In my humble opinion, the thousands of toothpastes currently available on the market can be categorized into 7 different types of toothpastes. Their effects are fully derived from the ingredients within its formulation.
Types of toothpaste:
Other people may have their own way of categorizing dentifrices but these 7 categories will aptly fit every toothpaste on the market. I'll briefly describe what each of them do and their pros/cons if you decide to use them on a daily basis. They can also be designed differently but it doesn't affect how they function or work.
Anti-cavity Toothpastes
The sole purpose of an anti-cavity toothpaste is to prevent tooth decay so that you can maintain healthy teeth. These products utilize either fluoride or hydroxyapatite (non-fluoridated agent) to protect your dentition.
Anti-cavity ingredients in toothpaste:
Fluoride. A naturally occurring mineral but is formulated in different forms in toothpaste (sodium fluoride, stannous fluoride, sodium monofluorophosphate, and amine fluoride). Fluoride strengthens enamel by converting the hydroxyapatite minerals to fluorapatite.
Hydroxyapatite. Touted as a fluoride alternative, hydroxyapatite is the same mineral that our teeth are made of. It is a biomimetic substance that can help fight cavities.
Pros:
Prevents cavities.
Protects against acid erosion.
Strengthens enamel.
Cons:
Not the most effective at whitening.
Some people prefer fluoride-free.
Who should use anti-cavity toothpastes: This should be the default toothpaste for the vast majority, granted you do not have any particular needs (sensitivity, staining, or bad breath).
Exception: If you are prone to cavities then you should definitely be using an anti-cavity toothpaste with no ifs or buts. In other words, it becomes a necessity rather than a recommendation.
Anti-gingivitis Toothpastes
Anti-gingivitis toothpastes are focused on preventing plaque and tartar build up to reduce the risk for gum disease (gingivitis/periodontitis). The ingredients will either kill bacteria or prevent them from adhering (sticking) onto the enamel.
Anti-gingivitis ingredients in toothpaste:
Stannous fluoride. While all forms of fluoride have antibacterial properties, SnF2 is especially effective at hindering bacteria.
Pyrophosphates. These are known as anti-tartar or anti-staining agents and what they do is prevent adhesion onto the surfaces of teeth. That means bacteria, plaque, and stains are prevented from sticking onto the enamel.
Pros:
Helpful for those with active gum disease.
Reduces gum bleeding.
Decreases plaque and bacterial build up.
May help improve breath.
Cons: Anti-tartar agents are counterproductive for teeth sensitivity.
Who should use anti-gingivitis toothpastes: Patients with active gum disease or have had an extensive history of deep teeth cleanings should use this toothpaste. Basically if your gums bleed easily you can use it but you still need a dental check up for permanent treatment.
Anti-sensitivity Toothpastes
Anti-sensitivity toothpastes (sensitive toothpastes) use desensitizers in its formulation to help reduce/alleviate teeth sensitivity. The desensitizing mechanism for these toothpastes work via depolarizing the tooth nerve or by occluding the exposed dentinal tubules.
Desensitizing ingredients in toothpaste:
Potassium Salts. Both potassium nitrate and potassium citrate will depolarize the nerve using its K+ ions.
Stannous Fluoride. Yes, the stannous version of fluoride does have anti-sensitivity effects because it can occlude the open dentinal tubules.
Hydroxyapatite. A biomimetic tubular occlusion agent.
Strontium Chloride. Not as commonly found nowadays but still works.
Arginine. The colgate pro-relief toothpaste use to contain it but is no longer available in the US markets.
Pros:
Reduce teeth sensitivity.
Improves quality of life by allowing you to enjoy cold foods/beverages.
Cons: Whitening ingredients often reduce sensitive toothpaste efficacy.
Who should use anti-sensitivity toothpastes:
Discomfort from cold foods/beverages or acidic foods.
Generalized gum recession.
Eroded enamel or thin enamel.
Whitening Toothpastes
The sole purpose of a whitening toothpaste is to remove stains and make your teeth whiter in appearance. They tend to accomplish at the expense of cavity prevention and sensitivity reduction.
Teeth whitening ingredients in toothpaste:
Hydrogen peroxide. Peroxide based products can form powerful free radicals that can diffuse through to tooth while oxidizing stains.
PAP. Touted as a peroxide-free alternative, it is a novel way of oxidizing teeth stains. It also alleges to do so without sensitivity or with reduced discomfort.
Abrasives. Mild abrasives within the toothpaste can help mechanically/physically scrub off stains forming on the tooth surfaces.
Most whitening toothpaste actually only uses whitening abrasives and they do not contain peroxide nor PAP. Of course the most effective ones do include them.
Pros:
Highly effective stain remover.
Can whiten discolored teeth.
Less expensive than other whitening products.
Cons:
May induce teeth sensitivity.
Not as effective as teeth whitening products (strips, professional).
Who should use whitening toothpastes:
Prone to accumulating teeth stains.
Heavy smokers or staining beverage drinker.
Those wanting whiter teeth.
Exception: I recommend against using whitening toothpastes if you have pre-existing sensitivity. This type of toothpaste will make the sensitivity worst, so you're better off using a sensitive toothpaste instead.
Bad Breath Toothpastes
Toothpastes designed to reduce oral malodors typically contain a zinc salt, which has antibacterial properties. It can also reduce the amount of volatile sulfur compounds (VSC) which are known to be a cause for bad breath.
Anti-malodor ingredients in toothpastes:
Zinc chloride. Contains the essential mineral zinc which also has antibacterial as well as anti-VSC properties. Perceived benefit is reduction in bad breath.
Pros:
Reduces malodor (halitosis).
Antibacterial.
Safe since zinc is an essential mineral found in the body.
Cons:
Studies have shown anti-cavity effects of zinc but when used in toothpaste, there are no additional benefits.
Zinc competitively binds with calcium.
Who should use bad breath toothpastes:
Gum disease with bad breath.
Without gum disease but still experiencing bad breath.
Natural Toothpastes
Natural toothpastes are typically fluoride free and will also exclude a lot of potentially harmful chemicals in its formulation. These types of toothpastes will often substitute more natural ingredients.
Examples of natural toothpastes:
Fluoride-free. Any toothpaste that is sans fluoride falls into this category.
Baking soda. You may be surprised but sodium bicarbonate is actually a base ingredient in most toothpastes. It is very safe due to its low abrasiveness.
Herbal flavored. There are all types of herbal flavored pastes available.
Charcoal. This is natural and is quite trendy due to its black color. Although it can be harmful if it is too abrasive from poor formulations.
Hydroxyapatite. The same mineral that your teeth are made of, it can't get more natural than that.
Pros:
Perceived to be safer.
More natural and holistic.
Cons:
May lack anti-cavity benefits.
Not as effective in cleaning teeth due to exclusion of certain ingredients.
Who should use natural toothpastes:
Those who are health conscious.
If you have allergies to certain chemicals in toothpastes.
Toothpaste Alternatives
There are a couple of unique types of toothpaste alternatives which can be used to clean your teeth. Their purpose remains the same in that they're meant to keep your teeth clean and healthy.
Alternatives to toothpaste:
Toothpaste tablets. Often marketed as a zero waste product, this is toothpaste that comes in the form of a chewable tablet. After chewing it, you still brush like you normally do.
Make your own toothpaste. Some people prefer to have full control over the ingredients in their paste so they make their own.
Dry brushing. In lieu of using any toothpaste, some people prefer to just brush with their toothbrush and water.
Pros: Fun and trendy to use.
Cons:
Not as convenient or readily available.
May not be as effective.
Who should use toothpaste alternatives:
For those who are bored with traditional toothpaste.
You can also make your own if you want full control of what goes into your oral care product.
