there is both ingested fluoride (the stuff you drink) and topical fluoride (the stuff that touches the outside of your teeth), and adults need both.

Maybe it's because I have a PhD in math that I think that I can challenge professionals in other fields, but I wasn't sure I believed her.  So I went to the American Dental Association website to see what they say about toothpastes and fluoride.  

They recommend toothpaste, but not because of the fluoride; they recommend it for removing plaque (which my dentist thinks I do just fine).  That is, they seem to agree with the Tightwad Gazette:
Toothpaste, also called dentifrice, is essential to your daily oral hygiene routine. Toothpastes are pastes, gels or powders that help remove plaque, a film of bacteria that forms on teeth and gums. Toothpaste improves the mechanical brushing and cleaning power of a toothbrush.  [From]
What does the ADA say about ingested versus topical fluoride?  That by drinking fluoridated water, I get topical fluoride anyway:
Systemic fluorides are those that are ingested into the body and become incorporated into forming tooth structures. Systemic fluorides can also give topical protection because fluoride is present in saliva, which continually bathes the teeth. Systemic fluorides include water fluoridation or dietary fluoride supplements in the form of tablets, drops or lozenges.  [From]
What do I have against toothpaste?  Nothing really.  I'm not an anti-toothpaste crusader, just a curious experimenter. My kids, whose teeth are still developing, drink city water AND use fluoride toothpastes regularly -- I'm not experimenting on them!   I'll probably start using toothpaste every once-in-a-while again myself, but I'll do it for the taste or the fun of it, if-and-when I do it.  

The moral of this story, if you want to take one away, is that it's the act of regular flossing and brushing -- and brushing well -- that cleans your teeth, not the act of sticking some toothpaste in your mouth and swishing it around.


  1. I'm glad to hear this reinforced. I have not used toothpaste in quite a few years due to the fact that I am the one person on Earth who really, really HATES the taste of mint. I was using a "ginger" toothpaste for a while but really it tasted like soil so I just stopped. I have never had a cavity and my dentist also remarks on how great my teeth are. I use baking soda once in a while because I am a big coffee drinker and it whitens m'teeth. Like you, I still make the kids use it but it seems to be more for minty freshness than actual cleaning power.

  2. First off, I want to say that I love reading your blog! Secondly, I am a dental hygienist and I have to completely agree that the toothbrush removes majority of the plaque. If your hygienist and dentist think you are doing a great job, keep it up! No sense in using toothpaste if you are doing a thorough job brushing and flossing! I actually brush my teeth without toothpaste for about 1 min, and then add toothpaste because I enjoy the minty taste.