If you’ve ever wandered down the toothpaste aisle, you likely know that there are scores of different kinds available, such as whitening toothpastes, fresh-breath formulations, deep clean options, charcoal toothpastes and more.
With so many possibilities, it can be hard to know which toothpaste is best for keeping your teeth cavity-free and your gums healthy.
Dentists told HuffPost there are a few specific factors to keep in mind when shopping for toothpaste. Here’s what to know:
Toothpastes that contain fluoride are the best option for dental health.
“Although the topic has become somewhat controversial in recent years, the scientific data still strongly supports fluoride as the most important ingredient to look for when choosing a toothpaste,” Dr. Albert A. Coombs III, dentist and owner of Smile Services in Washington, D.C., told HuffPost via email.
U.S. Health and Human Services Secretary Robert F. Kennedy Jr. has pushed for fluoride bans in tap water and has spread misleading claims about fluoride causing thyroid disease and arthritis. Despite what Kennedy has said, the research shows that fluoride is safe when used properly and appropriately, according to the American Academy of Pediatrics and the American Dental Association.
“Fluoride is a naturally occurring mineral that belongs to a group of chemical compounds containing the element fluorine,” Dr. Jarrett L. Manning, a dentist and founder of JLM Dental Studio, previously told HuffPost.
Decades of research show that fluoride “strengthens enamel and helps prevent cavities by promoting remineralization of early enamel damage,” said Coombs.
“Most dentists recommend selecting a toothpaste that contains fluoride and carries the ADA seal of acceptance, which indicates that the product has been evaluated for both safety and effectiveness,” Coombs added.
This is generally shown on a small label on the toothpaste that says “ADA Accepted American Dental Association.”
“In order for a toothpaste to have the ADA seal, it has to contain some form of fluoride,” noted Dr. Mia L. Geisinger, a professor and the chair of the department of periodontology at the University of Alabama at Birmingham’s School of Dentistry.
On the toothpaste box, below the seal, there are often bullets describing what the toothpaste has been tested to show, such as helping prevent tooth decay or helping prevent gingivitis, Geisinger said. This indicates that certain ingredients, including fluoride, are present.
“I recommend … making sure that the toothpaste that you’re choosing has that ADA seal and at least those two bullet points for ‘helps prevent tooth decay’ and ‘reducing gingivitis,’” Geisinger explained.
It’s recommended that people use a toothpaste that contains fluoride.
If you have specific dental concerns like tooth sensitivity, you can consider that when shopping for a toothpaste, too.
Depending on your health goals and dental problems, there may be additional factors to keep in mind when shopping for a toothpaste.
“Some toothpastes are formulated to address specific concerns such as tooth sensitivity, gum inflammation or surface stains,” Coombs said. “Potassium nitrate is commonly used in sensitivity toothpastes, such as Sensodyne, and works by helping reduce nerve sensitivity within the tooth.”
In the case of whitening toothpastes, these products often contain mild abrasives to help remove surface stains from things like coffee, wine or tea, said Coombs.
“While these toothpastes are generally considered safe, their whitening effects tend to be modest,” he notes. “In my experience, they may also increase the likelihood of tooth sensitivity in some patients, so they are not usually my first recommendation unless someone is specifically concerned about surface stains.”
There are also certain people who require prescription toothpaste, such as those who have a higher risk of cavities or someone with severe dry mouth, according to Geisinger. In these cases, your dentist will let you know this is needed and prescribe you a toothpaste.
There are a few ingredients you should likely avoid.
Toothpastes that are marketed as fluoride-free aren’t the best choice. Not only do they not contain ingredients that can fight cavities, some can also cause larger problems.
“There are fluoride-free toothpastes that have ‘natural ingredients,’ things like aloe vera, charcoal. And these have much less evidence, and there’s actually some evidence that some of those formulations can be harmful to patients,” Geisinger said.
These products are known to cause allergic reactions, dermatitis or are often more abrasive than standard toothpaste and can cause wear on the tooth, she explained.
“Ingredients such as baking soda or xylitol can contribute to oral hygiene, but they do not replace the protective benefits of fluoride,” Coombs said.
These toothpastes won’t have the ADA seal mentioned above, and there are currently no charcoal toothpastes that are ADA-approved, Geisinger added.
While toothpastes that are made with “natural” ingredients may have good branding or fun messaging, that doesn’t make them a reliable way to keep your teeth clean.
“One thing I often tell patients is that marketing can make toothpaste options feel overwhelming, but the fundamentals of oral health are relatively simple,” Coombs said. “I usually recommend sticking with well-established brands that carry the ADA seal of acceptance rather than spending extra money on heavily marketed specialty products.”
Proper brushing and flossing are potentially even more important than toothpaste choice.
If you buy the best toothpaste but only brush your teeth for 20 seconds instead of the recommended two minutes, it won’t actually matter that you’re using good toothpaste.
“The type of toothpaste, as long as you’re meeting those parameters — you’re choosing a fluoride-containing toothpaste, you’re choosing one with the ADA seal ― probably matters less than how you brush your teeth and how effective you are at brushing your teeth,” Geisinger said.
You should make sure you use proper brushing techniques and ask your dentist if there are certain areas of your mouth that you should pay particular attention to, she said.
“Ultimately, toothpaste selection is only one part of maintaining good oral health,” Coombs said. “Brushing twice daily for two minutes, flossing regularly and maintaining routine dental visits remain the most important steps for preventing cavities and gum disease.”
