Types of Toothpaste and How to Choose the Best One

The toothpaste aisle is the proverbial poster child for overchoice: The sheer quantity of brightly colored boxes is enough to overwhelm anyone. Add to that all the conflicting advice you may hear: Some say fluoride is the most important ingredient and others talk about it like a villain from a fairy tale. 

How does anyone know what to choose?

I find it’s best to give people all the facts and let them decide for themselves, so that’s what we’ll do. Let’s talk about the real purpose of toothpaste, some of the most common ingredients, and a few of the most popular types of toothpaste. Then you can decide what you and your family really need.

About toothpaste: Ingredients, benefits, and what to watch for

One of the most important truths to understand is that you don’t really need toothpaste. It sounds crazy, because most of our information about toothpaste comes from toothpaste commercials (and they think you do need it!), but it’s true. 

Good brushing—even dry brushing—is crucial, but most toothpaste is nothing more than a polishing agent that helps to remove the film that builds up on your teeth (called pellicle). Some types of toothpaste can also help restore and whiten teeth, but your oral hygiene does not depend on the right toothpaste as much as some people think. 

That means that choosing the “right” type of toothpaste means choosing what’s best for you and your family, which should take some of the pressure off.

Next, it’s helpful to be able to recognize and decipher some common toothpaste ingredients. Fluoride toothpaste is discussed below, but other common ingredients include:

• Abrasives: Ingredients like calcium carbonate and silicates are added as abrasives, to help remove food and stains from teeth. If a toothpaste is too “gritty,” however, it can actually damage tooth enamel.
• Artificial coloring: Kids like bright colors and adults expect their toothpaste to be bright white. The former requires unnecessary food dyes—many of which have been linked to ADHD in children. Titanium dioxide is often used to make toothpaste white.
• Flavoring: Any number of sweeteners and flavoring agents, including essential oils, are usually included to make toothpastes taste better.
• Sodium lauryl sulfate (SLS): SLS is a detergent that is added to most commercial toothpastes in order to produce that foaming effect we’ve come to expect. It also, however, causes canker sores in some people.

1. Fluoride toothpaste

Fluoride toothpaste is probably the most common type of toothpaste, and many professionals will tell you that it’s the only kind of toothpaste you should use … but it’s not. 

First, because fluoride may not be as safe as we’ve been told. You might have heard that fluoride is a naturally occurring mineral and that’s true—calcium fluoride is found in well water, soil, and even seaweed. But there are different kinds of fluoride, and the type that is commonly added to toothpastes is sodium fluoride, which is a synthetic additive.

Secondly, fluoride in toothpaste doesn’t really work the way it’s promoted. Fluoride is supposed to be absorbed by your teeth to strengthen them, but fluoride is best absorbed after teeth are brushed, when it’s left on the enamel. Using a fluoride toothpaste is like trying to wax and wash your car at the same time … and then immediately rinsing all the wax off.

More and more people, and doctors, are choosing to learn more about fluoride. In short, the benefits (none) don’t outweigh the risks, in my opinion. Plus, with so many better options on the market today, ditching fluoride toothpaste is easy.

2. Tartar control toothpaste

First of all, what is tartar? And why does it need to be controlled? 

Tartar is plaque deposits on teeth that build up and harden. This build-up can lead to cavities and gum disease, so tartar control, as a concept, is a good idea.

The difficulty is that most tartar control toothpastes use additional chemicals such as pyrophosphates, zinc citrate, and triclosan (an antibiotic) to help prevent tartar build-up. Some of these additives are universally recognized as safe, but not all. One study, for example, reports, “It is well established that pyrophosphates inhibit crystal growth of hydroxyapatite in bones and teeth …”

Hydosyaptite is the primary ingredient that tooth enamel is made of. Why is an ingredient that inhibits the healthy growth of teeth being added to toothpastes?

It’s also important to note that gum disease is caused by tartar below the gumline. You can’t brush below the gumline, which is why tartar control toothpastes claim to prevent tartar buildup—not treat or reverse it.

Tartar control is just about preventing plaque build-up, and that’s easily done without the additives, by just keeping good oral health habits.

3. Whitening toothpaste

Whitening toothpastes are widely available now and many are actually proven effective. Of all the odd claims that some toothpastes make, whitening is actually valid.

How, and how well, different toothpastes whiten teeth varies by the type and brand. Choosing a good whitening toothpaste means understanding just a few things about the different ways these toothpastes work:

1. Special ingredients, like carbamide or hydrogen peroxide, are added to some whitening toothpastes to help lift stains off tooth enamel.
2. Mild abrasives are added to some whitening toothpastes to provide extra “scrubbing power.” Remember, it’s important to use a toothpaste that’s not too abrasive.
3. Hydroxyapatite toothpastes can actually fill in scratches and fissures in tooth enamel, restoring and visibly whitening teeth.

4. Toothpastes for sensitive teeth

Toothpaste for sensitive teeth (aka desensitizing toothpaste) uses additional ingredients to block pain signals from reaching the nerves in your teeth. Potassium nitrate, for example, is common in this type of toothpaste, and is proven to be a “low hazard” chemical.

If you have sensitive teeth, it’s important to know that desensitizing toothpastes are not a cure. They treat a symptom (pain), not the cause (decay). Teeth become sensitive to temperatures and certain types of food when enamel is worn away, and the inner part of the tooth (the dentin) is exposed—however slightly. And lots of factors can wear away tooth enamel: from teeth grinding to acidic foods.

If you have sensitive teeth, a desensitizing toothpaste can help, but work on treating the cause as well. There is a lot you can do to treat sensitive teeth holistically, depending on what’s causing the sensitivity. 

One of my first recommendations for anyone with sensitive teeth is usually to try a nano-hydroxyapatite toothpaste. Hydroxyapatite, again, is the stuff tooth enamel is made from, and proper use of this kind of toothpaste can help remineralize damaged enamel to reduce sensitivity.

5. Charcoal toothpaste

Charcoal toothpaste is toothpaste that contains activated charcoal, or activated carbon, which claims to whiten teeth, freshen breath, and prevent cavities. It has become a popular trend in recent years, as photos of people with black smiles started to bounce around social media.

But does it work? Skepticism seems to be growing.

The truth is, some charcoal toothpastes may whiten teeth after two to three weeks of use, but not as well as a basic hydrogen peroxide toothpaste. While activated carbon does help to lift stains off of enamel, many of these toothpastes are also fairly gritty. They use abrasives to help polish your smile, but many of them are too harsh—damaging enamel after prolonged use.

Charcoal toothpastes do win points for effectively freshening breath. They absorb acidic compounds in the mouth very well. 

But the final claim falls flat too. Charcoal toothpastes have not been proven to prevent cavities—at least not better than any other type of toothpaste.

How to choose a toothpaste

Now that you know what basic types of toothpaste are out there, you can start to choose what’s best for you and your family. Decide what’s most important and what your family needs. 

If health is a primary factor, for example, you can start by eliminating dangerous, and even just unnecessary, ingredients and additives. This strikes fluoride, tartar control, and charcoal toothpastes off the list for me.

Then, do you have sensitive teeth? Stained teeth? Some early decay or damage? There are fluoride-free, healthy options for all of the above. My personal favorites are hydroxyapatite toothpastes. We’ve seen that they’re a natural, best option for whitening, strengthening, and cleaning teeth. They’ve also been proven as effective (or more) compared to fluoride toothpastes.

Your guide to toothpaste

The toothpaste aisle will probably be the butt of first-world-problem jokes forever, but it doesn’t have to be intimidating too. When you know enough to separate the gimmicks from the science, you can make the best choice for you and your family.

Start by thinking about what you need (and what you don’t need) from your toothpaste, and you’ll end up with the right tube in your bathroom.

Pain point – choosing a toothpaste is overwhelming. Confusing. All this conflicting advice—some people say fluoride is the most important ingredient. Others say it’s the devel and a communist plot! What to do?

Promise – let’s talk about the basics, the purpose of toothpaste (why do we need it in the first place?) and leave you feel empowered to how to choose what’s right for you and your family.

About toothpaste: Ingredients, benefits, and what to watch for

A. Do you really need toothpaste … ?

B. Common ingredients …

Fluoride toothpaste

A. Fluoride is …

B. Fluoride toothpaste is the most common and many professionals will tell you that it’s the best … but it’s not.

1. Fluoride may not be safe.
2. Fluoride in toothpaste doesn’t work the way it is promoted.

C. It’s still a somewhat controversial opinion (although the tide is changing), but you don’t need a fluoride toothpaste.

1. And the risks don’t out-weight the benefits.
2. There are better options on the market today.

Tartar control toothpaste

A. First of all, what is tartar anyway?

1. Plaque deposits that build up and harden
2. Can build up and lead to gum disease.

B. Tartar control toothpastes use additional chemicals such as pyrophosphates, zinc citrate, and triclosan (an antibiotic) to prevent tartar build-up.

1. “It is well established that pyrophosphates inhibit crystal growth of hydroxyapatite in bones and teeth …”

C. But gum disease is caused by tartar below the gumline, and you can’t brush below the gumline.

D. Tartar control is just about preventing plaque build-up and that’s easily done without the additives, by just keeping good oral health habits.

Whitening toothpaste

A. Whitening toothpastes are widely available now and many are actually proven effective.

B. Two ways to whiten teeth

1. Extrinsic
2. Intrinsic

C. Three ways that whitening toothpastes work:

1. Carbamide or hydrogen peroxide

a) Extrinsic

2. Mild abrasives

a) Extrinsic

3. Hydroxyapatite

a) Intrinsic

b) How it works to whiten teeth from the inside out …

Toothpaste for sensitive teeth

A. Toothpaste for sensitive teeth (aka desensitizing toothpaste) uses additional ingredients to block pain signals from reaching the nerves in your teeth. 

1. Potassium nitrate is common, and is a “low hazard” chemical.

B. If you have sensitive teeth, it’s important to know that desensitizing toothpastes are not a cure.

1. They treat a symptom, not the cause.

C. Tooth sensitivity happens when enamel is worn away and the inner part of the tooth (the dentin) is exposed to air and food.

1. Lots of things wear away enamel: from teeth grinding to acidic foods.

D. In addition to desensitizing toothpaste, work on treating the cause as well. 

1. Lots of actions you can take, depending on what’s causing your sensitive teeth.
2. Consider a nano-hydroxyapatite toothpaste …

Charcoal toothpaste

A. Charcoal toothpaste is toothpaste that contains activated charcoal, or activated carbon, which claims to whiten teeth, freshen breath, and prevent cavities.

1. Popular trend in recent years …

B. Charcoal toothpaste may whiten teeth after 2 to 3 weeks, but not as well as hydrogen peroxide toothpastes.

1. Many charcoal toothpastes are also relatively gritty, which can cause serious damage to tooth enamel.

C. It does freshen breath by absorbing acidic compounds in the mouth.

D. It does not prevent cavities – at least not better than any other toothpaste.

How to choose a toothpaste

A. There are an overwhelming number of toothpaste options and brands …

1. Finding the right one by process of elimination is easy …
2. Figure out, first, what’s most important and what you/your family needs …

B. If health is a primary factor, for example, you can start by eliminating dangerous, and even unnecessary, ingredients and additives.

1. This strikes fluoride, tartar control, and charcoal toothpastes off the list.

C. Do you have sensitive teeth? Stained teeth?

1. Surprising good news is there’s one kind of toothpaste that checks all the boxes: hydroxyapatite toothpastes.

a) We’ve seen that it’s a natural best option for whitening, strengthening, and cleaning teeth.

Your guide to toothpaste

A. Review

B. Next step

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