Oral Health Month Part II: What's In Your Dental Products?

April is National Oral Health Month! This is Part 2 of a 4 part series about everything to do with oral health.

April 23rd, 2021

Building on last week's post, today we'll take a closer look at 2 ingredients commonly found in conventional toothpaste, mouthwash, etc. Again, this post is not meant to replace medical or dental advice. But, it is my hope that I raise awareness and inspire you to take a closer look at what you put on your toothbrush and in your mouth!



1) Fluoride

The history of fluoride in the world of dentistry is quite interesting, you can read it here.

Fluoride can be perceived as "controversial"for the following reasons:

• Although it is a naturally occurring mineral, it is not an essential mineral required for human life. At this point in time, no disease has been linked to a fluoride deficiency.
• Only 50% of the daily ingested fluoride is excreted through the kidneys. Too much fluoride has been linked to kidney damage in children.
• In animal and human studies, there is a correlation between fluoride exposure and chromosome damage. A study conducted by Harvard University showed a significant link between fluoridation and a rare form of bone cancer called osteosarcoma in young boys; these findings were consistent with the results of the 1990 animal study.
• Fluoride has a high affinity for calcium, and too much fluoride may accumulate in bones, teeth, and also the pineal gland in the brain (from animal studies). Accumulation in the pineal gland may affect melatonin production.
• In animal studies, fluoride demonstrated the ability to interfere with the functions of the brain and the body. In one study which took place in China, children exposed to 8 ppm fluoride in water were found to have lower average IQs, less children attaining high IQ, and more children affected by low IQ.

While a little bit of fluoride is great for preventing and reducing dental cavities, more fluoride is not better! Fluorosis is an important public health problem in 24 countries, including India, which lies in the geographical fluoride belt that extends from Turkey to China and Japan through Iraq, Iran, and Afghanistan.

With the widespread availability of fluoridated toothpastes and fluoride varnishes as well as fluoridated drinking water, there is a potential for enamel fluorosis or skeletal fluorosis. According to the 2018 CDC statistics, 73% of the US population have access to fluoridated water. Per Statistics Canada, 37.4% of the Canadian population had access to fluoridated drinking water. In Ontario, this number goes up to 76%. Prior to this blog post, I did not realize we were getting fluoride from so many places.

Sources of fluoride include:

• drinking water (check with your municipality to see if your local water supply is fluoridated). In Toronto, this is set to 0.5 - 0.6 ppm. In this case, you are INGESTING fluoride. Since the 1980s, it's been demonstrated that the effects of fluoride on cavities is due to its topical effects, not systemic.
• conventional toothpastes (Kid's Crest toothpaste contains sodium fluoride 0.243% w/w = 2430 ppm, or 2430mg/L, Crest Gum Detoxify toothpaste contains stannous fluoride 0.454% w/w = 4540ppm)
• conventional mouthwashes (e.g. Listerine Ultraclean Enamel Protection mouthwash contains Sodium Fluoride/fluorure de sodium 0.022% w/v = 220 ppm, or 220mg/L)
• fluoride treatments at the dental office (this can contain up to 22, 600 ppm of sodium fluoride)
• brewed tea (the tea plants take up fluoride from the soil)
• trace amounts in other foods

While I am certainly not suggesting that you stop using fluoride toothpaste, this is an opportunity to consider:

• Do you drink tap water? Is it fluoridated? How much water do you drink? With fluoridated drinking water, it is impossible to control how much each person drinks. Some people (e.g. athletes, diabetics, and peoples with kidney disease) drink more water than others.
• In today's society, most individuals receives fluoride from sources other than the water supply such as fluoridated oral hygiene products such as toothpastes, mouthwash, etc. We also have better tools (e.g. toothbrushes, floss) and more knowledge on practicing good dental hygiene.
• The most important question for myself is - How much toothpaste do you actually use? Remember those commercials where there's a brilliant strip of toothpaste across the entire toothbrush head? That's absolutely INCORRECT and misleading. For adults and children over 6, a pea-sized amount is all you need. For children between 2-6 years old, use a rice sized amount. Lastly, try not to swallow any toothpaste!

2) Sodium Lauryl Sulfate

Sodium Lauryl Sulfate, also known as SLS, is often used as a cleansing or foaming agent. It is ubiquitous and found in grooming products, hair products, bath products, creams, lotions, toothpastes, teeth whitening products, and mouthwashes. In toothpastes, it's often added for its foaming action (as most people perceive this as the cleaning action).

For toothpastes which contain sodium fluoride, SLS is also added to prevent the fluoride ions from reacting with the silica abrasives which decreases the amount of fluoride available for cavity prevention.

According to the Environmental Working Group (EWG), there is strong evidence to suggest that SLS is an irritant to the eyes, skin, or lungs. In one study, the use of SLS-free toothpaste reduced the healing time and reduced pain with canker sores. If you suffer from frequent canker sores (i.e. mouth sores, aphthous stomatitis), then it may be a good idea to consider using an SLS-free toothpaste.

3) Other ingredients to watch out for:

The colouring used in kids' toothpastes (e.g. FD&C Blue No. 1 or D&C Blue No. 4).

Sodium saccharin - derived from coal tar, this product is extremely sweet and only serves to improve the flavour of toothpaste. It has not been linked to any benefits effects on oral health.

What I'm doing in my own household:

1. We have a reverse osmosis system for our drinking water; this removes fluoride, as well as other minerals from my drinking water.
2. Routine visits with the dentist every 6 months for dental cleaning; my 7 year old is prone to staining so we go more often for her.
3. We floss daily; even my 23 month old gets flossed! I've been using Dr. Tung's Smart Floss; it does not contain genetically modified ingredients, known allergens, phthalates, soy or silica, and is dairy-free, gluten-free and fluoride-free. I'm still on the hunt for an eco-friendlier, effective floss for the kids.
4. I've recently transitioned to Green Beaver Green Apple Natural Toothpaste (SLS-free, fluoride-free) as I am prone to canker sores.
5. As my older child has had several cavities - we will be using fluoride toothpaste with her, but monitoring to make sure she only uses a pea-sized amount.
6. My 23 month old uses the Colgate Zero for Kids Toothpaste, which contains no artificial flavours, sweeteners, preservatives, and colours.
7. We are always trying to eat better as a family!

Now that you know what you know, what do you plan to do? Drop me a line!

Note: this post and website receives commissions on purchases made through the Amazon Affiliate Program. This means that a commission is paid to me at no additional cost to you when you make a purchase by clicking any or all of the above links through Amazon.

- Janet

Links and Citations:
Carey CM. Focus on fluorides: update on the use of fluoride for the prevention of dental caries. J Evid Based Dent Pract. 2014;14 Suppl:95-102. doi:10.1016/j.jebdp.2014.02.004

Unde MP, Patil RU, Dastoor PP. The Untold Story of Fluoridation: Revisiting the Changing Perspectives. Indian J Occup Environ Med. 2018;22(3):121-127. doi:10.4103/ijoem.IJOEM_124_18

Grant WB. High vitamin D and calcium requirements during pregnancy and tooth loss. Am J Public Health. 2008;98(11):1931-1932. doi:10.2105/AJPH.2008.144451

What is Sodium Lauryl Sulfate?