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Paging Dr. Frischer - Toothpaste
WRITTEN BY :   Dr. Alan Frischer

I recently saw an old TV ad for toothpaste and was amused when the actor applied a two-inch long strip of paste on his toothbrush. This struck me because I just had my own six-month check-up and was told that I should either use a pea-sized amount of toothpaste, or none at all.
No, I’m not a dentist, but advanced tooth or gum decay can lead to infection, illness, hospitalization, and even death…so let’s explore toothpaste.
We all know that toothpaste is a paste used with a toothbrush to clean and maintain both the look and the health of teeth. It serves as an abrasive to remove dental plaque and food from the teeth, freshens breath, and delivers fluoride. Let’s note that most of the benefits are achieved through the mechanical action of brushing, not from the toothpaste itself.
Typically, toothpastes are made up of 20 – 42% water, as well as:

1) An abrasive, to remove plaque from the teeth.
2) Fluoride, to prevent cavities through the formation of dental enamel and bones.
3) Surfactants, which are foaming agents which help to distribute the toothpaste. Many toothpastes contain sodium lauryl sulfate (SLS), also seen in other personal care products such as shampoos.

Toothpaste also often contain antibacterial agents, flavorings, and remineralizers for the enamel.
Should we have health concerns about toothpaste? Toothpaste can alter taste perception; you may notice, for example, that it makes a morning glass of orange juice taste unpleasant. This is due to a chemical reaction between the stanous fluoride in toothpaste and acetic acid in the juice. Interestingly, apples take on a more pleasant taste! Toothpaste may increase the risk of mouth ulcers. Most toothpaste is not intended to be swallowed; swallowing too much can lead to nausea and diarrhea. Children under 12 who swallow excessive amounts could develop dental fluorosis. Note that toothpastes sold in the United States tend to have lower concentrations of fluoride than those sold in European countries.
Experts agree that only a pea-sized dab on the toothbrush is enough. The major purpose for toothpaste is to deliver fluoride, and if fluoride comes from other sources, toothpaste may be unnecessary. Baking soda and water are an alternative, or consider choosing from among natural products. As the saying goes, if you can’t pronounce the ingredients, you may not want it in your body.
Here are some recommendations:
* Brush your teeth thoroughly at least twice a day.
* Use a soft-bristled toothbrush that fits comfortably in the mouth or an electric toothbrush.
* Use a fluoride toothpaste in minimal quantities, or no toothpaste at all.
* Keep your toothbrush clean. Rinse it with water after brushing, and store it in an upright position. Allow it to dry out in order to discourage the growth of bacteria.
* Replace your toothbrush every three to four months or sooner, before the bristles get frayed.
* Floss daily to clean those hard to reach areas.
* Consider using an antimicrobial mouth rinse containing fluoride but not alcohol.
Remember that oral hygiene is part of maintaining a healthy body!
Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.

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Published: Sept. 12, 2013 – Volume 12 – Issue 22



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