Are you aware that your toothpaste might be doing more harm than good? 

Our Expert, Entela Celiku (PhD Chemistry of Natural Products), looked at several common ingredients found in most toothpaste formulations and assessed their potential risks to overall health.

An optimal oral cavity is the home of over 400 different types of beneficial bacteria. Factors such as infections, dietary habits, lifestyle, and inadequate oral hygiene can lead to the appearance and overgrowth of pro-inflammatory microbes. These unfavourable species are the main cause of dental caries and other local and systemic diseases.

The most conventional method for oral hygiene, which we learn to make our habit at a very young age – is toothbrushing. However, toothpaste and mouthwash products we put in one of the most absorbent areas of our body—our mouths, contain many questionable ingredients that can damage the oral mucosal layer and tissue. Most of these ingredients have not been thoroughly tested by manufacturers and governing agencies, or they were tested in a way that did not account for the potential chronic toxicity likely to occur from long-term exposure (most commonly, people brush two or more times a day over a lifetime). 

Furthermore, synergistic effects, which are the potential toxic effects of chemical mixtures resulting from the combination of two or more chemical ingredients together, are generally not evaluated. And finally, the total cumulative chemical exposure resulting from the food we eat, the air we breathe, the water we drink, and the toothpastes, as well as the other personal care products we use, is never considered.

Some of these ingredients Kungul looked into are sodium fluoride, sodium lauryl sulphate, paraben, and artificial sweeteners, which have been shown to potentially harm the oral mucosal layer and tissues.

Sodium fluoride

One of the main components of many toothpaste is fluoride, the substance that supposedly in high amounts can cause neurotoxicity in adults. It has been argued that its potential risk factor is also a potential risk factor for the developing human brain. Fluoride is also said to be an endocrine disruptor, meaning that it may be affecting several glands in the body that secretes important hormones. Even low dosage can suppress thyroid activity, causing hypothyroidism (under-active thyroid), increase the glucose level in the blood, leading to Type II Diabetes and may reduce melatonin production, disturbing the sleep-wake cycle. Water fluoridation was praised as the major achievement in the 20th century. However, there is a probability of fluoride reacting with chlorine in water to form chloroform which is a carcinogen and can be harmful. Fluoride-containing toothpaste can be toxic if swallowed in large amounts. 

A major concern of dental fluorosis in children above 12 months of age is ingesting excessive fluoride through toothpaste. Nausea and vomiting are also problems that might arise from topical fluoride ingestion.

Sodium lauryl sulphate (SLS)

SLS is a skin, eye, and respiratory tract irritant, with a moderate toxicity to the organ. The negative effect of SLS on the oral mucus layer, causing an increase in the development and the worsening of mouth ulcers – which affect 10% to 20% of the population – have also been having a huge attention lately. Studies have shown that SLS breaks down the protective lining of the mouth, leaving the underlying tissues irritated and prone to break out with aphthous ulcers (canker sores), or if canker sores are present, lengthening the healing process.

Paraben

Parabens are frequently used as preservatives and antibacterial agents in cosmetics, including toothpaste. Parabens mimic estrogen and can act as potential endocrine disruptors; exposure to these compounds can lead to cancer, as well as developmental and reproductive toxicity. One of the major causes of the development of breast cancer is actually too much oestrogen, it has been proposed that parabens may have a negative effect on the endocrine system, therefore the progress of this disease. Certain parabens appear to reduce sperm production and decrease testosterone levels.

Flavorings 

The taste of toothpastes is due to the strong flavoring agents and the sweeteners which mask the taste of other ingredients and enhance the palatability of toothpaste. The commonly used artificial flavors include mint, cinnamon, anise, vanilla and popular fruits and leaves. The sweeteners used in the toothpaste are aspartame, sucralose, xylitol, and sodium saccharin. Flavor additives are oils, extracts, or synthetics. These additives can cause irritation to oral tissues and trigger heartburn. Aspartame is the most common artificial sweetener used, which is 200 times sweeter than sugar. Aspartame has been known to be metabolized inside the body to poisonous methanol and formaldehyde and its side effects include migraine, dizziness, seizures, nausea, numbness, muscle spasms, weight gain, rashes, depression, fatigue, irritability, insomnia, vision problems, hearing loss, heart palpitations, anxiety, vertigo, memory loss, brain tumors, birth defects, and joint pain. Aspartame consumption can lead to Alzheimer’s disease, diabetes, multiple sclerosis, epilepsy, lymphoma, Parkinson’s disease, and fibromyalgia. Saccharin is a petroleum-based sugar substitute from crude oil and is 350 times sweeter than cane sugar, hence used in toothpaste. It has been linked to a cancer-causing agent.

Pigments

Blue, red, yellow, and green are common colorants found in toothpaste, with artificial food dyes such as Red #30, Red #33, Blue #1, and Yellow #5 frequently used. FD&C Blue Dye No. 2, though popular, has been linked to potential issues such as hyperactivity in children, severe allergic reactions, and even health problems like cancer.

Originally derived from coal tar, FD&C and D&C dyes are now primarily manufactured from petroleum. While natural colorings from plant, animal, and mineral sources were once prevalent, they fell out of favor in the early 20th century due to cost and inconsistency. However, there’s a resurgence in natural colorings due to consumer demand for healthier options.

Studies indicate that artificial food dyes, particularly when combined, can affect children’s behavior, potentially contributing to hyperactivity and ADHD. Even natural toothpastes may contain metals like titanium dioxide, zinc oxide, and iron oxides. While some metals are essential for bodily functions, excessive ingestion can lead to harmful effects, including the promotion of cancer-causing free radicals.

While research on the effects of ingested nanoparticles is ongoing, there’s debate over their potential toxicity and ability to penetrate bodily tissues. Titanium dioxide’s role in toothpaste is primarily as a pigment for opacity and brightness, driven by its inertness and affordability. However, controversies persist regarding its safety, particularly regarding its classification as a potential human carcinogen. Ongoing research aims to clarify the safety profile of titanium dioxide, but definitive conclusions have yet to be reached.

Thickening Agents 

Carrageenan, cellulose gum, guar gum, xanthan gum, and gluten are used to thicken the toothpaste, which makes the toothpaste thick and tacky. Gluten causes celiac disease. Carrageenan is a common thickening agent in toothpastes, it has potential to cause inflammation in the intestine and colonic tumors. Humectants, such as glycerol, propylene, glycol, and sorbitol, all prevent water loss from toothpaste and help to keep it moist. Xylitol is also used for this purpose, as it provides moisture and prevents cavities. It is more effective than fluoride in preventing dental caries in children’s permanent teeth. It has not been found to cause any harmful effects.

Microbeads 

Hydrated silica or microbeads are tiny plastic pellets. It is made from a crystallized compound mostly found in quartz, sand, and flint. Scratching the surface of the tooth with an abrasive such as hydrated silica harms the enamel and prevents re-mineralization, much like using sand to clean glass. Hence, the teeth may look yellow or discolored. Severe wear could eventually occur and can cause bacteria to creep down in the exposed cracks of the teeth and cause more damage.

These microbeads enter the water system and contaminate the environment. It can absorb toxins that are eaten by aquatic life and subsequently enter the human food chain. The microbeads are also reported in patient’s teeth and gums. They create space for bacterial growth and cause gum diseases. Biodegradable plastic such as polylactic acid is replacing plastic microbeads but even that causes gum diseases.

By addressing the risks associated with these ingredients, stakeholders can work towards promoting safer oral care practices and product formulations. Kungul can help you choose the safest and most effective products for you and your family.

References:

• Tabatabaei MH, Mahounak FS, Asgari N, Moradi Z. Cytotoxicity of the Ingredients of Commonly Used Toothpastes and Mouthwashes on Human Gingival Fibroblasts. Front Dent. 2019 Nov-Dec;16(6):450-457. doi: 10.18502/fid.v16i6.3444. Epub 2019 Dec 20. PMID: 33089246; PMCID: PMC7569277.
• Toxic ingredients in your toothpaste? A report by the Cornucopia Institute, July 2016