These basic types of toothpaste are available:

• non-fluoridated
• fluoridated
• highly fluoridated
• sensitive formula
• tartar control formula
• whitening
• with or without sodium lauryl sulftate soap

All toothpastes have pretty much the same ingredients, but try to make themselves stand out in various ways.  The most common ingredients are:

Abrasives: Abrasives are what do the cleaning in toothpaste.  They take off yellowish plaque and scrub off stains.  The most common abrasives are calcium phosphate, silica, calcium carbonate and alumina.  Toothpaste abrasives should be strong enough to remove plaque and stain, but should not be so abrasive that they damage the tooth enamel.

Coloring Agents: Coloring agents make toothpastes more attractive and more palatable.  White toothpaste has titanium dioxide and other artificial dyes make other toothpaste colors.

Detergents: Detergents cause toothpaste to foam. Foam helps keep toothpaste inside our mouths instead of running out as we brush. Sodium lauryl sulfate (SLS) is the detergent used most commonly. Unfortunately, detergents are believed to contribute to formation of  canker sores (ulcers) in some people. Detergents are bad-tasting so strong flavorings are used to hide the bad taste.

Flavoring Agents: Flavors are added to toothpaste so you enjoy using them. Most toothpastes have strong flavors to cover up the bad tasting detergents.

Fluoride: Fluoride is the active ingredient in toothpaste.

Fluoride incorporates itself into tooth enamel making your teeth more resistant to acids produced by plaque bacteria, as well as acids found in fruit juices, soda (both regular and diet) and certain foods.  Fluoride in toothpaste can be in the form of sodium monofluorophosphate, stannous fluoride, or sodium fluoride. Prescription toothpastes (for people that need more cavity fighting help such as those with dry mouth or after cancer radiation treatment, etc.) have a much higher concentration of sodium fluoride than regular over-the-counter toothpastes.

Humectants: Humectants are moisturizers and also provide smooth texture to toothpaste. Glycerin is a common humectant and sorbitol acts as both a sweetener as well as a humectant. Xylitol acts as both a humectant and as a sweetener but it is less common although it seems to be a great cavity-fighter.

Preservatives: Preservatives stop toothpaste from growing germs so you can keep the tube on your sink counter instead of in the refrigerator.  Common preservatives are methylparaben, ethylparaben. and sodium benzoate.

Sweeteners: Sweeteners also improve the taste of toothpaste. Most toothpaste sweeteners are artificial and contribute very little to cavity formation. Saccharin is a common toothpaste sweetener.

Thickeners: Thickeners, of course, determine how ‘thick’ the texture of toothpaste is. Cellulose gum, carrageenan, and xanthan gum are often used for thickening.

So what do I recommend?

• Since most toothpastes have similar ingredients, I recommend prescription 5000 parts per million Fluoride toothpaste for most people over the age of six with the caution that the reason it is prescription is that you must keep it out of reach of children (who may eat it all and get very sick).
• For kids under age two, I recommend non-fluoride toothpaste or regular toothpaste and use very little, a dry grain of rice size.
• Kids between two and six can use regular toothpaste.
• People who frequently get canker sore ulcers in their mouths should try one of the toothpaste brands without SLS such as Rembrandt.
• I recommend avoiding tartar control toothpastes because they are more acidic and can actually soften teeth as well as soften tartar.
• Sensitive teeth can be helped with one of the several sensitive toothpastes, such as Sensodyne, or come to the dentist for application of fluoride varnish on the sensitive areas.
• All toothpastes whiten teeth by removing yellowish plaque and surface stains.  Tooth whitening is best accomplished with bleaching gels rather than with toothpastes.

Just remember that cleaning teeth well has more to do with brushing technique and the use of floss than the brand of toothpaste!

Post from: Great Grins

The Best Toothpaste

Parents have an incredible influence on their children; both positively and negatively.

Kids are so tuned into parental non-verbal communication that even if a mother does not say anything negative about an upcoming dental visit, their own worries and fears will cause their child to worry too.

A clinging two year old is expected.  A tearful eight year old is a challenge.  A fearful 28 year old mother is very hard to overcome.

One of the best ways to help your child prepare for a dental visit is to ask yourself if you have fears yourself.  If you do, perhaps your spouse may be a better choice for the first dental exam.

We pride ourselves on getting kids to have a reasonably good time and once they come and see all the fun stuff we do, they will feel better coming back.

Post from: Great Grins

Tears & Fears

• Autism is a developmental disorder of the brain that has no known cure and usually appears before age 3.
•  Poor social interactions and communication with repetitive behaviors are indicators of Autism.
• Autistic people have a genetic tendency to be more sensitive to toxins than other people because they cannot easily remove environmental toxins from their bodies.

Diagnosing Autism in dental offices:

• Poor social interaction by minimal sharing, showing, or pointing?
• Non-verbal actions like poor eye-to-eye, expressions, and gestures?
• Poor verbal communication at age-appropriate levels?
• No make-believe play?
• Preoccupation with routine, ritual, or repetitive motions such as finger twiddling?

Treating Autistic dental patients:

• Lots of preparation by showing pictures in the sequence of a typical dental appointment.
• Be very directive.
• Be extremely consistent with provider, assistant, chair, flavors, sequence, etc.  Follow a routine!
• Briefly introduce very small changes with frequent steps back to remind them of the routine.
• They appear to respond well to therapeutic wrapping such as heavy blankets.

Resources for parents:

Autism Speaks

Autism Tools

Post from: Great Grins

Autism & dental care

The most common problem is fainting, followed by hyperventilation due to anxiety and fear.  Pediatric dentists are probably the best trained dentists to reduce fear of dentistry but we still have some hyperventilating kids; luckily not to the point of medical emergencies though.

Luckily, as pediatric dentists we see kids that are almost all extremely healthy so we do not have to worry much about heart attacks and strokes.  What we do have to worry about is asthma, aspirating (breathing something into a lung), allergic reactions, and sedation problems.

Sedation problems are the most easily dealt with because we use very safe drugs to sedate kids into a more relaxed state and both our Oregon City and our Portland offices have monitors that tell us if kids are not breathing well enough.  

See our article on Sedation options if you have questions about sedating your children in Portland or Oregon City.

Post from: Great Grins

Medical Emergencies