|
Dentists are frequently asked, what's the best
toothpaste for my children and me? The answer is not as simple as it
used to be.
Although it is generally accepted that it is the
actual scrubbing action of toothbrush bristles and dental floss that
physically breaks up decay-causing bacterial plaque, today's
dentifrices offer dentists and patients a wide variety of other
desirable and helpful characteristics that go beyond mechanical
intervention.
Dentifrices are commonly available as powders, gels
and pastes, although most consumers generally refer to the entire
group of tooth cleaning agents as toothpaste. Most popular available
dentifrices contain flavoring, sweeteners, thickeners, abrasive agents
and foaming agents, the most common being sodium lauryl sulfate. To
these basic formulations the manufacturers add varying agents to
address other consumer expectations, such as carie prevention, tartar
or calculus control, desensitizing, anti-gingivitis-anti-plaque, tooth
whitening and bad breath effects.
The American Dental Association's Seal of Acceptance
program currently recognizes six categories of dentifrices, based on
the presence of certain active ingredients. All dentifrices approved
by the ADA must contain fluoride, since research has proven that the
continuous direct exposure of tooth enamel to fluoride ions is the
most effective way to prevent caries or to remineralize early lesions.
The mechanism that accounts for this benefit is the continual exchange
of minerals, such as phosphate and calcium, between the enamel and
saliva.
It is currently believed that although fluoridation of
community water supplies has had a positive effect on caries
reduction, that ingestion of fluoride at an early age through this
method does not offer lifetime protection against cavities.
Epidemiological studies are now giving credit to fluoride-containing
dentifrices for the decline in caries in the United States.
The recognized active ingredients are included in the
following categories:
* Caries Prevention - through the incorporation of a
fluoride component such as sodium fluoride, stannous fluoride, or
monofluorophosphate. Or, via the interference in the metabolic process
of decay-causing bacteria through the use of polyphenolic catechin
compounds like green tea extract.
* Desensitizing - by blocking the sensitive dental
tubles of the teeth with potassium nitrate, sodium citrate, strontium
chloride or acetate.
* Tartar Control (calculus reduction) - with
pyrophosphates or zinc. These agents, however, cannot remove calculus
once it has already formed.
* Anti-plaque - agents such as triclosan, sanguinaria
and polyphenols that reduce the enzyme activity of bacteria.
* Anti-gingivitis - agents such as triclosans,
stannous fluoride, and pure essential oils that reduce the number and
strength of active bacteria. (Pure essential oils may also have an
anti-halitosis effect.)
* Tooth Whitening - to remove stain or to bleach teeth
- peroxide, citroxain, titanium dioxide, abrasives.
Additionally, there are more and more dentifrices that
contain baking soda. It is unproven whether sodium
bicarbonate-containing dentifrices actually reduce the amount of oral
bacteria, but they may cause less acidity of plaque, which may result
in less tooth demineralization.
Since there are many dentifrices in the marketplace
that do not carry the ADA Seal, but contain similar beneficial agents,
It is up to each individual dentist to recommend a particular product
to patients.
Dr. Eric Lebowitz is a pediatric dentist specializing
in dental and orthodontic care for infants, children, and teens. He is
in private practice in Kendall at Tooth Fairy-Land, located near
Baptist Hospital. Questions about this dental topic can be directed to
Dr. Lebowitz at 305-279-4312.
|
