Can toothpaste be a waste of time and money?

We have all been brought up to believe that brushing your teeth is an effective way to remove the build-up of plaque and bacteria from your teeth, but, a recent report has thrown doubt on the efficacy of toothpaste in the process.

Generations of loving, parental advice, combined with compelling marketing, has driven the message home and there is little doubt that the mechanical action of brushing your teeth is an effective means of removing dental plaque and food debris – and has been for centuries.

‘There is moderate certainty that toothbrushing with a toothpaste does not provide an added effect for the mechanical removal of dental plaque.’

In fact, mankind has been using toothbrushes since the Chinese developed a bristle toothbrush in 1498 that is similar to those that we use today. Before then it was not an uncommon practice for an aromatic twig with a frayed end, or ‘chew stick’, to be rubbed against the teeth. Evidence of this activity has been traced back as far as 3000BC, and the Ancient Egyptians.

Over the years, different cultures have had different takes on the design of the actual device employed for dental cleansing. The combination of a bone or bamboo handle, and hogs hair, proved to be the most popular. That was until 1938 when Du Pont introduced the modern nylon-bristled version – the descendants of which we all know and love today.

Taking it out on toothpaste

However, brushing only covers half of our morning and nighttime ritual and a group of investigators in Amsterdam have challenged the effectiveness of toothpaste’s part in this process.

The report, to be published in the Journal of Clinical Periodontology, claims: ‘There is moderate certainty that toothbrushing with a toothpaste does not provide an added effect for the mechanical removal of dental plaque.’

Fans of minty-fresh breath may be feeling a little flustered at this revelation, but fear not.

The British Society of Periodontology (BSP) feel that: ‘The paper is an interesting review of the available evidence and a useful addition to the scientific literature on oral hygiene habits, but it does not mean that toothpaste is a waste of time and money.

Furthermore, the European Federation of Periodontology has released an extensive statement that pays respect to the research but challenges the conclusion.

The statement begins by under-pinning what we already know. It says: ‘There is no doubt that mechanical toothbrushing twice-daily provides vital health benefits and that the toothpaste itself may not add to that mechanical removal.’

Then they continue to make the case for our tube-dwelling chum: “However, it is also essential to appreciate that toothpastes also carry other active ingredients, such as fluoride, anti-halitosis agents (good mouth smell), and anti-bacterial agents that may kill bacteria in the plaque. In addition, toothbrushing with a toothpaste reduces external tooth discolouration due to mild abrasives, which has aesthetic importance, as well as potentially removing roughness that may in the future encourage more plaque build-up.”

Let’s hear it for toothpaste

The statement concludes that there is overwhelming evidence is that toothpaste does provide added benefit to oral and gum health. As dental professionals we should continue to encourage the use of toothpaste as it carries a whole range of active ingredients which protect the teeth and gums:

  • • Fluorides to strengthen the teeth against the ravages of dental decay;
  • • Agents which reduce tooth sensitivity;
  • • Anti-bacterial agents which kill bacteria in plaque.

In addition to these benefits, for which there is abundant evidence, toothpaste use can help with:

  • • Stain removal;
  • • Breath freshening;
  • • Making the mouth feel cleaner and healthier.