Evidence-Based Recommendations for the Optimal Selection and Utilization of Toothpaste in Oral Health Care Practices

Abstract

Toothpaste serves as an effective medium for delivering substances that contribute to both individual and population-wide oral health. It is crucial that recommendations for toothpaste use are grounded in robust scientific evidence rather than the subjective opinions of experts or authoritative bodies. Fluoride remains the most significant active ingredient in toothpaste for managing dental caries, complementing the mechanical action of brushing. Substantial evidence supports the use of fluoride toothpaste to prevent caries in both children and adults, with its effectiveness depending on a fluoride concentration of at least 1000 ppm and consistent use (at least twice daily). Concerns about dental fluorosis resulting from fluoride toothpaste ingestion in children have been largely overstated, as there is insufficient evidence to support delaying its use until after the age of 3-4, that low-fluoride toothpaste effectively prevents fluorosis, or that fluorosis significantly impairs quality of life in individuals exposed to fluoridated water and toothpaste. Additionally, research supports the efficacy of other therapeutic agents in toothpaste, such as triclosan/copolymer, which has been shown to reduce dental biofilm, gingivitis, periodontitis, calculus, and halitosis. Similarly, stannous fluoride-containing toothpastes have demonstrated benefits in reducing biofilm and gingivitis.