Toothpaste Ingredients: Safety, Scientific Evidence & Types

Toothpaste is an oral hygiene product that uses foaming properties to distribute beneficial substances to your teeth and mouth.

It’s considered a “polishing agent,” to give your pearly whites a shiny finish, but can also offer dental health benefits including cavity prevention.

There are many ingredients used in commercial toothpaste — some beneficial, some controversial. Up to 40% of toothpaste is water, an inactive ingredient.

But… what’s in the other 60% of the tube?

What are the harmful ingredients in toothpaste? Depending on who you ask, harmful toothpaste ingredients may include:

Sodium lauryl sulfate
Triclosan
Carrageenan
Polyethylene glycol
Aspartame
Whitening agents (in excess)

What toothpastes do dentists really recommend? Conventional dentists will likely suggest fluoride toothpastes. Holistic dentists more often recommend toothpastes that do not contain any potentially toxic ingredients or antibacterial agents.

Toothpastes may have been used as long as 7,000 years ago. But modern toothpaste ingredients have come a long way since egg shells and ashes!

Below, we break down what each toothpaste ingredient is, what it does, and whether or not it’s truly good for you.

Active Ingredients for Remineralization

What is the active ingredient in toothpaste? Toothpaste’s active ingredient is usually fluoride. The active ingredient is whatever agent is remineralizing teeth and reversing/preventing tooth decay.

Toothpaste manufacturers use one or more of the following to remineralize teeth:

Fluoride
Chloro calcium phosphosilicate
Hydroxyapatite

For tartar control, manufacturers may put sodium pyrophosphate into their toothpaste products.

Fluoride

Fluoride is an all-natural cavity fighter. Fluoride is in most toothpaste because studies show that fluoride reduces and may help to reverse tooth decay.

The American Dental Association (ADA) only grants its ADA Seal of Acceptance to fluoride toothpastes.

The FDA only recognizes 3 forms of fluoride for cavity prevention:

Sodium fluoride
Sodium monofluorophosphate
Stannous fluoride

Fluoride-free toothpaste is any kind of toothpaste made without fluoride. There is a growing interest in fluoride-free toothpastes as more and more evidence reveals that fluoride may be toxic, even in small amounts.

It’s important to watch young children (who are typically using way too much toothpaste) to ensure they don’t swallow fluoride toothpaste.

Fluoride seems to be of most concern to infants and children, but most of this danger seems to be related to fluoridated water. It may cause fluorosis, a type of permanent tooth staining, before all adult teeth have come in.

Chloro Calcium Phosphosilicate

Chloro calcium phosphosilicate is a patented formulation that releases chloride ions instead of fluoride ions.

Also called calcium chloro-phosphosilicate, the chloride ions that they produce may form important minerals on your tooth surface.

BioMin C toothpaste utilizes chloro calcium phosphosilicate, aiming to help remineralize teeth and reduce tooth sensitivity. Click here to learn what’s in BioMin toothpaste.

Hydroxyapatite

Hydroxyapatite (HAp) is by far the most prevalent component of tooth enamel and dentin. HAp has been used in toothpastes in Japan for decades as an alternative to fluoride, and it’s becoming more popular in other countries each year.

Research in humans in its infancy, but hydroxyapatite toothpaste may offer a completely non-toxic method of tooth remineralization and cavity prevention. A few companies also offer floss coated with HAp.

Sodium Pyrophosphate

Also known as tetrasodium pyrophosphate (TSPP), sodium pyrophosphate is used in toothpaste (and floss) to remove calcium and magnesium from your saliva.

This prevents dental plaque from hardening into tartar. You may find sodium pyrophosphate in tartar-control toothpastes for this reason.

Some are concerned about the relatively low doses needed to be toxic. Sodium pyrophosphate is twice as toxic as table salt, yet it is “generally recognized as safe” by the FDA.

Abrasives

Abrasives in toothpastes are insoluble particles that help remove dental plaque and surface stains from teeth. This abrasive polishing action may erode a small amount of tooth enamel, unfortunately.

Common abrasive ingredients in toothpaste:

Calcium carbonate
Dicalcium phosphate
Hydrated silica gels
Alumina
Magnesium carbonate
Sodium bicarbonate (baking soda)

Relative dentin abrasivity (RDA) is a standardized measurement of how abrasive toothpaste is on your tooth enamel and/or dentin.

The abrasive effect of a toothpaste is determined by its RDA value. A high RDA value is dangerous. It is recommended that you use a daily toothpaste with an RDA value lower than 50. Click here for a helpful chart of popular toothpastes and their RDA values.

Whitening Agents

Pearly white teeth is usually what people think of when they imagine “perfect teeth”. 80% of Americans want whiter teeth. As a result, whitening agents are increasingly popular in commercial toothpaste.

Whitening toothpastes may contain hydrogen peroxide or powerful stain dissolvers, such as sodium tripolyphosphate.

Too much teeth whitening can be a bad thing. Potential side effects of teeth whitening ingredients include:

Degraded tooth enamel/dentin
Weakened tooth structure
Sensitive dental pulp
Imbalanced oral bacteria
Mercury exposure, if you have a dental amalgam filling

Antibacterial Ingredients

Toothpastes may contain antibacterial ingredients to help kill harmful bacteria in your mouth that may lead to cavities and/or gingivitis.

Unfortunately, these antibacterial ingredients may negatively affect your oral microbiome. Simply put, the oral microbiome is the balance of beneficial bacteria and harmful bacteria. An imbalanced oral microbiome may contribute to tooth decay and gum disease.

One antibacterial agent found in some toothpastes is triclosan. Triclosan is actually a very controversial toothpaste ingredient, especially since triclosan was banned by the FDA for use in soaps in 2016.

Triclosan has been linked to:

Developmental defects in infants
Immune response problems
Cardiovascular dysfunction
Endocrine disruption
Decrease in hormone production
Antibiotic resistance

Colgate Total, the most well-known brand selling triclosan toothpaste, removed the ingredient from their formulation in 2019 due to growing safety concerns.

Desensitizers

Desensitizers are supposed to reduce tooth sensitivity, either by numbing and calming tooth nerves or by blocking the dentin tubules that can act as a pathway to tooth nerves.

Examples of toothpaste ingredients meant for sensitive teeth:

Potassium nitrate
Strontium nitrate
Sodium fluoride

Detergents (for Foaming)

Most toothpaste contains foaming agents, called detergents or surfactants. This is perfectly normal, even though the word “detergent” may recall unpleasant memories of a soapy mouth.

The most common toothpaste detergent is sodium lauryl sulfate (SLS), which is controversial in many circles. SLS may trigger inflammation, gum irritation, dry mouth, or even canker sores.

You may also want to avoid the foaming agent called DEA (diethanolamine), which may contribute to breast, prostate, and skin cancer.

Humectants

Humectants in toothpastes retain moisture so the toothpaste doesn’t dry out and crack in the tube. A wet toothpaste retains its pleasing texture.

Sorbitol and glycerin are the most common humectants in toothpaste, especially because they do double duty as sugarless sweeteners.

Thickeners

Thickeners (AKA binders) thicken and stabilize toothpastes. Thickeners also contribute to a pleasing texture.

Carrageenan is a common toothpaste thickener, although research has linked ingestion of large amounts of carrageenan to:

Gastrointestinal inflammation
Ulcers
Colon cancer

Don’t swallow your toothpaste, and it shouldn’t be an issue.

Dispersants

Sometimes called surfactants, dispersants encourage the separation of particles and discourage clumping. The mechanism of dispersants may overlap with detergents.

Polyethylene glycol (PEG) is a common dispersant (and sometimes a humectant). It has been linked with a handful of allergic reactions, as well well as skin irritation and toxicity in certain body organs.

Sweeteners

Because sugar directly contributes to cavities and gum disease, no toothpaste has sugar in it.

But many toothpaste manufacturers include artificial sweeteners in their products, since artificial sweeteners do not lead to cavities or gingivitis and a sweet taste is pleasing to most consumers.

Plus, xylitol and erythritol (two sugar alcohols) may also help to remineralize teeth.

Examples of artificial sweeteners used in toothpastes:

Sorbitol
Xylitol
Erythritol
Glycerol, or glycerin
Propylene glycol
Aspartame
Saccharin
Potassium acesulfame (Ace-K)

Some of these, including aspartame, saccharin, and Ace-K are controversial for their potential health dangers. However, these are typically associated with consuming the sweeteners in foods and drinks, not being exposed to them via toothpaste.

Preservatives (Including Parabens)

Toothpastes often contain preservatives to prevent the growth of bacteria and other microorganisms, which makes the toothpaste last longer.

5 commonly used toothpaste preservatives:

Sodium benzoate
Sodium methylparaben
Sodium propylparaben
Methyl paraben
Ethyl paraben

Parabens are endocrine disruptors that may lead to cancer. Though restricted in other countries, US companies still use parabens as preservatives.

Flavorings

Flavorings are required in toothpastes to mask the unpleasant taste of the detergents and any other unpalatable tastes.

Common flavoring agents in toothpaste:

Peppermint
Spearmint
Wintergreen
Cinnamon
Menthol
Vanilla
Bubblegum (particularly for children)
Fruity (particularly for children)

Pro tip: If you’re avoiding artificial flavors for you or your kiddos, stay away from bubblegum or berry flavors, which can only be created artificially.

Artificial Coloring

Artificial coloring is used in toothpastes to make the toothpaste more aesthetically pleasing.

However, artificial coloring is not necessary. Artificial coloring agents have been described as a public health problem in some scientific studies. That’s why most natural toothpastes avoid using them.

Ingredients in Natural Toothpastes

Nowadays, many toothpastes are using less common ingredients as we learn more about their potential for your dental health. More and more companies proudly offer natural toothpastes.

Here are some popular ingredients in natural toothpastes:

Probiotics — Supposed to promote a healthy oral microbiome, probiotics seem to die too quickly in practice. We suggest you opt for oral probiotics, separate from your toothpaste, as it’s up for debate whether or not probiotics can stay alive in a tube of toothpaste.
Essential oils — These may be used as flavorings, preservatives, or even ingredients to promote healthy teeth.
Turmeric — A famous anti-inflammatory and antimicrobial, turmeric in toothpaste is gaining popularity as a whitening agent, though the evidence is mostly anecdotal.
Aloe — Many consider aloe to be a pleasant alternative to artificial mint flavors. Some claim that aloe is not as abrasive as most toothpastes. It may also soothe some gum inflammation.
Grape seed extract (GSE) — GSE seems to reduce erosion of the tooth enamel and/or dentin.
Green tea — A healthful antibacterial with no major side effects, green tea may help prevent plaque formation and bad breath.
L-arginine — Arginine may be an effective treatment for cavity intervention and prevention.
Pomegranate — Punica granatum (pomegranate) is a potent antibacterial, anti-inflammatory, antiviral, antioxidant probiotic that may fight against periodontal disease (AKA gum disease).
Coconut oil — Oil pulling is when you swish coconut oil around your mouth. This is so effective because of coconut oil’s antibacterial and antimicrobial effects. The same properties make coconut oil a great alternative to conventional toothpastes.

Here at Triple Bristle, we believe that — whatever toothpaste you use — you should be using a triple-sided toothbrush. Click here to discover the Triple Bristle difference!

Sources

Godel, J., Canadian Paediatric Society, & Community Paediatrics Committee. (2002). The use of fluoride in infants and children. Paediatrics & Child Health, 7(8), 569-572. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2798610/
Amaechi, B. T., AbdulAzees, P. A., Alshareif, D. O., Shehata, M. A., Lima, P. P. D. C. S., Abdollahi, A., … & Evans, V. (2019). Comparative efficacy of a hydroxyapatite and a fluoride toothpaste for prevention and remineralization of dental caries in children. BDJ open, 5(1), 1-9. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6901576/
Deshpande, S. S. (2002). Handbook of food toxicology. CRC Press. Selected text: https://books.google.com/books?id=Mk-IdNTTJB0C&pg=PA259&lpg=PA259&dq=tetrasodium+phosphate+toxicity&source=web&ots=UTcG2wT0y9&sig=_c9T9HRdwiV7pMk01T8ZLTzFkl8#v=onepage&q=tetrasodium%20phosphate%20toxicity&f=false
Goldberg, M., Grootveld, M., & Lynch, E. (2010). Undesirable and adverse effects of tooth-whitening products: a review. Clinical oral investigations, 14(1), 1-10. Abstract: https://pubmed.ncbi.nlm.nih.gov/19543926/
Gao, L., Xu, T., Huang, G., Jiang, S., Gu, Y., & Chen, F. (2018). Oral microbiomes: more and more importance in oral cavity and whole body. Protein & cell, 9(5), 488-500. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5960472/
Weatherly, L. M., & Gosse, J. A. (2017). Triclosan exposure, transformation, and human health effects. Journal of Toxicology and Environmental Health, Part B, 20(8), 447-469. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6126357/
Herlofson, B. B., & Barkvoll, P. (1994). Sodium lauryl sulfate and recurrent aphthous ulcers: a preliminary study. Acta Odontologica Scandinavica, 52(5), 257-259. Abstract: https://pubmed.ncbi.nlm.nih.gov/7825393/
International Agency for Research on Cancer. (2013). DIETHANOLAMINE. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, No. 101. Full text: https://www.ncbi.nlm.nih.gov/books/NBK373177/
Tobacman, J. K. (2001). Review of harmful gastrointestinal effects of carrageenan in animal experiments. Environmental health perspectives, 109(10), 983-994. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1242073/
Pan, S., Yuan, C., Tagmount, A., Rudel, R. A., Ackerman, J. M., Yaswen, P., … & Leitman, D. C. (2016). Parabens and human epidermal growth factor receptor ligand cross-talk in breast cancer cells. Environmental health perspectives, 124(5), 563-569. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4858398/
Arnold, L. E., Lofthouse, N., & Hurt, E. (2012). Artificial food colors and attention-deficit/hyperactivity symptoms: conclusions to dye for. Neurotherapeutics, 9(3), 599-609. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3441937/
Boteon, A. P., Kato, M. T., Buzalaf, M. A. R., Prakki, A., Wang, L., Rios, D., & Honório, H. M. (2017). Effect of Proanthocyanidin-enriched extracts on the inhibition of wear and degradation of dentin demineralized organic matrix. Archives of Oral Biology, 84, 118-124. Abstract: https://pubmed.ncbi.nlm.nih.gov/28987724/
Hewlings, S. J., & Kalman, D. S. (2017). Curcumin: a review of its’ effects on human health. Foods, 6(10), 92. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5664031/
Nascimento, M. M. (2018). Potential uses of arginine in dentistry. Advances in dental research, 29(1), 98-103. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5784480/
Prasad, D., & Kunnaiah, R. (2014). Punica granatum: a review on its potential role in treating periodontal disease. Journal of Indian Society of Periodontology, 18(4), 428. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4158581/