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Dr. Frank Vascimini

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Are you like many patients in my practice wondering which toothpaste is best?

With the many different pastes on the store shelves, it’s no wonder there is such confusion. Every brand wants you to believe they have the best toothpaste for a plethora of dental needs. I even had a patient tell me that she saw a toothpaste that was meant for the elderly patient!

Your dental needs should dictate which toothpaste you should buy; however, in order to choose, you need to know something about the ingredients in the toothpaste — most importantly, fluoride.

For many years, the fluoride in toothpaste was sodium fluoride exclusively. It was introduced as an alternative to stannous fluoride, which had been around since the 1950s, as a less-expensive and better-tasting fluoride.

Sodium fluoride prevents decay by strengthening and repairing enamel that has been weakened by acids produced by bacteria in the mouth. Crest, Colgate and many other companies contain sodium fluoride in some of their toothpastes; however, stannous fluoride has made a comeback in recent years and is now included in other toothpastes being offered by these companies.

After much research, it has been established that stannous fluoride not only provides the same cavity protection as the sodium fluoride, but it also has strong antimicrobial properties. This means that it fights the bacteria that is present in the mouth, thereby reducing the acids that can lead to both tooth decay and gingivitis.

These antimicrobial properties also prevent plaque from adhering to tooth surfaces. So, if sodium fluoride only prevents tooth decay, while stannous fluoride prevents decay, reduces gingivitis and prevents plaque buildup, why would you choose a toothpaste that addresses only decay?

As I stated early, your choice of toothpaste should rely on your needs. If you are faithful to daily flossing and brushing and don’t have an issue with gingivitis and plaque buildup, then sodium fluoride is all you really need.

Keep in mind that stannous fluoride toothpastes have been known to cause stain. And in order to counteract the issue of stain, most of the toothpaste companies add more abrasives to their toothpastes.

Many of the toothpastes containing stannous fluoride also promote their sensitivity-fighting properties, but the abrasives added can lead to further erosion, increasing your sensitivity.

Again, it is a matter of which of your needs should be addressed. If you continually have an issue with gingivitis, perhaps stannous fluoride is best for you.

You should know that while we have been discussing the use of stannous fluoride in over the counter pastes, it is important to know that this is only one way of using stannous fluoride. Instead of purchasing one of these pastes to use on a daily basis, your dentist or hygienist may have another suggestion.

Continue using your sodium fluoride toothpaste for its cavity-fighting properties and use a prescription-strength mouth rinse containing stannous fluoride for a period of 10 days to address incidences of gingivitis and to disturb plaque formation. This method gives you more of a concentration of stannous fluoride for a limited amount of time and continues to provide the benefit after the 10 days.

At your next recall appointment, your dental professional can determine how well this method worked for you. This method can be instituted again any time you show signs of gingivitis. This also allows you to continue using the less-expensive toothpastes that contain sodium fluoride instead of the newer, more expensive, multipurpose toothpastes.

Also, stain buildup will be less of an issue when the stannous fluoride is used for a limited time rather than daily, and since their are no abrasives added to the mouth rinse, erosion is not a problem.

One other thing to note about the stannous fluoride toothpastes on the market — stannous fluoride works best if it applied after brushing with regular toothpaste and not rinsed off for at least 30 minutes. Stannous fluoride’s inclusion in your daily toothpaste is of a lesser concentration and since you would be using it as your regular toothpaste, you would not have the benefit of it remaining on your teeth.

I hope this article has helped clear up some of the confusion and helps you make an informed choice the next time you are in the toothpaste aisle.

Dr. Frank Vascimini is a dentist practicing in Homosassa. Send your questions to 4805 S. Suncoast Blvd., Homosassa, FL 34446 or email them to him at questions@MasterpieceDentalStudio.com.

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