Shining a spotlight on toothpaste

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  Posted by: The Probe      5th April 2021

Every dental professional understands the importance of toothpaste to daily oral hygiene and disease prevention. Recommending the right toothpaste is essential in order to ensure patients maximise on their benefits. However, given that toothpaste formulas continue to change, it can be difficult to determine which product is right for each patient. Therefore, it is vital for dental teams to do their research before making any recommendations, particularly as certain ingredients contained in some conventional toothpastes can have undesirable effects.

Sodium lauryl sulphate (SLS)

For several decades, SLS has been a common element of cosmetic and personal care products, including some toothpastes. It works as a surfactant to trap oil-based dirt so that it can be rinsed away with water. It is also an effective foaming agent designed to enhance the performance of a product by enabling it to better penetrate and thoroughly clean surfaces following application, which is why SLS is used in many household cleaners and detergents.[1] Yet despite being used prolifically since the 1930s, SLS has developed a bad reputation in recent years.

Whilst many experts agree that it is safe to use, SLS is a well-known irritant – so much so that it is used as a positive control in dermatological testing, where new products are tested to determine how irritating they are to human skin in comparison to SLS.[2] It has even been suggested that SLS can cause cancer, infertility or development issues, although there is no scientific evidence to support such theories.[3] Nevertheless, people with a history of sensitive or hyperirritable skin, and those suffering from skin conditions such as eczema or dermatitis, are often advised to avoid products containing SLS, especially as it can trigger heightened allergic reactions.[4]

Triclosan

As with SLS, triclosan has become controversial as an anti-bacterial agent. It is contained in various products ranging from soaps and cosmetics to clothing and toys, with the intention of reducing or preventing bacterial contamination.[5] Triclosan is also commonly used as an ingredient in some toothpastes to help protect the oral cavity from gingivitis.[6] However, questions have been raised as to whether triclosan is hazardous to human health, especially as the body can absorb small amounts of it. Indeed, new research has shown that triclosan can alter hormone regulation in animals.

Other studies have pointed to the possibility that triclosan may be harmful to the human immune system, and could contribute to the development of antibiotic-resistant microbes. In light of health and safety concerns regarding the long-term use of triclosan, the Food and Drug Administration (FDA) in the US recently banned the substance from personal cleaning products, as well as antiseptic solutions used in hospitals and other healthcare settings.[7] No such ban has been implemented in the UK, which is why some toothpastes that can be bought here still contain triclosan.

Bleaching agents

Many whitening toothpastes contain bleaching agents such as hydrogen peroxide or carbamide peroxide that help remove extrinsic stains from the teeth, making them whiter. Although these toothpastes are generally considered safe to use, studies show that toothbrushing with such products for a prolonged period can damage the enamel, increasing the risk of developing sensitive teeth or gingiva, and dental caries.[8], [9] Damage can also be done to the oral soft tissues, resulting in mucosal irritation, ulceration and circumoral dermatitis.[10] As such, the use of whitening toothpastes containing bleaching agents should only be recommended to suitable patients for a limited time.

Plastic microbeads

Plastic microbeads were traditionally added to many toothpastes as a way of improving their abrasive qualities and making them more effective at cleaning the teeth and gingiva. Whilst they are an excellent exfoliant and abrasive substance, the inability of plastic microbeads to biodegrade means they pose a significant environmental threat.[11] Until recently, up to 680 tonnes of plastic microbeads were used in cosmetic and personal care products sold in the UK every year.[12] Plastic microbeads are able to pass through sewage and water treatment systems, resulting in billions of them entering our oceans annually and causing serious harm to marine wildlife. This was a key driver behind the UK government’s decision in 2018 to ban the sale of products containing plastic microbeads.[13]

The need for an alternative

The potential health and environmental effects of SLS, triclosan, bleaching agents and plastic microbeads emphasise the need for alternative toothpastes free from these substances. For example, the ‘Be you’ range from Curaprox contains a variety of natural ingredients, including extracts of Echinacea, bitter orange, devil’s claw and Indian pennywort. Available in six exciting flavours, ‘Be you’ toothpastes offer the benefits of a more natural formula than traditional oral healthcare products to facilitate gentle but effective cleaning even in the most hard-to-reach areas of the mouth, meaning you can recommend them with confidence.    

With the sheer number of different toothpastes available on the market, it can be difficult for patients to determine the best option for them, which is why many turn to dental professionals for advice and guidance. It is important that any recommendations on toothpaste are made with careful consideration to help ensure patients benefit from a lifetime of good oral health.

 

For more information please call 01480 862084, email info@curaprox.co.uk or visit www.curaprox.co.uk

 

  

[1] Whitworth, G. (2019) What Is Sodium Lauryl Sulfate (SLS)? Healthline. Available at: https://www.healthline.com/health/beauty-skin-care/what-is-sodium-lauryl-sulfate. [Last accessed: 06.01.21].

[2] Agner, T. and Jørgen, S. (1990) Sodium Lauryl Sulphate for Irritant Patch Testing- A Dose-Response Study Using Bioengineering Methods for Determination of Skin Irritation. Journal of Investigative Dermatology. 95(5): 543–547. DOI: 10.1111/1523-1747.ep12504896.

[3] Wilson, D. R. (2019) Should You Be Going Sulfate-Free? Healthline. Available at: https://www.healthline.com/health/beauty-skin-care/sulfates#:~:text=There%20is%20no%20direct%20evidence,skin%2C%20mouth%2C%20and%20lungs. [Last accessed: 06.01.21].

[4] Schwitulla, J. et al. (2014) Skin irritability to sodium lauryl sulfate is associated with increased positive patch test reactions. Br J Dermatol. 171(1): 115­–23. DOI: 10.1111/bjd.12893.

[5] FDA. (2019) 5 Things to Know About Triclosan. Available at: https://www.fda.gov/consumers/consumer-updates/5-things-know-about-triclosan. [Last accessed: 06.01.21].

[6] Grey, H. (2018) Why Controversial Ingredient Triclosan Is in Toothpaste but Not Bodywash. Healthline. Available at: https://www.healthline.com/health-news/why-triclosan-is-in-toothpaste-not-bodywash#Banned-in-some-products-but-not-others. [Last accessed: 06.01.21].

[7] Tosh, P. K. (2020) Should I avoid products that contain triclosan? Mayo Clinic. Available at: https://www.mayoclinic.org/healthy-lifestyle/adult-health/expert-answers/triclosan/faq-20057861. [Last accessed: 06.01.21].

[8] Epple, M., Meyer, F., and Enax, J. (2019) A Critical Review of Modern Concepts for Teeth Whitening. Dentistry Journal7(3): 79. DOI: 10.3390/dj7030079.

[9] Rahardjo, A. et al. (2015) Potential Side Effects of Whitening Toothpaste on Enamel Roughness and Micro Hardness. International Journal of Clinical Preventive Dentistry. 11(4): 239–242. DOI: 10.15236/ijcpd.2015.11.4.239.

[10] Kalliath, C. et al. (2018) Comparison between the effect of commercially available chemical teeth whitening paste and teeth whitening paste containing ingredients of herbal origin on human enamel. 39(2): 113–117. DOI: 10.4103/ayu.AYU_82_18.

[11] Prabhakar, M. (2020) Myth Buster: Toothpaste still contains plastic ingredients! Beat the Microbead. Available at: https://www.beatthemicrobead.org/myth-buster-toothpaste-still-contains-plastic-ingredients/. [Last accessed: 06.01.21].

[12] GOV.UK. (2017) Implementation of the Environmental Protection (Microbeads) (England) Regulations 2017. Available at: https://www.legislation.gov.uk/ukia/2017/178/pdfs/ukia_20170178_en.pdf. [Last accessed: 06.01.21].

[13] GOV.UK. (2018) World leading microbeads ban comes into force. Available at: https://www.gov.uk/government/news/world-leading-microbeads-ban-comes-into-force. [Last accessed: 06.01.21].


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