Boy... the marketing gurus have been hard at work on this one for the last few years. From peroxide to baking soda to all-natural - there's something for everyone. Here's some straight forward information for you to chew on.

The primary role of toothpaste is to work in conjunction with your brushing to remove plaque from your teeth. Toothpastes generally contain fluoride which helps strengthen your teeth and make them more resistant to decay. Fluoride can also help repair the early stages of decay so that if a cavity has already started it can actually stop and the tooth can 'heal'. New generation toothpastes can also contain tartar control ingredients that can help keep tartar from forming above the gum line. The most noticeable thing that toothpastes contain, though, is flavoring and coloring agents which help make your breath fresh and your mouth feel 'clean'. I don't believe you will find a reputable source that will ever recommend a toothpaste that does not contain fluoride. It doesn't make sense.

I am often asked what kind of toothpaste to buy. I always answer the same way 'Anything that you like the taste of, costs under $1 and contains fluoride'. Patients think I'm being flip, but I'm not. The single most important thing about a toothpaste is that you like it, you use it, and it has fluoride to help strengthen your teeth. No one toothpaste is better than any other.

Despite this, people are people and they get lured into expensive toothpastes that they liked the marketing campaign for. Some things you should know about toothpastes:

• Although some people swear by them, my experience has been that sensitive tooth formulas (those containing Strontium Chloride or Potassium Nitrate) don't work that well - a fluoride rinse is, in many cases, far more effective, and far less expensive. Sodium fluoride rinses are available in most pharmacies. Ask your pharmacist for .2% (weekly) or .05% (daily) sodium fluoride rinse. Desensitizing toothpastes work for very mild cases of tooth hypersensitivity, but expect to wait four to six weeks before you feel any results.
  
  
• Miracle ingredients in toothpastes are no miracle. Peroxide and baking soda are flavoring agents and have no significant effect regardless of what their manufacturers will tell you. If you like the taste enough to pay the extra money for them then enjoy the flavor - it's all you're getting for the money. Peroxide can actually cause soft tissue damage and is not at the time of this writing allowed to be used in toothpastes in Canada. The bubbling feeling that people attribute to peroxide toothpastes is not the feeling of your teeth getting cleaner - it's the feeling of your wallet getting lighter.
  
  
• Whitening toothpastes don't. Period. Exclamation point. Some have mild abrasives which will take some of the stain off your teeth. Having your teeth polished at your dental office will do the same thing in a less harmful manner. None have EVER been shown to effectively whiten your teeth. You can spend a fortune on these things and they just don't work. I won't be able to convince many of you and you'll go out and buy a $12-15 tube of toothpaste anyways. Bookmark this page and go try out a couple of tubes of it. When you find it hasn't made one whit of difference come back and email me apologizing for doubting. If you want your teeth whitened, see your dentist for a take-home bleaching kit. They work phenomenally well and will cost you less in the long run than wasting your money on expensive toothpastes.
  
  
• Tartar control toothpastes help control tartar above the gum line. Tartar above the gum line is EASY to remove. It's the tartar below the gum line that causes periodontal disease. If you want to buy these products feel free - just be aware that the claims, though accurate, are misleading. They do NOT remove tartar - they help prevent it from forming in the first place. Only your dentist or hygienist can remove tartar once it is formed. There have also been some cases of mouth irritation from tartar control toothpastes - so be cautious - and if you change toothpastes then notice mouth sores - consider changing back.

More marketing hype.....

You should NOT be using the amount of toothpaste that they show you on the commercials. It's not necessary, and in the case of children it's not desirable. Adults should use a pea sized amount of toothpaste (one pea - not the whole pod!). Children under 6 should be using about the size of a baby pea. You don't want your children swallowing gobs and gobs of fluoride containing toothpaste. A little is good - a lot is not better. A lot of fluoride given to a child can cause marks on the permanent teeth called fluorosis. These marks do not come off and, though generally they are white and not unattractive, they are sometimes discolored and in need of repair.

Smoker's toothpastes are often abrasive and should be avoided. Brushing with an abrasive toothpaste can actually help you carve notches in your teeth as well as remove your gums at the gumline. The gum loss does not grow back. Not ever. The enamel that gets carved away does not grow back. Not ever. Teeth that have been heavily notched by toothbrush abrasion generally get so cold sensitive they require root canals just so you can drink a cold beer again.

Stannous fluoride is good - Sodium fluoride is good, Monofluoro-phosphate (MFP) is good. Choose what you like. Sodium fluoride and MFP are generally the staple of anti-cavity toothpastes while stannous fluoride is used more frequently in 'gum-care' toothpastes. All three strengthen enamel and help prevent tooth decay.

Gels are not better than pastes, pastes are not better than gels - pick what you like, use what you pick. Just because it is a gel does not mean it is less abrasive. Yes, it looks less abrasive - No, it isn't necessarily so.

It's hard to find out the abrasive index of a toothpaste. The studies are generally done occasionally by dental schools and the information doesn't always find it's way into a medline search. Claims by manufacturers are just that. Caveat emptor! A little research on the web and a quick question of your dentist may net you the information you seek.