Creating a Healthy Mouth -Toothpaste Part II

Why use toothpaste? 

It helps you create a healthy oral environment!  It helps you prevent and or reverse gum disease, tooth decay and bad breath. 

No DQ Swirl- it's Too Much Toothpaste

My ideal toothpaste has a job to do. It should remineralize tooth structure, and then disorganize, disperse, detoxify, and thereby decontaminate the pathogenic bad bacterial biofilm (plaque) living on your teeth and in your mouth. It is more than just cosmetic and minty. Your toothbrush, floss, picks and oral irrigators all help reduce and remove this biofilm from your mouth.

 Toothpaste:

It tastes good and makes people want to brush.  Period.  That is the bottom line- make folks brush, and brush longer to get the plaque out.  

Products in commercial toothpaste can reverse early tooth decay- fluoride, calcium and phosphate.

Over the counter products such as Arm and Hammer Complete Care Enamel Strengthening and Carifree CTX4 Gel 1100,  and  prescription level pastes such as Carifree CTX4 Gel 5000  and Enamelon will help heal small and beginning areas of tooth decay.   They put minerals back in the tooth structure.  (Check out Tooth Decay, What's pH got to do with it? to learn about decay and demineralization.) 

Sensitive teeth can often benefit from special toothpastes to stop or reduce sensitive teeth.

The ingredients in desensitizing toothpaste that desensitize teeth:

                          Potassium Nitrate - numbs the nerve endings in the tooth tubules.  It can take up to two to four weeks to work.  Many desensitizing toothpastes contain this ingredient.  It does not cure the real problem, which is open tooth tubules. Another post- Got Sensitive Teeth? - explains this in more detail. 

                           Pro-Arginine- closes the tooth tubules. The two pastes for sale in the US that contain this ingredient are  Colgate Sensitivity Pro-Relief  and Elmex Sensitive Professional toothpaste (Elmex is also available in Europe, as well as through Amazon.com here in the USA).

                      ** There's a great product available in Europe, Asia, Australia, South America, and the Middle East, for folks with sensitive teeth- Sensodyne Repair and Protect.  It contains something they call Novamin/45S4 Bioglass which releases calcium and phosphate, and sounds incredible.  Unfortunately, it is not available here in North America.  

The U.S. version of Sensodyne Repair and Protect product is NOT the same formulation as the one sold throughout the rest of the world.  Do not be fooled.  GlaxoSmithKline could not get the FDA to approve the Novamin/Bioglass formula.  Instead the U.S. product contains stannous fluoride.  So, U.S. folks, I wouldn't waste my money on the US brand. It looks like you can order in on Amazon from Europe.   Everyone else, LUCKY YOU!

Side note on root sensitivity:

The mallet is cold water and the bell is your nerve

 At Great-Smile Dental, we use ozone gas to kill the bacteria in the tooth tubules and then close those open tubules with calcium and phosphate.  The sensitivity is caused by the open tooth tubules transmitting cold right to the nerve, zing!  Ozone works very well to reduce sensitivity.  Call our office manager, Shannon and ask her about her formerly sensitive tooth surface. 425-788-1551 ;)   (Knowing the cause of a particular tooth's sensitivity goes a long way toward fixing the problem.  See my post on sensitive teeth if this is a problem you have.) 

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My recommendations:

Fluoride: This is the "active" ingredient in ADA accepted toothpaste- it does make the tooth stronger, more resistant to the acids the bacteria excrete.  Bacteria "poop acid" on your teeth.  That's the toxin they give off.  Fluoride makes the tooth more resistant to that acid.  Not impenetrable, but it does put the odds in your favor.  Fluoride does not make your teeth any cleaner though.  From a hygienist's perspective, I see a difference between teeth in folks who use fluoride and those that don't.  I vote for its use.  If you don't, so be it.  I respect your choice.  Consider using MI Paste to remineralize with calcium and phosphate. 

Novamin: remineralizes teeth with calcium and phosphate, part of the building blocks of the tooth.  It closes off the tooth tubules and reverses early tooth decay.  Good stuff! 

Toothpastes that interfere with the plaque attaching to the tooth: 

     Toothpaste with xylitol- see my post on Mouth Magic - Any toothpaste with xylitol is great, in my opinion.   Xylitol is a sugar alcohol that promotes a healthy mouth.  Five servings of xylitol daily will reduce plaque buildup and tooth decay by 60%.  And, it tastes good!  No plaque = no disease

Spry, Squigle and Carifree are my favorite brands in this department. 

      Colgate Total with Triclosan is still okay in my book.  Triclosan keeps plaque from adhering to teeth.  It reduces gingivitis by 22% and with continued use reduces bleeding by 48%.   Triclosan has been getting a bad rap but so far, the research shows it's safe to use.  I will let you know if I change my mind in the future.  Colgate Total is one of my current Toothpastes.

Remineralizing Toothpastes: In addition to the above pastes 

ProNamel toothpaste claims to have greater bioavailability of remineralizing agents and is SLS free, low abrasive and has fluoride.  That covers all my concerns above.  

All the Carifree CTX gels remineralize teeth.  Some are available without a prescription.

Products that detoxify, disorganize, disperse and decontaminate: 

"New to me" products that sound verrrrry interesting:

The neem tree (Wikipedia)

Neem toothpaste-The neem tree is generally found in India and all parts of the tree are used in traditional medicine.   I did come across a study that mentioned Neem toothpaste reduced plaque buildup and bacterial count when compared to a control mouthwash.  While the results were statistically significant, I would have preferred a comparison to an antibacterial toothpaste.

From my reading about Neem products, it looks very interesting.  It's all "natural" and may be antibacterial. There are many Neem products so if this interests you, do your own research.  Under NO circumstances should you put neem oil in children's mouths.  No, not ever!!!  Since I have never used this product, I cannot vouch for it at this time.  I will seek some out and get back with you in the future. 

Livionex Dental Gel- In my research about toothpaste, I learned so much.  This product was my favorite "pearl".   If this is half as good as it sounds, it may turn toothpaste on its ear.   This toothpaste is a ”new to me" item whose information and research sounds perfect.  I have not used it yet but have ordered three tubes for me and my family to test.  My ideal toothpaste would help repel plaque from adhering to the tooth surface.  Remember, it's all about the plaque.  No plaque = no gum disease or tooth decay.  The bacteria, viruses, and other pathogens reside in the plaque biofilm.  If this biofilm can't attach to the tooth then there is no destruction.  The Livionex Dental Gel uses a novel method to keep plaque from sticking to teeth.  Think back to high school chemistry.  Teeth have a negative charge and so does plaque bacteria.  Now, negative charged items should repel other negatively charged items just like two south pole magnets.  Your saliva adds the positive charge in the way of positively charged calcium ions. (Like peanut butter causing bread to stick together.)  The calcium reduces the negative charges of both the tooth and the bacteria, and that is how biofilm is formed.   The Livionex Dental Gel has a patent pending technology that allows the chelator to bind up the calcium in your plaque and not from your teeth.  This exposes the negative charges of bacteria and tooth surface, and repels plaque from sticking to your teeth. (Now, think about adding jelly to that sandwich.  It is not as sticky on one side. )    I love science and analogies!    
Update 7/5/15 :  
Plus side- I have now been using Livionex Toothpaste for six months and am very happy with the results.  My teeth feel and look  clean.  It's a gentle flavor, not too minty.  Very little if any tartar build up behind my front teeth, and over all I'm happy to recommend this paste. 
Minus side- Livionex has withdrawn  use of my discount code on the internet.  I was very disappointed to receive their phone call about this.  I have a new code and am happy to give it out to any patients, email me.  If you are in the neighborhood drop on by.  Sooo sorry to everyone else.  They requested I not have the discount number on my blog.   I still like what their paste does, just not pleased with their switching the rules midstream.  :( 

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Homemade or Alternative Toothpastes   

One of my all-time favorite mentors is Dr. Paul Keyes.  He is the father of nonsurgical periodontal therapy and using the phase contrast microscope chairside to monitor the oral bacteria.  I trust his research and suggestions:

Baking soda- plain old baking soda, about as natural as it gets, raises the pH and if wet, is the gentlest toothpaste.  It disinfects, detoxifies, cleans and changes the oral flora to a healthy state.  Mix with glycerin.  According to Dr. Keyes, glycerin kills the oral pathogens instantly.  I put this to the test this week with my newly purchased bottle of glycerin.  Not bad at all.  My mouth felt clean and no bad flavors. 

Baking soda and hydrogen peroxide- another simple and effective paste.  It breaks down rapidly to oxygen and water.  It helps to disperse and disorganize the biofilm.  Make it fresh with each use.

 Vinegar-yes, you read that correctly- at half strength will, according to Dr. Keyes, "pickle" all the motile bacteria and dissolve tartar deposits.  Use several times per week.  (I'd recommend rinsing immediately after with a baking soda water mixture to raise the pH of your mouth.)

Unsweetened Cranberry Juice- can be used as a mouthwash and also as a toothbrush solution.  It kills all motile bacteria and helps disintegrate plaques.  Again, it's acidic so use only several times a week, and rinse with baking soda and water afterwards to raise the pH of your mouth. Best part, it can be swallowed!  For folks that can't spit or rinse, this may be a great alternative to conventional pastes.  

Unscented Neutrogena Soap-Yes, it tastes soapy but it kills the motile bacteria.  I have purchased a bar and am using it.  Yes, it's soap but not as bad as you might think.  Definitely use the unscented model. 

You can use the above items alone or in combination.  So far I've mixed baking soda with the soap, the glycerin and the peroxide although not all at the same time...  And I'm not sure you'd want to mix baking soda and vinegar in your mouth.  Then again, it could be interesting :)

Simple, easy, natural, and most inexpensive toothpastes ever!  

Should you brush or floss first? 

Truly, I’m just happy if you do it at all.  Ideally, I would suggest:

 #1. Irrigate with a Water pik or Hydroflosser and baking soda in the water

 #2. Then floss and/or pikster to clean in-between the teeth,

#3. Then dry brush with a manual toothbrush

#4. THEN toothpaste:

                Brush (preferably with an electric tooth brush), spit, don't rinse (let the paste remineralize your teeth),

#5. Next, tongue deplaquing twice daily- the tongue has plaque biofilm too! and this eliminates most halitosis.

#6. Mouthwash if you like but be aware of the pH of the rinse. (Look for a post on mouthwash soon.)

(Please stop scrubbing like you are removing the grime off the shower floor.  Brush your gums, brush gently, with the ends of the toothbrush bristles, in little circles, NO back and forth motion, and really, it's time to break down and use an electric toothbrush, especially if you have sensitive teeth.) 

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The Bottom Line: Get the plaque off, any way you can.  Help your body to heal your gum infection and tooth decay.

Help 'em stay clean!

Toothpaste Trivia: Pastes to clean your teeth have been around for thousands of years.  The ancients used powdered ashes of ox hooves, powdered and burnt egg shells, rock salt, or even pepper in various combinations.  Even urine, crushed bones and burnt mice heads were used throughout the ages.  Not so yummy!  About 123 years ago, the first tube of toothpaste was sold- Dr. Sheffield's Cream Dentifrice.  Toothpaste came in tubs and Dr. Sheffield saw this as unsanitary. He liked the way paint came in tubes and was the first to put toothpaste in this kind of dispensary.  This company went on to become Colgate. 

Happy Brushing,

Barbara

P.S. Anytime you see a highlighted/different colored word, click on it, and that'll take you to my research link.  Everything has a reference link or I'll state it as my opinion.