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The takeaway on toothpaste

It's pretty simple

Toothpaste manufacturers are trying to get our attention. Yet, for understandable reasons, most of us don’t spend much time picking a toothpaste. First off, there are far too many to choose from. Second, the claims made on the packaging often seem too good to be true. And third, who has time for this?

“Most of my patients have the same formula for choosing a toothpaste,” says Holly Hunter, a dental hygienist from Polk City, Iowa. “They typically pick up whatever is on sale and choose from one of the two major brands.”

When it comes to toothpaste, Hunter has the same general message for the majority of her patients, “Keep it simple. Really, all you need is fluoride. It’s the main ingredient in toothpaste. It strengthens tooth enamel to keep cavities away. For most people, this will suffice. If you like the flavor and you’re getting the topical fluoride, you’re good.”

Aside from fluoride, most toothpastes contain a mild abrasive, such as calcium carbonate, to remove food debris and surface stains.

As a general guide, the toothpaste you choose should have an American Dental Association (ADA) Seal of Acceptance. That means the ADA considers it safe and effective.

The word on fluoride

“The fluoride in toothpaste is safe and meant to be swished and spit out, not swallowed or ingested,” says Hunter. “Parents should supervise their children when brushing teeth, and teach children to spit, not swallow.”

According to the Poison Control Center, swallowing the fluoride in toothpaste can cause an upset stomach. The bottom line, according to their website, is that fluoride can lead to serious toxicity in very large amounts, but it is unlikely to occur from small, unintentional ingestion of over-the-counter, fluoride-containing toothpaste.

Do you need the "extra" ingredients?

When you start flipping the boxes over and reading the ingredients, most toothpastes are basically the same. The trend, however, is to pack toothpastes full of extra stuff, plus a number of big promises. So, do they work?

Detergents (sodium lauryl sulfate, or sls)

  • What are they?

    sls is a soaping agent, meaning it makes the toothpaste foam up as you brush.

  • The bottom line.

    For most people, sls isn’t problematic. Many consumers just like a toothpaste that suds up, because they associate foamy bubbles with better cleaning power. However, these detergents do not bolster the cleaning power of toothpaste, or make your teeth cleaner.

  • Your best bet.

    Some people have mouth tissue that breaks down more quickly, or they may be prone to canker sores. “If this is the case, use an sls-free toothpaste, such as Biotene®. The key is to use sls-free toothpaste exclusively,” says Hunter. “If you are sensitive to these substances, as little as one use can be problematic.”

Whiteners (hydrogen peroxide, polyphosphates)

  • What are they?

    A product that bleaches the tooth, or removes deep or surface stains.

  • The bottom line.

    When in toothpaste, whiteners generally aren't concentrated enough, or in contact with the surface of the tooth long enough, to be effective. Some of these ingredients may also be problematic for people who have sensitive mouth tissue.

  • Your best bet.

    “If you want whiter teeth, do so under the supervision of a trusted dental professional,” says Hunter. “For people who want something more affordable, white strips are a good value. It is still worth a discussion with your dentist or hygienist.”

Desensitizers (potassium nitrate, stannous fluoride, strontium chloride)

  • What are they?

    These ingredients block pain signals to the nerve of the tooth.

  • The bottom line.

    If your teeth are sensitive when exposed to cold or hot food or drinks, or even cold air, you might want a toothpaste for sensitive teeth. Desensitizing toothpastes work when used exclusively.

  • Your best bet.

    First, talk to a dental professional to determine what is causing your sensitive teeth. You may need a filling, crown or another treatment to address what’s causing the problem.


  • What is it?

    Xylitol is a sugar alcohol used as a sweetener. It increases saliva production and stops the growth of bacteria that cause gum disease and cavities.

  • The bottom line.

    The more teeth are exposed to xylitol, the less decay-causing bacteria survives on the surface of the tooth. You can find xylitol in gum, mints, some toothpastes and mouth sprays.

  • Your best bet.

    Hunter recommends chewing gum with xylitol after meals for 5–10 minutes to clean the teeth. It should not substitute for regular dental care. In other words, you still need to brush and floss daily.

  • fyi:

    Xylitol is fatal to dogs, so keep products containing xylitol away from your canine companion.

Don’t toss the floss

“There is no getting around it, flossing is an essential part of dental health,” according to Hunter. “First, it removes plaque from the teeth. Second, it helps stimulate the gum tissue around your teeth, where periodontal gum disease begins.”

Are you pregnant or have diabetes?

Your teeth and gums need special care.You may be eligible to receive coverage for an extra dental cleaning (to help keep your teeth healthy) or an extra periodontal maintenance procedure (to help keep your gums healthy) each benefit year.

If you have Blue DentalSM coverage, and you are pregnant or have diabetes, check to see if you are eligible for this extra dental benefit:

  • Log in to myWellmark to view a summary of your dental benefits.
  • Call the customer service number on your Blue Dental ID card.

If you're interested in purchasing Blue Dental coverage, talk to your employer or agent.