Dentifrices were originally developed to provide a cosmetic effect and deliver a pleasant taste. They are effective in removing extrinsic stains, those that occur on the surface of the tooth. These stains, which are often the end-products of bacterial metabolism, range in color from green to yellow to black. Stains may also result from foods, coffee, tea, cola-containing drinks, and red wines. Over the counter dentifrices do not remove intrinsic stains, which are a result of altered tooth development, such as the white-to-brown color changes seen in fluorosis or the grayish-blue appearance of enamel following administration of tetracycline. Toothpastes are also ineffective in altering the yellowing color of teeth seen with normal aging and in altering the tooth color produced by differing shades of dentin. Therefore, they can only claim to “make your teeth their whitest or brightest”; they cannot state, “Makes your teeth whiter or tooth color lighter.”
Toothpastes and gels contain the same components, except that gels have a higher proportion of thickening agents. Both tooth gels and toothpastes are equally effective in plaque removal and in delivering active ingredients, such as fluoride.
Baking soda (sodium bicarbonate) has had a long history of use as an oral-hygiene aid. All pastes with baking soda contain hydrated silica that is compatible with fluoride. No dentifrice containing baking soda as the sole active ingredient has received the ADA Seal of Acceptance. It was only after fluoride was added to the formulations that several baking soda-fluoride dentifrices were accepted as effective in caries control. These baking-soda dentifrices actually contain only a small amount of baking soda, in addition to the standard fluoride-compatible abrasives.
Triclosan is a broad-spectrum antibacterial agent effective against a wide variety of bacteria and is widely used as an antibacterial agent in OTC consumer products. Colgate Total, containing Triclosan, is the toothpaste recommended by O’Malley Dental as it is most effective at preventing gingivitis, plaque, and caries. It has also been shown to help reduce the formation of plaque and tartar above the gum line. Recently, a 2-year study on Total has documented long-term anticaries efficacy. Research on a triclosan-pyrophosphate combination in a dentifrice has demonstrated plaque regrowth inhibition and anticalculus activity.
Many people experience pain when exposed areas of the root (cementum) are subjected to heat or cold. Several dentifrices have been accepted with active agents such as potassium nitrate, strontium chloride, and sodium citrate. The American Dental Association’s Council on Dental Therapeutics has approved a dentifrice (Sensodyne) with a combination of active ingredients, demonstrating both antihypersensitivity and caries-preventive benefits (desensitizing and anti-cavity benefits). In short, the nitrates plug the tiny holes in the cementum that communicate with the nerve within the tooth, thereby reducing painful stimulation of the nerve. This results in decreased sensitivity. Please allow up to 2 weeks for the toothpaste to take effect when initially beginning a regimen.