Toothpaste

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Toothpaste from a tube being applied to a toothbrush

Toothpaste is a paste or gel dentifrice

used with a toothbrush as an accessory to
clean and maintain the aesthetics and
health of teeth. Toothpaste is used to
promote oral hygiene: it serves as an
abrasive that aids in removing the dental
plaque and food from the teeth, assists in
suppressing halitosis, and delivers active
ingredients (most commonly uoride) to
help prevent tooth decay (dental caries)
and gum disease (gingivitis).[1] Salt and
sodium bicarbonate (baking soda) are
among materials that can be substituted
for commercial toothpaste. Toothpaste is
not intended to be swallowed due to the
uoride content, but is generally not very
harmful if accidentally swallowed in small
amounts; however, one should seek
medical attention after swallowing
abnormally large amounts.[2]

Ingredients
In addition to 20%42% water, toothpastes
are derived from a variety of components,
the three main ones being abrasives,
uoride, and detergents.

Abrasives

Abrasives constitute at least 50% of a

typical toothpaste. These insoluble
particles help remove plaque from the
teeth. The removal of plaque and calculus
helps minimize cavities and periodontal
disease. Representative abrasives include
particles of aluminum hydroxide (Al(OH)3),
calcium carbonate (CaCO3), various
calcium hydrogen phosphates, various
silicas and zeolites, and hydroxyapatite
(Ca5(PO4)3OH).

Abrasives, like the dental polishing agents

used in dentists' ofces, also cause a
small amount of enamel erosion which is
termed "polishing" action. Some brands
contain powdered white mica, which acts
as a mild abrasive, and also adds a
cosmetically pleasing glittery shimmer to
the paste. The polishing of teeth removes
stains from tooth surfaces, but has not
been shown to improve dental health over
and above the effects of the removal of
plaque and calculus.[3]

The abrasive effect of toothpaste is

indicated by its RDA value. Too high RDA
values should be considered critical, and
some dentists recommend toothpaste of
an RDA value no higher than 50 for daily
use.

Fluorides

Fluoride in various forms is the most

popular active ingredient in toothpaste to
prevent cavities. Fluoride occurs in small
amounts in plants, animals, and some
natural water sources. The additional
uoride in toothpaste has benecial
effects on the formation of dental enamel
and bones. Sodium uoride (NaF) is the
most common source of uoride, but
stannous uoride (SnF2), olaur (an
organic salt of uoride), and sodium
monouorophosphate (Na2PO3F) are also
used. Stannous uoride has been shown
to be more effective than sodium uoride
in reducing the incidence of dental
caries[4] and controlling gingivitis, but
causes somewhat more surface stains.[5]
Much of the toothpaste sold in the United
States has 1,000 to 1,100 parts per million
uoride. In European countries, such as
the UK or Greece, the uoride content is
often higher; a NaF content of 0.312% w/w
(1,450 ppm uoride) is common.

Surfactants

Many, although not all, toothpastes

contain sodium lauryl sulfate (SLS) or
related surfactants (detergents). SLS is
found in many other personal care
products, as well, such as shampoo, and is
mainly a foaming agent, which enables
uniform distribution of toothpaste,
improving its cleansing power.[3]

Despite the different ingredients included

in the toothpaste, recent study (meta
analysis) indicates that brushing with or
without toothpaste has no impact on the
level of plaque removal.[6]

Other components

Antibacterial agents

Triclosan, an antibacterial agent, is a

common toothpaste ingredient in the
United Kingdom. Triclosan or zinc chloride
prevent gingivitis and, according to the
American Dental Association, helps reduce
tartar and bad breath.[1][7] A 2006 review of
clinical research concluded there was
evidence for the effectiveness of 0.30%
triclosan in reducing plaque and
gingivitis.[8]

Flavorants

Toothpaste comes in a variety of colors,

and avors intended to encourage use of
the product. Three most common
avorants are peppermint, spearmint, and
wintergreen. Toothpaste avored with
peppermint-anise oil is popular in the
Mediterranean region. These avors are
provided by the respective oils, e.g.
peppermint oil.[3] More exotic avors
include Anethole anise, apricot,
bubblegum, cinnamon, fennel, lavender,
neem, ginger, vanilla, lemon, orange, and
pine. Alternatively, unavored toothpastes
exist.

Remineralizers

Hydroxyapatite nanocrystals and a variety

of calcium phosphates are included in
formulations for remineralization,[9] i.e. the
reformation of enamel.
Toothpaste is sold in many brands.

Miscellaneous components

Agents are added to suppress the

tendency of toothpaste to dry into a
powder. Included are various sugar
alcohols, such as glycerol, sorbitol, or
xylitol, or related derivatives, such as 1,2-
propylene glycol and
polyethyleneglycol.[10] Strontium chloride
or potassium nitrate is included in some
toothpastes to reduce sensitivity. Sodium
polyphosphate is added to minimize the
formation of tartar.

Safety
Fluoride

Although water uoridation has been

praised as one of the top medical
achievements of the 20th century,[11]
uoride-containing toothpaste can be
acutely toxic if swallowed in large
amounts.[12][13] Approximately 15mg/kg
body weight is the acute lethal dose, even
though as small amount as 5mg/kg may
be fatal to some children.[14]

Risk of using uoride is low enough that

the use of full-strength toothpaste (1350
1500 ppm uoride) is advised for all ages
(although smaller volumes are used for
young children; a smear of toothpaste until
three years old).[13] A major concern of
dental uorosis is for children under 12
months ingesting excessive uoride
through toothpaste. Nausea and vomiting
are also problems which might arise with
topical uoride ingestion.[14]
Diethylene glycol

The inclusion of sweet-tasting but toxic

diethylene glycol in Chinese-made
toothpaste led to a recall in 2007 involving
multiple toothpaste brands in several
nations.[15] The world outcry made
Chinese ofcials ban the practice of using
diethylene glycol in toothpaste.[16]

Triclosan

Reports have suggested triclosan, an

active ingredient in many kinds of
toothpastes, can combine with chlorine in
tap water to form chloroform,[17] which the
United States Environmental Protection
Agency classies as a probable human
carcinogen. An animal study revealed the
chemical might modify hormone
regulation, and many other lab researches
proved bacteria might be able to develop
resistance to triclosan in a way which can
help them to resist antibiotics also.[18]

Miscellaneous issues and

debates

With the exception of toothpaste intended

to be used on pets such as dogs and cats,
and toothpaste used by astronauts, most
toothpaste is not intended to be
swallowed, and doing so may cause
nausea or diarrhea. Tartar ghting
toothpastes have been debated.[19] Case
reports of plasma cell gingivitis have been
reported with the use of herbal toothpaste
containing cinnamon.[20] SLS has been
proposed to increase the frequency of
mouth ulcers in some people, as it can dry
out the protective layer of oral tissues,
causing the underlying tissues to become
damaged.[21]

Alteration of taste perception

After using toothpaste, orange juice and

other juices have an unpleasant taste.
Sodium lauryl sulfate alters taste
perception. It can break down
phospholipids that inhibit taste receptors
for sweetness, giving food a bitter taste. In
contrast, apples are known to taste more
pleasant after using toothpaste.[22]
Distinguishing between the hypotheses
that the bitter taste of orange juice results
from stannous uoride or from sodium
lauryl sulfate is still an unresolved issue
and it is thought that the menthol added
for avor may also take part in the
alteration of taste perception when
binding to lingual cold receptors.

Other types of toothpaste

Whitening toothpastes

Many toothpastes make whitening claims.

Some of these toothpastes contain
peroxide, the same ingredient found in
tooth bleaching gels. The abrasive in these
toothpastes, not the peroxide, removes the
stains.[23] Whitening toothpaste cannot
alter the natural color of teeth or reverse
discoloration by penetrating surface stains
or decay. To remove surface stains,
whitening toothpaste may include
abrasives to gently polish the teeth or
additives such as sodium
tripolyphosphate to break down or
dissolve stains. When used twice a day,
whitening toothpaste typically takes two to
four weeks to make teeth appear whiter.
Whitening toothpaste is generally safe for
daily use, but excessive use might damage
tooth enamel. Teeth whitening gels
represent an alternative.[24] However, the
whitening process can permanently
reduce the strength of the teeth, as the
process scrapes away a protective outer
layer of enamel.[25]

Herbal and natural toothpastes

Companies such as Tom's of Maine,

among others, manufacture natural and
herbal toothpastes and market them to
consumers who wish to avoid the articial
ingredients commonly found in regular
toothpastes. Many herbal toothpastes do
not contain uoride or sodium lauryl
sulfate. The ingredients found in natural
toothpastes vary widely but often include
baking soda, aloe, eucalyptus oil, myrrh,
plant extract (strawberry extract), and
essential oils.

According to a study by the Delhi Institute

of Pharmaceutical Sciences and Research,
many of the herbal toothpastes being sold
in India were adulterated with nicotine.[26]

Striped toothpaste
The red area represents the material used for stripes,
and the rest is the main toothpaste material. The two
materials are not in separate compartments; they are
sufciently viscous that they will not mix. Applying
pressure to the tube causes the main material to issue
out through the pipe. Simultaneously, some of the
pressure is forwarded to the stripe-material, which is
thereby pressed onto the main material through holes
in the pipe.

Striped toothpaste was invented by a New

Yorker named Leonard Lawrence
Marrafno in 1955. The patent (US patent
2,789,731 , issued 1957) was
subsequently sold to Unilever, who
marketed the novelty under the Stripe
brand-name in the early 1960s. This was
followed by the introduction of the Signal
brand in Europe in 1965 (UK patent
813,514). Although Stripe was initially very
successful, it never again achieved the 8%
market share that it cornered during its
second year.

Marrafno's design, which remains in use

for single-color stripes, is simple. The
main material, usually white, sits at the
crimp end of the toothpaste tube and
makes up most of its bulk. A thin pipe,
through which that carrier material will
ow, descends from the nozzle to it. The
stripe-material (this was red in Stripe) lls
the gap between the carrier material and
the top of the tube. The two materials are
not in separate compartments, however
they are sufciently viscous that they will
not mix. When pressure is applied to the
toothpaste tube, the main material
squeezes down the thin pipe to the nozzle.
Simultaneously, the pressure applied to
the main material causes pressure to be
forwarded to the stripe material, which
thereby issues out through small holes (in
the side of the pipe) onto the main carrier
material as it is passing those holes.
In 1990 Colgate-Palmolive was granted a
patent (USPTO 4,969,767 ) for two
differently colored stripes. In this scheme,
the inner pipe has a cone-shaped plastic
guard around it, and about halfway up its
length. Between the guard and the nozzle-
end of the tube is a space for the material
for one color, which issues out of holes in
the pipe. On the other side of the guard is
space for second stripe-material, which
has its own set of holes.

Striped toothpaste should not be confused

with layered toothpaste. Layered
toothpaste requires a multi-chamber
design (e.g. USPTO 5,020,694 ), in which
two or three layers extrude out of the
nozzle. This scheme, like that of pump
dispensers (USPTO 4,461,403 ), is more
complicated (and thus, more expensive to
manufacture) than either the Marrafno
design or the Colgate design.

History
Early toothpastes

Since 5000 BC, the Egyptians made a

tooth powder, which consisted of
powdered ashes of ox hooves, myrrh,
powdered and burnt eggshells, and
pumice. The Greeks, and then the Romans,
improved the recipes by adding abrasives
such as crushed bones and oyster
shells.[27] In the 9th century, Iraqi musician
and fashion designer Ziryab invented a
type of toothpaste, which he popularized
throughout Islamic Spain.[28] The exact
ingredients of this toothpaste are
unknown,[29] but it was reported to have
been both "functional and pleasant to
taste".[28] It is not known whether these
early toothpastes were used alone, were to
be rubbed onto the teeth with rags, or were
to be used with early toothbrushes, such
as neem-tree twigs and miswak.
Toothpastes or powders came into general
use in the 19th century.
Tooth powder

Tooth powders for use with toothbrushes

came into general use in the 19th century
in Britain. Most were homemade, with
chalk, pulverized brick, or salt as
ingredients. An 1866 Home Encyclopedia
recommended pulverized charcoal, and
cautioned that many patented tooth
powders that were commercially marketed
did more harm than good.

Arm & Hammer marketed a baking soda-

based toothpowder in the United States
until approximately 2000, and Colgate
currently markets toothpowder in India
and other countries.

Modern toothpaste

Modern toothpaste gel

An 18th-century American and British

toothpaste recipe called for burned bread.
Another formula around this time called
for dragon's blood (a resin), cinnamon, and
burned alum.[30]
By 1900, a paste made of hydrogen
peroxide and baking soda was
recommended for use with toothbrushes.
Pre-mixed toothpastes were rst marketed
in the 19th century, but did not surpass the
popularity of tooth-powder until World War
I. In 1880, Doctor Washington Shefeld of
New London, CT manufactured toothpaste
into a collapsible tube, Dr. Shefeld's
Creme Dentifrice. He had the idea after his
son traveled to Paris and saw painters
using paint from tubes. In York in 1896,
Colgate & Company Dental Cream was
packaged in collapsible tubes imitating
Shefeld. The original collapsible
toothpaste tubes were made of lead.[31][32]
Promotional poster for the Kolynos toothpaste from
the 1940s

Together with Willoughby D. Miller, Newell

Sill Jenkins developed a toothpaste and
named it Kolynos, the rst toothpaste
containing disinfectants.[33] The name's
origin is from Greek Kolyo nosos (
), meaning "disease prevention".
Numerous attempts to produce the
toothpaste by pharmacists in Europe have
been uneconomic. After returning to the
US, he continued experimenting with Harry
Ward Foote (1875-1942), professor of
chemistry at Shefeld Chemical
Laboratory of Yale University.[34] After 17
years of development of Kolynos and
clinical trials Jenkins retired and
transferred the production and distribution
to his son Leonard A. Jenkins, who
brought the rst toothpaste tubes on the
market on April 13, 1908. Within a few
years the company expanded in North
America, Latin America, Europe and the
Far East. A branch operation opened in
London in 1909. In 1937 Kolynos was
produced in 22 countries and sold in 88
countries. Until modern times Kolynos is
widespread mainly in South America and
in Hungary. Colgate-Palmolive took over
the production of American Home
Products in 1995 at a cost of one billion
US dollars.[35]

Colgate Dental Cream (Toothpaste) With Gardol - ca.

1950s
Fluoride was rst added to toothpastes in
the 1890s. Tanagra, containing calcium
uoride as the active ingredient, was sold
by Karl F. Toellner Company, of Bremen,
Germany, based upon the early work of
chemist Albert Deninger.[36] An analogous
invention by Roy Cross, of Kansas City,
Missouri, was initially criticized by the
American Dental Association (ADA) in
1937. Fluoride toothpastes developed in
the 1950s received the ADA's approval. To
develop the rst ADA-approved uoride
toothpaste, Procter & Gamble started a
research program in the early 1940s. In
1950, Procter & Gamble developed a joint
research project team headed by Dr.
Joseph Muhler at Indiana University to
study new toothpaste with uoride. In
1955, Procter & Gamble's Crest launched
its rst clinically proven uoride-containing
toothpaste. On August 1, 1960, the ADA
reported that "Crest has been shown to be
an effective anticavity (decay preventative)
dentifrice that can be of signicant value
when used in a conscientiously applied
program of oral hygiene and regular
professional care."

In 2006 BioRepair appeared in Europe with

the rst toothpaste containing synthetic
hydroxylapatite as an alternative to
uoride for the remineralization and
reparation of tooth enamel. The
"biomimetic hydroxylapatite" is intended to
protect the teeth by creating a new layer of
synthetic enamel around the tooth instead
of hardening the existing layer with
uoride that chemically changes it into
uorapatite.[37]

See also
Dental oss
Fluoride therapy
List of toothpaste brands
Tube (container)

References
1. American Dental Association Description
of Toothpaste"Toothpaste" . April 15, 2010.
2. "Toothpaste overdose" . National Library
of Medicine. National Institutes of Health.
Retrieved 7 February 2014.
3. Wolfgang Weinert in "Oral Hygiene
Products" Ullmann's Encyclopedia of
Industrial Chemistry, 2005, Wiley-VCH,
Weinheimdoi:10.1002/14356007.a18_209
4. Nevitt GA, Witter DH, Bowman WD
(September 1958). "Topical applications of
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Public Health Rep. 73 (9): 84750.
doi:10.2307/4590256 . JSTOR4590256 .
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5. Perlich, MA; Bacca, LA; Bollmer, BW;
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Beiswanger, BB; Eichold, WA; et al. (1995).
"The clinical effect of a stabilized stannous
uoride dentifrice on plaque formation,
gingivitis and gingival bleeding: a six-month
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(2016-12-01). "Does dentifrice use help to
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10501058. doi:10.1111/jcpe.12615 .
ISSN1600-051X .
7. "Triclosan: What Consumers Should
Know" . April 17, 2010.
8. Gunsolley, JC (December 2006). "A meta-
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doi:10.14219/jada.archive.2006.0110 .
PMID17138709 . Seventeen studies
support the antiplaque, antigingivitis effects
of dentifrices containing 0.30 percent
triclosan, 2.0 percent Gantrez copolymer.
9. Calcium Phosphate Technologies from .
dentist.net. Retrieved on April 4, 2013.
10. Simon Quellen Field "Why There's
Antifreeze in Your Toothpaste: The
Chemistry of Household Ingredients" 2008,
Chicago Review Press. ISBN1-55652-697-0
11. Division of Oral Health, National Center
for Chronic Disease Prevention and Health
Promotion, CDC. Achievements in public
health, 19001999: Fluoridation of drinking
water to prevent dental caries . MMWR
Morb Mortal Wkly Rep. 1999;48(41):933
40.
12. Canedy, Dana (March 24, 1998).
"Toothpaste a Hazard? Just Ask the F.D.A" .
New York Times. Retrieved December 21,
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13. Delivering Better Oral Health: An
evidence-based toolkit for prevention. NHS.
UK, 2007.
14. Kidd, Fejerskov, Edwina, Ole (2016).
Essentials of Dental Caries. Oxford
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ISBN9780198738268.
15. "Tainted toothpaste across the world" ,
New York Times, September 30, 2007.
16. Bogdanich, W. "The Everyman Who
Exposed Tainted Toothpaste" , New York
Times, October 1, 2007.
17. Rule KL, Ebbett VR, Vikesland PJ (2005).
"Formation of chloroform and chlorinated
organics by free-chlorine-mediated
oxidation of triclosan". Environ. Sci.
Technol. 39 (9): 317685.
doi:10.1021/es048943 . PMID15926568 .
18. Mukherjee, Ketan (2010-09-04). "FDA
Reviewing Triclosan, an Antibacterial Agent
Found in Soap" . Retrieved 2010-10-27.
19. "Tartar Fighting Toothpastes & Toxic
Reactions" . toxictoothpaste.org. Archived
from the original on 2012-04-23.
20. Anil S. (2007). "Plasma cell gingivitis
among herbal toothpaste users: a report of
three cases" (PDF). J Contemp Dent Pract.
8 (4): 606. PMID17486188 . Archived
from the original (PDF) on 2009-03-06.
21. Canker Sores Archived February 8,
2006, at the Wayback Machine..
Dentalgentlecare.com. Retrieved on April 4,
2013.
22. DeSimone A., John; Heck, Gerard L.;
Bartoshuk, Linda M. (1980). "Surface active
taste modiers: a comparison of the
physical and psychophysical properties of
gymnemic acid and sodium lauryl sulfate".
Chemical Senses. 5 (4): 317330.
doi:10.1093/chemse/5.4.317 .
23. Tooth Whitening
24. Carr, Alan et al. Whitening toothpaste:
Does it actually whiten teeth?
mayoclinic.com
25. "Are yellow teeth stronger?" .
sciencefocus.com.
26. Chandra, Neetu (September 11, 2011).
"Toothpastes contain cancer causing
nicotine, nds study" . Mail Today.
indiatoday.in. Retrieved 22 August 2014.
27. The History of Toothpaste and
Toothbrushes . Bbc.co.uk. Retrieved on
April 4, 2013.
28. Sertima, Ivan Van (1992). The Golden
Age of the Moor. Transaction Publishers.
p.267. ISBN1-56000-581-5.
29. Lebling Jr., Robert W. (JulyAugust
2003). "Flight of the Blackbird" . Saudi
Aramco World: 2433. Retrieved
January 28, 2008.
30. "Other ingredients in toothpaste" .
Archived from the original on October 18,
2007. Retrieved December 23, 2007.
31. Schlosser, Jim (December 20, 2005)
"Get the lead out didn't always mean for
soldiers to speed up during World War II. It
meant removing lead from toothpaste tubes
to make bullets." blog.news-record.com
32. The Talk of the Town: Collapsible . The
New Yorker (August 6, 1960). Retrieved on
April 4, 2013.
33. Kerry Segrave (January 27, 2010).
America Brushes Up: The Use and
Marketing of Toothpaste and Toothbrushes
in the Twentieth Century . McFarland. p.35.
ISBN978-0-7864-5684-0.
34. Obituary on Harry Ward Foote , Science,
March 6, 1942, p. 241242
35. Kolynos Toothpaste and Nalgiri
Cosmetics A curious blend of Greek and
Hindu .
36. Early dental uoride preparations
(dentifrice, mouthwash, tablets, etc.) .
Fluoride-history.de. Retrieved on April 4,
2013.
37. An enamel toothpaste that repairs
teeth . BioRepair (January 18, 2013).
Retrieved on April 4, 2013.

External links
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to Toothpaste.

Chemistry of Plaque Prevention with

Toothpaste
Fluoride toothpaste history

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