Natural tooth care products
We are aware that many patients are amenable to
trying natural ingredient products for their oral care. The American
Dental Association tests many products and will give the product
a "seal" of approval if it is found to be safe and effective.
Even in these cases, some products on the market contain ingredients
that have been found to be carcinogenic when taken in much higher
doses than a patient would in average usage. Manufacturers continually
modify their products for marketing purposes. We sell products
that minimize these risks. The following article is here not to
scare you, but allow you to be informed.
American Council on Science & Health (June 18,
2002)
Cancer caused by mouthwash? Lethal doses of toothpaste?
Natural oral care products are creeping onto store
shelves, using scare tactics to increase their sales. Are they
attempting a hostile takeover of the oral hygiene market by instilling
fear in the American public? You decide. One natural toothpaste
company warns on their website, "Check your toothpaste and
you will probably see a poison warning!" But you won't see
any warning labels on these "natural" alternatives.
They are supposedly better because they don't contain dreaded
fluoride or alcohol. In addition, they are advertised as "excellent
for children" and "safe and powerful for dogs with bad
breath." They can attempt to hide behind their superfluous
warnings and statements of superiority, but when it comes down
to it, the only thing they excel at is price.
Natural mouthwash makers claim that conventional
mouthwashes containing 25% or more alcohol have been "implicated
in mouth, tongue, and throat cancers." They assert that alcohol
makes the body tissues more susceptible to carcinogens. One "natural"
brand without alcohol markets itself under the name Eliminator.
While there are over thirty years of scientific data linking increased
risk for oral cancer with excessive, regular alcohol consumption
and tobacco use, there is no such data linking mouthwash use and
oral cancer. A 1995 study reviewed the data from seven case control
studies and found that there was insufficient evidence to establish
a causal relationship between mouthwash use and oral cancer. Dr.
Sol Silverman, in his dental text on oral cancer for the American
Cancer Society, concluded that there was no risk association.
The natural mouthwash makers make extreme statements but cannot
back their claims with any scientific proof. Since the non-alcohol,
natural mouthwashes do not effectively kill plaque, they must
scare the public in order to make a profit.
While natural toothpaste makers heavily publicize
the alleged toxicity of fluoride, citing the "Clinical Toxicology
of Commercial Products" report of 1984, in reality the report
shows us that we have nothing to worry about if we ingest a miniscule
amount of fluoride while brushing our teeth. If anything, it will
benefit us. While regular tooth-brushing will not prevent tooth
decay, there is a proven benefit from regular brushing with a
fluoride toothpaste. Clinical trials show that dental decay can
be reduced by 15 to 30% with fluoride toothpastes. The lifetime
reduction is probably greater than that reported in clinical trials
lasting for short periods of time.
First, this 1984 report tells us that the lethal
dose of fluoride in a human is "not accurately known."
However, it is estimated that the mean lethal dose is around 5
grams. The average 232 gram tube of toothpaste contains 1500 parts
per million of fluoride. This means that there are roughly 15
grams of fluoride for every 10,000 grams of toothpaste. So, how
much toothpaste would you have to ingest to risk dying of fluoride
poisoning? Around fourteen tubes. Never fear: you won't die from
adding a little too much toothpaste to your brush while drowsy.
At the levels found in toothpaste, fluoride is safe.
The only possible side-effect is a minor "flecking"
of tooth enamel if small children swallow significant amounts
regularly over many years while their permanent teeth are forming.
That is why dentists recommend that children up to age seven use
only a "pea-sized" amount when brushing.
Yes, fluoride-containing toothpastes carry a warning
label, required by the Food and Drug Administration (FDA): "Keep
out of reach of children under 6 years of age. If you accidentally
swallow more than used for brushing, seek professional assistance
or contact a Poison Control Center immediately." However,
the American Dental Association (ADA) released a statement in
1997 renouncing some of the frightening language in this warning.
Prior to FDA regulation, the ADA had limited the amount of fluoride
allowed in toothpastes and required toothpaste manufacturers to
include a usage recommendation. The ADA feels that the current
warning label required by the FDA "greatly overstates any
demonstrated or potential danger," and they have pointed
out to the FDA that a child could not ingest enough fluoride from
toothpaste to cause a serious health problem.
The natural toothpaste manufacturers also frighten
the public with the idea that fluoride will accumulate in the
body and lead to various health problems. The truth is that the
kidneys will excrete about 50% of fluoride in the three to six
hours following ingestion. The other half of the ingested fluoride
will be taken up by bone and teeth, preventing dental decay and
possibly aiding in increasing bone mass for individuals suffering
from osteoporosis. While the "natural" manufacturers
cite a long list of health problems associated with fluoride-retention,
there is no proven link between normal fluoride consumption and
increased hip fractures, increased bone cancer, or increased skeletal
fluorosis (deformation). In fact, only five cases of skeletal
fluorosis have been confirmed in the last thirty-five years. The
daily dose of fluoride most Americans ingest has not been shown
to have any adverse effect on bone health.
Dentists remain skeptical of the efficacy of natural
toothpastes, especially those that do not contain fluoride. Fluorideless
toothpastes do often contain higher quantities of abrasives than
the conventional brands. Sea salt, baking soda, and silica may
remove some plaque, but they also could be wearing away your tooth
enamel. Also, some "natural" brands may contain vitamin
C, which increases the levels of acidity in your mouth and erodes
enamel. And there is no evidence proving that natural toothpastes
containing ingredients such as baking soda instead of fluoride
will prevent tooth decay. In summary, if we are really concerned
about fluoride toxicity in children and fluorosis: 1) we should
be supervising our children's brushing and not leaving them alone
with whole tubes of toothpaste and 2) we should refrain from buying
the kiddie toothpastes that taste just like candy. Eating a whole
tube may not kill a child, but the candy-flavored variety may
entice children to swallow more than their fair share and lead
to a tummyache or two.
While natural oral care product makers play on people's
fears concerning alcohol and fluoride, there really is no reason
to worry. It's all a ploy to get consumers to spend three times
more on the "natural" brands than they would on tubes
of the common brand-name toothpastes.
Karen L. Schneider is a research intern at the American
Council on Science and Health.
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