Theobromine Toothpaste May Encourage Tooth Remineralization

toothpaste in tubeOkay, so you don’t really neeeeed toothpaste.

Yes, you read that right. In fact, in many cases, you’re better off without it – especially if your only “option” is the average toothpaste you find in your average big box or drug store.

In our opinion, that option’s no option, due to the potentially toxic ingredients conventional toothpastes typically contain.

Take sodium fluoride, for instance – a drug under the jurisdiction of the FDA. It’s the ingredient that merits the poison warning you see on every box.

Whether from hygiene products, “supplements,” or fluoridated water, too much fluoride during the first eight years, while teeth are still developing, can cause dental fluorosis. In severe cases, the teeth turn brown, with rough and pitted surfaces. It’s a clear sign of too much fluoride.

If only the concerns were “just cosmetic,” right? But fluoride has also been linked with many chronic conditions. These include arthritis, neurological issues, cancer, cardiovascular disease, pineal gland problems, thyroid disease, kidney disease, and endocrine disruption – to list but a few.

And for all this, it may not even prevent decay. (It certainly doesn’t address the cause.)

Other problem ingredients include sodium lauryl sulfate, triclosan, and FD&C blue dye 1 and 2.

So if that’s what’s available, then ditching the toothpaste is a good thing. You don’t neeeeed it. After all, the main reason we use it is just to provide a little grit to help remove plaque more easily – and for the pleasant taste and clean feeling it leaves.

And for that reason, most of us probably don’t want to do without.

Fortunately, there are great nontoxic alternatives available. One of our favorites, as we’ve mentioned before, is Theodent. It’s an option you can feel good about.

cocoa Theodent’s active ingredient is theobromine, a natural compound derived from cocoa beans. Research suggests that this alkaloid may encourage tooth remineralization by restoring minerals to the tooth’s structure – all without relying on fluoride.

Even more promising research has published of late, further supporting theobromine as a safe and effective alternative to fluoride.

One study serendipitously found that theobromine causes the formation of large hydroxylapatite (HAP) crystals. Hydroxylapatite is the main mineral in tooth enamel. While small crystals were seen to increase demineralization during acid exposure, large crystals did not and were associated with less decay. Because of this – and its safety – the authors consider theobromine “a better ingredient than fluoride.”

We believe that theobromine can be used as an ingredient of dentifrices and even if swallowed accidentally, there are no adverse effects.

A second study pitted Theodent classic – in both fluoride-free and fluoridated forms – against Colgate Regular (containing fluoride) and a prescription remineralizing paste. The goal was to compare their effectiveness at decreasing tooth sensitivity. Theodent did so more quickly than the others. Colgate fared the worst. Clearly, the theobromine made a difference.

If you want to decrease sensitivity, prevent decay, freshen your breath, and avoid a whole host of toxins, Theodent is definitely worth a try. Even though you don’t really neeeed it, we think you’ll waaaant it.

Images by Adam Minter & Carsten ten Brink

Fluoride, Fluoride, Fluoride…

children's toothpasteWe all want the best for our kids, and like everything in life, there are different opinions on how to get there.

Maybe you go out of your way to read labels in your attempt to give your family the best quality products you can. But there’s one label you might have missed: the one on your family’s toothpaste.

warning on children's toothpasteBuying that bright, candy-esque packaged toothpaste because it might encourage brushing is naturally based on the best of intentions for the child.

But if it’s fluoridated, you’ll notice a poison control warning.


Seek first to understand, then to be understood.
– Dr. Stephen Covey

The Fluoridated Party Line

In January, a Norwegian study on oral health messages was published in the International Journal of Dental Hygiene. The aim was to investigate recommendations given to the general public by dentists, dental hygienists, dental nurses, and public health nurses on preventing caries (tooth decay).

More than 800 health professionals answered the authors’ questionnaire.

  • 59-71% judged oral hygiene education to be the most important part of preventing caries.
  • 84-98% recommended that all children use fluoride toothpaste.
  • Half recommended fluoride lozenges for 50% or more of children.

The message is clear: Fluoride, fluoride, fluoride. But does that make it right? Accurate? Effective?

It’s Too Much Sugar, NOT too little Fluoride

Frankly, it’s distressing to realize that diet seems not to have been mentioned at all – or not by enough to merit highlighting.

In terms of prevention, fluoride is, at best, a stop-gap measure – an attempt to minimize damage rather than keep it from happening in the first place. It’s a point that was made nicely in a paper published last year in the Journal of Dental Research.

The importance of sugars as a cause of caries is underemphasized and not prominent in preventive strategies. This is despite overwhelming evidence of its unique role in causing a worldwide caries epidemic. Why this neglect? One reason is that researchers mistakenly consider caries to be a multifactorial disease; they also concentrate mainly on mitigating factors, particularly fluoride. However, this is to misunderstand that the only cause of caries is dietary sugars. These provide a substrate for cariogenic oral bacteria to flourish and to generate enamel-demineralizing acids. Modifying factors such as fluoride and dental hygiene would not be needed if we tackled the single cause—sugars. [emphasis added]

Instead, preventive self-care for children gets reduced to a “how-to” message for parents: fluoridate. This is concerning.

Education as a Foundation of Health

When it comes to families with young children, the emphasis on fluoride is a culturally ingrained message that supersedes parental control. As a parent, you can regulate the cookie jar, but, how do you regulate, much less know, the quantity of fluoride your child ingests from toothpaste? Fluoridated water? Juices? Soft drinks? Processed meat? Other sources?

You can’t.

If you’ve ever left a dental office feeling shamed because you didn’t embrace fluoride for your kids, you should know there are alternatives. In biological dentistry, generally speaking, oral health care isn’t so much a “message” as it is a holistic philosophy.

Rather than just throwing fluoride recommendations at you, we seek to understand the desires and goals you have for your family’s dental care. Once we understand, we work to identify individual habits that may influence health outcomes and emphasize education regarding diet and effective cleaning techniques rather than fluoride.

We believe this approach not only empowers you and your family to achieve your health goals, but employs the truest sense of “self-care for children” in the prevention of tooth decay.

Other than a Toothbrush

Pop quiz: What do you need in order to clean your teeth thoroughly and effectively?



If your answer included “toothpaste,” you might be a little bit wrong. Or at least not entirely right.

Believe it or don’t, but there’s actually some argument as to whether toothpaste helps clean teeth. Consider, for instance, a study published a few years back in the Indian Journal of Dental Research. Not only did its authors find that toothpaste didn’t help remove plaque but that it might actually interfere with the process. While toothpaste users reduced plaque by about 57%, non-toothpaste users reduced 9% more.

Yet toothpaste has other purposes. For one, the taste can be refreshing and actually provide a little extra incentive to brush. It can also provide a way of applying essential oils such as clove, thyme, tea tree and peppermint (to name but a few) that can keep oral pathogens – “bad” bacteria and other microbes – in check. Likewise, it can deliver compounds such as theobromine, which can help the teeth remineralize more effectively – more so than fluoride, and more safely, as well.

toothbrush and waterFor the simple sake of breaking up dental biofilm (plaque), though, it’s the mechanical action of brushing that really counts. At most, as we’ve noted before, toothpaste can provide a little extra grit to help in the process.

As for the other answers to the quiz? A toothbrush (natch), floss (or a proxy brush or oral irrigator to clean between the teeth), good technique, and making good hygiene a habit.

(And in case you’re wondering if there’s a best type of brush, see this and this.)

Image by Greg Foster

Triclosan: Modest Benefits & Much Reason for Concern

triclosan_labelFluoride, as we mentioned before, is far from the only you-don’t-really-want-this-in-your-toothpaste ingredient there is. Among those we listed: triclosan.

A powerful antibacterial and antifungal agent, triclosan was first registered as a pesticide by the EPA in 1969. That’s right: a pesticide. Over the years it has found it’s way into a dizzying array of personal care products – from soaps, deodorants, toothpastes and spa products to clothes, paint, furniture, kitchenware and even toys! (You’ll find a good list of specific products here.)

Recent research in Evidence-Based Dentistry shows that this controversial additive may prevent gingivitis (gum disease), plaque buildup and tooth decay. According it its author, “The volume of evidence, and its reasonable quality, has provided clear evidence of the modest benefits of using a triclosan/copolymer toothpaste.”

Still, it has to be asked: Does a “modest” benefit – in this case, 22% reduction in plaque and gingival inflammation and 5% reduction in coronal caries (cavities on the tops of teeth) – justify the risks of muscular and hormonal damage other studies have found to be caused by triclosan?

It doesn’t seem to be an issue for the American Dental Association. And even as the FDA acknowledges that “animal studies have shown that triclosan alters hormone regulation,” the agency still considers it safe to use on and in the human body. After all, they say, “data showing effects in animals don’t always predict effects in humans.”

Of course. That’s been acknowledged by scientists doing the research, as well, such as the authors of one study which showed that even a rather small dose of triclosan can dramatically affect muscle contraction in mice. But they weigh that against the strengths of their findings, discussed in detail in a media release from their university:

[Nipavan Chiamvimonvat, professor of cardiovascular medicine at UC Davis] cautioned that translating results from animal models to humans is a large step and would require further study. However, the fact that the effects were so striking in several animal models under different experimental conditions provides strong evidence that triclosan could have effects on animal and human health at current levels of exposure.

* * *

[Isaac Pessah, professor and chair of the Department of Molecular Biosciences in the UC Davis School of Veterinary Medicine] questioned arguments that triclosan — introduced more than 40 years ago — is safe partly because it binds to blood proteins, making it not biologically available. Although triclosan may bind to proteins in the blood, that may not necessarily make the chemical inactive, he said, and actually may facilitate its transport to critical organs. In addition, some of the current experiments were carried out in the presence of blood proteins, and disrupted muscle activity still occurred.

Ultimately, said Dr. Pessah, ““These findings provide strong evidence that the chemical is of concern to both human and environmental health.”

Why would such problems arise? Each of the several billion cells that make up your body is surrounded by a protective membrane. What triclosan does is disrupt the synthesis and function of the fatty acids that make up the membrane. It damages the cell. If that happens, hormones have a hard time telling it to do its job – regulating your metabolism, for instance, or your circadian rhythm or immune function.

Environmentally, triclosan has been shown to be especially toxic to aquatic environments. As a 2012 report from Environment Canada put it,

Since triclosan is expected to be continuously present in certain aquatic ecosystems, organisms that live in these environments are likely to be exposed to this substance on a chronic basis. Triclosan has a high inherent toxicity to a variety of aquatic organisms, such as algae, macrophytes, invertebrates, amphibians and fish. Adverse effects on these organisms include reduction in growth, reproduction and survival. Based on the numerous toxicity data available, a predicted no-effect concentration of 115 ng/L was derived. Triclosan may also interfere with the action of thyroid hormones in amphibians at environmentally relevant concentrations.

Suffice it to say, this has ripple effects up the food chain. There are also concerns that environmental exposure to triclosan from product manufacturing may create antibiotic resistant strains of bacteria in the grey water that gets used in agriculture, also affecting our food supply.

In this respect, too, whatever benefits triclosan may confer seem far outweighed by the potential damage it can do.

Avoid products containing triclosan by checking the label. There are plenty of natural alternatives available, including many easy DIY options using common household ingredients.

EWG’s Guide to Triclosan

What’s in YOUR Toothpaste?

If you look at the label of a fluoridated toothpaste – Crest Cavity Protection, say – you’ll see just one active ingredient: fluoride. But you know it contains more than just that. What are those inactive ingredients all about?

toothpaste label showing ingredients

That seems like a lot of inactivity… and it may be a little misleading. While none of those ingredients are active cavity-fighters, that doesn’t mean they don’t have any effect.

Consider sodium lauryl sulfate (SLS). This chemical is used in laundry detergents and other cleaning supplies. It also has some use as a pesticide. So what’s it doing in toothpaste? It’s a thickening agent and creates the sudsy feeling you get when you brush. It may also cause soft tissue damage and contribute to a range of systemic health issues, including cancer.

Note, too, that SLS is found in many more personal care products beyond toothpaste, from shampoo to facial cleansers to shaving cream.

Potential carcinogens may be found among the artificial flavors and dyes used to make conventional toothpastes. Blue 1, for instance, is among those substances “reasonably anticipated to be human carcinogens” by the American Cancer Society.

Toothpaste formulations differ, of course, from brand to brand, as well as among products produced under the same brand. Crest Pro-Health for Me, for instance, contains something Crest Cavity Protection does not: plastic – polyethylene (PE), to be exact. PE helps hold the toothpaste together, and it appears to get easily embedded in the gums. Dental hygienist Trish Walraven reports finding these small blue bits of plastic in her patients’ mouths every day and neatly explains why this is an issue:

plastic flecks on gingiva

Around our teeth we have these little channels in our gums, sort of like the cuticles around our fingernails. The gum channel is called a sulcus, and it’s where diseases like gingivitis get their start. A healthy sulcus is no deeper than about 3 millimeters, so when you have hundreds of pieces of plastic being scrubbed into your gums each day that are even smaller than a millimeter, many of them are getting trapped.

The thing about a sulcus is that it’s vulnerable. Your dental hygienist spends most of their time cleaning every sulcus in your mouth, because if the band of tissue around your tooth isn’t healthy, then you’re not healthy. You can start to see why having bits of plastic in your sulcus may be a real problem, sort of like when popcorn hulls find their way into these same areas. Ouch, right?

Other inactive ingredients to actively avoid include triclosan (a pesticide that disrupts hormones) and pyrophosphate compounds (causes skin irritation). You can learn more about such ingredients here and here.

So should you avoid toothpaste all together? Not necessarily. Although the mechanical action of brushing is the main thing that helps get the biofilm (plaque) off your teeth, toothpaste can make it easier by providing a bit of grit to the process. If you’re a DIYer, you can easily make your own healthy toothpaste at home, but there are plenty of alternatives available. Often, these products contain essential oils and other natural compounds known to control oral pathogens and support good gum health – lots of the good stuff, none of the bad.

Whichever you choose – or if you choose none at all – the main thing remains: Brush. Regularly. Correctly.

Note: This post was revised August 29, 2016.

Fluoride for the Just-Turning-Toddler Set?

teethingOnce upon a time, the ADA said that children under two years of age should not be given fluoride.

How the times have changed!

Now, the organization is stating that children’s teeth should be brushed with fluoride toothpaste as soon as the first tooth comes in.

* * *

The new guidance is intended to provide children with the full benefit of cavity protection while limiting their risk of developing fluorosis.

This means, according to the systematic research review that accompanied the new recommendation, that “the appropriate amount of fluoride toothpaste should be used by all children regardless of age.”

We say the appropriate amount is none, regardless of age.

When you can get the same results – caries prevention – through things like proper nutrition and hygiene, why go with a toxin instead?

For fluoride is no risk-free medicament. Of course, there’s the matter of fluorosis already mentioned. But there are also problems that come from swallowing too much of the stuff, which is why the recommendations also state that kids should spit out toothpaste just as soon as they’re able. (Yet by some weird magic, fluoride’s considered just fine to swallow if it’s in water. Go fig’.)

More, recent science suggests prevention should actually start earlier than the sight of the first tooth. Bacteria associated with early childhood caries can be found in the saliva of infants.

In a comparative analysis using DNA sequencing methods, scientists from the University of Illinois at Urbana-Champaign and two research institutes in Lubbock in Texas identified hundreds of bacteria species in saliva taken from infants whose teeth were still erupting, including those that are involved in the formation of biofilm and ECC. The disease, which usually occurs in primary teeth between birth and six years of age, has turned out to be one of the most prevalent infectious diseases in U.S. children in recent years.

So what can you do about this?

  1. Limit how much sugar your child consumes. Among other things, this means going easy on fruit juice, which is just as sugary as soda pop.
  2. If you must let your child sleep with a bottle, fill it with fluoride-free water.
  3. After feeding, clean your infant’s gums with a moistened soft washcloth or gauze pad.
  4. When your child’s teeth begin to erupt, offer teething rings or gently massage their gums with your finger. Avoid teething gels with benzocaine, which can raise the risk of methemoglobinemia (a blood disorder that makes it harder for cells to get the oxygen they need).

Image by evilpeacock, via Flickr