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Toothpaste

Toothpaste, also known as dentifrice, is a paste, gel, or powder formulation used with a toothbrush to clean the accessible surfaces of the teeth by mechanically removing plaque, food debris, and surface stains through abrasion. It serves as a key component of daily oral hygiene, helping to prevent dental caries, gingivitis, and other conditions by delivering active agents that inhibit bacterial growth and remineralize enamel.^[1] Modern toothpastes contain small amounts of active therapeutic ingredients for effects such as caries prevention and the majority inactive ingredients for structure, stability, and user appeal.^[2] Active ingredients often include fluoride compounds such as sodium fluoride (0.22%), stannous fluoride (0.454%), or sodium monofluorophosphate (0.76%), which strengthen tooth enamel against acid attacks from oral bacteria and reduce cavity risk by up to 25% when used regularly.^[3]^[1] Other active components may address specific needs, such as potassium nitrate (5%) or stannous fluoride for desensitizing sensitive teeth by blocking dentin tubules, or low concentrations of hydrogen peroxide (1–3%) or carbamide peroxide for whitening by breaking down stains.^[4]^[5] Inactive ingredients form the paste's base and enhance usability; abrasives like hydrated silica, calcium carbonate, or baking soda (sodium bicarbonate) polish teeth without excessive wear, comprising 20–50% of the formula. Humectants such as glycerin, sorbitol, or propylene glycol (20–50%) prevent drying, while thickeners like carboxymethyl cellulose or xanthan gum provide viscosity.^[6] Foaming agents like sodium lauryl sulfate (1–2%) aid cleaning but may irritate mucous membranes in some users, and flavors from essential oils (e.g., peppermint or spearmint, 0.5–2%) freshen breath.^[7] Preservatives such as sodium benzoate or parabens (0.1–0.5%) inhibit microbial contamination, and sweeteners like saccharin improve taste without promoting decay.^[6] The American Dental Association recommends fluoride toothpastes with its Seal of Acceptance for safety and efficacy in caries prevention when brushed twice daily for two minutes.^[7] The origins of toothpaste trace back over 5,000 years to ancient Egypt and Mesopotamia, where mixtures of crushed ox hooves, eggshells, pumice, and myrrh were used as abrasives, evolving through Roman and medieval eras with herbal additions like sage and salt.^[2] Commercial powdered dentifrices emerged in the 19th century, but the modern paste form gained popularity in the early 1900s with collapsible tubes, and the introduction of fluoride in 1956 marked a pivotal advancement in caries prevention.^[8] Today, global formulations vary by region, with some incorporating natural alternatives like hydroxyapatite for remineralization^[9] or charcoal for stain removal,^[10] though efficacy depends on concentration and evidence-based claims. While generally safe, overuse in young children can lead to dental fluorosis, prompting guidelines for pea-sized amounts for ages 3–6.^[11]

History

Ancient and Early Formulations

The origins of toothpaste-like substances trace back to ancient Egypt around 5000 BC, where the earliest known formulations consisted of powdered ashes from ox hooves, myrrh, eggshells, pumice, and sometimes crushed rock salt, mixed into boluses or pastes applied to the teeth for cleaning and freshening.^[12] These mixtures served primarily as abrasives to remove debris, with myrrh providing antiseptic properties, and were used by rubbing them onto teeth using fingers or primitive tools.^[13] Archaeological evidence from Egyptian tombs supports this practice, highlighting oral hygiene as a valued aspect of daily and ritual life in the civilization.^[14] In ancient Greece and Rome, these Egyptian influences evolved into more refined dentifrices, incorporating abrasives like crushed animal bones, oyster shells, or eggshells to polish teeth, often combined with herbal extracts for added medicinal benefits.^[15] For instance, mastic gum from the Pistacia lentiscus tree was utilized by Greeks not only as a chewable resin for breath freshening but also in powdered form mixed with other ingredients to combat oral odors and promote gum health.^[16] Romans expanded on these recipes by adding flavors such as mint or bark infusions, creating powders applied with cloths or early brushes, emphasizing both mechanical cleaning and cosmetic whitening.^[12] During the medieval Islamic Golden Age in the 9th century, advancements in oral hygiene formulations emerged, featuring mixtures of salt for its abrasive and antibacterial qualities, charcoal for stain removal, and herbal powders like those from salvia or cinnamon for soothing gums and preventing decay.^[17] These dentifrices, often documented in medical texts, were popularized by influential figures such as the polymath Ziryab in Islamic Spain, who developed a pleasant-tasting paste that integrated functional cleaning with aromatic herbs.^[18] Such innovations reflected a holistic approach to health, drawing from translated Greek works and empirical observations, and spread through trade routes across the Islamic world. By the 18th and 19th centuries in Europe, these traditions transitioned into commercial tooth powders, typically composed of precipitated chalk as the primary abrasive, combined with castile soap for foaming and essential oils like peppermint or clove for flavor and mild disinfection.^[19] These powders, sold in tins or jars, were dusted onto brushes or fingers and represented a shift toward more accessible, standardized products amid growing awareness of dental health in urban societies.^[20] This era marked the bridge from ancient boluses to the paste forms that would later dominate.

Development of Modern Toothpaste

The development of modern toothpaste began in the 19th century with the commercialization of dental care products, transitioning from homemade powders to mass-produced formulations suitable for widespread use. In 1873, Colgate introduced the first commercially produced toothpaste, an aromatic variant sold in jars, marking a significant step toward accessible oral hygiene products.^[21] This initial offering was primarily a powder-based formula, reflecting the era's reliance on dry abrasives, but it laid the groundwork for industrial-scale production by emphasizing pleasant scents and consistent quality.^[22] A pivotal advancement occurred in 1892 when Dr. Washington Wentworth Sheffield, a dental surgeon from New London, Connecticut, invented the collapsible metal tube for toothpaste dispensing, inspired by Parisian artists' paint tubes observed by his son. This innovation allowed for hygienic, portable packaging and easier application, revolutionizing distribution and consumer convenience; Sheffield's company began manufacturing these tubes and filling them with his proprietary creme dentifrice formula, which avoided the gritty texture of powders and incorporated smoother ingredients for better usability.^[23] The shift from powders to pastes was further enabled by the addition of stabilizers like glycerin in the mid-19th century, which provided moisture retention and a semi-liquid consistency, while the high-pressure design of the tubes facilitated controlled dispensing without mess.^[22] Colgate adopted this tube technology in 1896, launching Colgate Ribbon Dental Cream as one of the first paste toothpastes in such packaging, solidifying the paste format's dominance.^[24] The mid-20th century brought therapeutic enhancements, particularly with the integration of fluoride to combat tooth decay. Procter & Gamble introduced Crest toothpaste in 1955, featuring stannous fluoride developed through collaboration with Indiana University researchers, representing the first major commercial fluoride dentifrice.^[25] In 1960, the American Dental Association granted Crest its Seal of Acceptance as the first toothpaste clinically proven to prevent caries, validating fluoride's efficacy and spurring industry-wide adoption of active ingredients beyond mere cleaning.^[26] Key patents from this period, including Sheffield's foundational work on tube-based formulations in the 1890s, emphasized soap-free compositions to reduce irritation, prioritizing gentle abrasives and humectants for daily use.^[23] These milestones transformed toothpaste from a luxury item into an essential, scientifically backed product by the 1970s.

Recent Innovations

In the 1990s, triclosan was introduced as an antibacterial agent in toothpaste formulations to combat plaque and gingivitis by inhibiting bacterial growth.^[27] Colgate Total, launched in 1997, marked one of the first major commercial toothpastes incorporating triclosan at 0.3%, demonstrating superior efficacy in reducing gingival inflammation compared to non-antibacterial variants in clinical trials.^[28] However, concerns over potential endocrine disruption and antibiotic resistance led to regulatory scrutiny; the U.S. Food and Drug Administration (FDA) ruled in 2016 to ban triclosan from over-the-counter hand soaps due to insufficient safety data, though it remained permissible in toothpaste at that time.^[29] By 2019, amid ongoing safety debates and voluntary industry actions, major manufacturers like Colgate-Palmolive phased out triclosan from toothpaste products globally, reformulating with alternatives such as stannous fluoride.^[30] Nano-hydroxyapatite (n-HA), first commercialized in toothpaste in Japan in 1978 based on 1970s research, represents a significant advancement in remineralizing agents, serving as a biocompatible alternative to fluoride by mimicking the mineral composition of tooth enamel.^[31] Originating from research in the 1970s and early commercial hydroxyapatite toothpastes in Japan during the 1980s, nano-sized particles (typically 20-80 nm) were refined in subsequent decades including the 2000s to enhance penetration into enamel lesions, promoting calcium phosphate deposition and reducing dentin hypersensitivity.^[32] Clinical studies have shown n-HA toothpastes to be comparable to fluoride in preventing demineralization, with particular popularity in Asian markets like Japan and China, where brands such as Apagard dominate sales due to cultural preferences for non-fluoride options and established efficacy in caries prevention.^[33] Entering the 2020s, emerging trends in toothpaste innovation have focused on microbiome modulation and natural anti-inflammatory compounds. Probiotic toothpastes, incorporating strains like Lactobacillus reuteri or Streptococcus salivarius, aim to restore oral microbial balance by suppressing pathogenic bacteria while supporting beneficial flora, with studies indicating reductions in plaque accumulation and gingival bleeding after four weeks of use.^[34] These formulations, first commercialized around 2010 but gaining traction post-2020 amid holistic health movements, represent a shift toward preventive care that complements traditional antimicrobials.^[35] Similarly, CBD-infused toothpastes have proliferated since 2020, leveraging cannabidiol's anti-inflammatory properties to alleviate tooth sensitivity and soothe irritated gums; initial products like CBDent demonstrated pH-balancing effects and cavity risk reduction in preliminary evaluations, though long-term clinical data remains limited.^[36]^[37] In the mid-2010s, toothpaste tablets emerged as an eco-friendly alternative, compressing paste ingredients into dissolvable tablets to eliminate tubes and reduce plastic waste; by the 2020s, brands like Lush and Bite popularized them, with the market projected to grow at a CAGR of 7.5% from 2025 to 2034 due to sustainability demands.^[38] Advancements in toothpaste aesthetics during the 1990s included patented striped and gel formulations, enhancing consumer appeal through visual variety without compromising functionality. Multi-chamber tubes, as described in a 1990 Colgate-Palmolive patent, allowed simultaneous dispensing of opaque paste and translucent gel stripes, creating multicolored effects that maintained stability and even distribution during extrusion. These innovations, building on earlier single-stripe designs from the 1950s, improved market differentiation and user engagement, with gel variants offering gentler abrasion for sensitive teeth while delivering equivalent cleaning efficacy.^[39]

Composition

Abrasives and Polishing Agents

Abrasives and polishing agents in toothpaste function primarily to mechanically dislodge plaque, extrinsic stains, and debris from tooth surfaces during brushing, thereby promoting oral hygiene while preserving enamel integrity. These materials provide the physical scrubbing action that complements other toothpaste components, with their particle size, hardness, and concentration carefully controlled to optimize cleaning without causing undue wear on dentin or enamel. The effectiveness of these agents is evaluated through standardized tests that assess both their cleaning potential and potential for abrasion. Common abrasives used in modern toothpaste formulations include hydrated silica, calcium carbonate, sodium bicarbonate (baking soda), and alumina (hydrated aluminum oxide), which are selected for their ability to polish teeth effectively at low concentrations.^[40] Hydrated silica, a synthetic form of silicon dioxide, is widely employed due to its fine particle structure that facilitates stain removal while maintaining a neutral pH. Calcium carbonate, a naturally derived mineral, serves as a mild abrasive in many basic toothpastes, contributing to bulk and cleaning without excessive hardness. Sodium bicarbonate acts as a very mild abrasive with low relative dentin abrasivity (RDA ~7-15), providing gentle cleaning and a slight buffering effect to neutralize acids. Alumina provides a harder edge for tougher stains but is typically blended to avoid over-abrasion. The relative gentleness of these abrasives is quantified using the Relative Dentin Abrasivity (RDA) scale, which measures wear on dentin relative to a standard reference (RDA 100); values range from 0 (non-abrasive) to 250 (highly abrasive upper limit), with toothpastes certified by the American Dental Association limited to RDA 250 or below to ensure safety for lifelong use. Low-RDA formulations (below 70) are particularly recommended for daily brushing, especially for individuals with sensitive teeth or exposed dentin, as they balance plaque removal with minimal risk of enamel erosion. Polishing agents, often distinct from primary abrasives, enhance the optical appearance of teeth by creating a smoother, more reflective surface through controlled micro-abrasion. Perlite, a volcanic glass expanded into lightweight, platy particles, excels in this role by offering superior cleaning and whitening effects with reduced dentin abrasion compared to traditional silica, as demonstrated in formulations where optimized perlite particles achieve high Pellicle Cleaning Ratio (PCR) scores while keeping RDA low. Rice hulls, ground into fine silica-rich particles from agricultural byproducts, serve as a natural polishing alternative in some eco-friendly toothpastes, providing gentle buffing action derived from their amorphous silica content. These agents are incorporated at levels that promote enamel safety, with finer particle sizes (typically under 10 microns) minimizing scratches and allowing for effective stain removal without compromising tooth structure. The development of these components reflects a historical evolution toward safer, more efficient materials. In the mid-19th century, toothpastes commonly relied on coarse chalk powders for abrasion, which effectively cleaned but posed risks of enamel damage due to their irregular, large particles. By the early 20th century, advancements in particle engineering shifted to hydrated silica and other synthetic abrasives, enabling finer, more uniform grains that deliver superior polishing with significantly lower abrasivity, as evidenced by the widespread adoption of RDA testing standards established in the 1970s. This progression ensures that contemporary toothpastes maintain a critical balance between mechanical cleaning efficacy and long-term enamel protection.

Active Therapeutic Ingredients

Active therapeutic ingredients in toothpaste are bioactive compounds designed to provide preventive and therapeutic benefits beyond mechanical cleaning, primarily targeting caries prevention, enamel remineralization, and control of oral pathogens. These agents interact chemically with tooth surfaces and oral biofilms to promote long-term oral health. Common examples include fluorides, stannous compounds, xylitol, specialized remineralization enhancers like arginine, casein phosphopeptide, and hydroxyapatite.^[41] Fluorides are the cornerstone of modern toothpaste's anticaries action, with sodium fluoride (NaF) at a typical concentration of 0.24% (approximately 1,100 ppm fluoride ion) and stannous fluoride (SnF₂) at 0.45% (also about 1,100 ppm fluoride ion) being widely used formulations for adults. These compounds promote remineralization by facilitating the replacement of hydroxide ions in hydroxyapatite—the primary mineral in tooth enamel—with fluoride ions, forming the more acid-resistant fluorapatite. This reaction can be represented as:

\text{Ca}_{10}(\text{PO}_4)_6(\text{OH})_2 + 2\text{F}^- \rightarrow \text{Ca}_{10}(\text{PO}_4)_6\text{F}_2 + 2\text{OH}^-

Fluorapatite's lower solubility in acidic environments helps inhibit demineralization and enhances enamel repair during exposure to saliva. Clinical evidence supports that toothpastes with these fluoride concentrations significantly reduce caries incidence when used twice daily.^[3]^[42]^[43]^[44] Stannous compounds, particularly stannous fluoride, extend beyond anticaries effects to provide antimicrobial benefits and relief from dentin hypersensitivity. At 0.454% w/w, stannous fluoride in toothpaste reduces gingival inflammation and bleeding by disrupting plaque bacteria and inhibiting their adhesion to tooth surfaces, demonstrating superiority over non-stannous formulations in 24-week clinical trials. Additionally, the stannous ions deposit on dentin tubules, occluding exposed areas to alleviate sensitivity to thermal, tactile, or chemical stimuli, with twice-daily use showing significant relief within weeks. These dual actions make stannous fluoride a preferred choice for patients with gingivitis or sensitivity.^[45]^[46]^[47]^[48] Xylitol serves as a non-fermentable sweetener with inherent antimicrobial properties, inhibiting the growth and metabolism of cariogenic bacteria such as Streptococcus mutans without contributing to acid production. Incorporated into toothpaste at concentrations around 16-25%, xylitol disrupts bacterial energy pathways by forming xylitol-5-phosphate, which accumulates and starves the microbes, thereby reducing plaque formation and enamel demineralization. Studies indicate that xylitol-containing toothpastes lower mutans streptococci levels in saliva and plaque, supporting caries prevention when combined with fluoride.^[49]^[50] Arginine and casein phosphopeptide (CPP) are advanced agents that enhance remineralization by stabilizing bioavailable calcium and phosphate ions at the tooth surface. Arginine, often at 1.5-8% in combination with fluoride, neutralizes plaque acids through bacterial metabolism into ammonia, raising local pH and promoting mineral deposition; clinical trials show it boosts enamel remineralization by up to 50% more than fluoride alone over two years. Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), derived from milk proteins, binds calcium and phosphate in a supersaturated state, delivering them directly to demineralized lesions for repair; in vitro and in situ studies confirm CPP-ACP toothpastes increase enamel mineral content by 20-30% compared to controls, particularly in early caries reversal. Abrasives in toothpaste formulations aid the delivery of these agents by facilitating their contact with enamel surfaces.^[51]^[52]^[53]^[54]^[55]^[56] Hydroxyapatite (HAP), often in nano form (nHAP), is another key remineralization agent that mimics the mineral composition of enamel, directly depositing calcium and phosphate ions to repair early demineralization and occlude dentin tubules for sensitivity relief. Typical concentrations range from 1-10%, with studies showing 10% HAP toothpastes provide remineralization comparable to 500-1450 ppm fluoride formulations, promoting enamel hardness and reducing caries risk without fluoride. It is particularly valued in natural or fluoride-free toothpastes for its biocompatibility and safety.^[9]

Humectants, Binders, and Surfactants

Humectants are essential non-volatile compounds in toothpaste formulations that maintain moisture and prevent the paste from drying out during storage or use, ensuring a consistent texture and usability. Common humectants include polyols such as glycerin and sorbitol, which comprise approximately 20-40% of the total formulation.^[57] These ingredients absorb and retain water, stabilizing the product's consistency by counteracting evaporation and preserving the suspension of other components like abrasives.^[43] Binders, also known as thickeners or gelling agents, control the viscosity and provide structural integrity to the toothpaste, allowing it to be dispensed as a smooth, non-dripping paste. Polysaccharides like carrageenan and xanthan gum are frequently used as binders due to their ability to form stable gels at low concentrations, typically 0.5-2% of the formulation.^[43] Carrageenan, derived from red seaweed, enhances shear-thinning properties, enabling easy extrusion from the tube while maintaining shape on the brush.^[58] Xanthan gum, a microbial polysaccharide, offers robust viscosity control across a wide pH range and temperature variations, contributing to the paste's homogeneity and resistance to separation.^[59] Surfactants facilitate foaming and emulsification in toothpaste, aiding in the dispersion of active ingredients and enhancing the cleaning action by reducing surface tension. Sodium lauryl sulfate (SLS), an anionic surfactant, is the most common choice, present at 1-2% to generate rich foam that improves user perception of cleansing efficacy.^[60] SLS promotes the even distribution of the paste in the oral cavity and helps solubilize hydrophobic components, thereby supporting the delivery of therapeutic agents like fluorides.^[61] Water serves as the primary solvent and base in toothpaste, typically accounting for 20-40% of the composition to dissolve soluble ingredients and achieve the desired fluidity.^[62] The formulation's pH is adjusted to a neutral to slightly alkaline range of 7-9 using buffers like sodium hydroxide or phosphates, which ensures compatibility with oral tissues, stabilizes active ingredients, and prevents enamel erosion during brushing.^[63]

Flavorings, Sweeteners, and Preservatives

Flavorings are essential additives in toothpaste formulations, primarily serving to mask the bitterness of other ingredients such as abrasives and therapeutic agents while providing a pleasant sensory experience during brushing. Common flavorants include essential oils like peppermint and spearmint, which are incorporated at concentrations typically ranging from 0.5% to 2% by weight of the total composition. These natural or synthetic agents, such as menthol, eucalyptus, cinnamon, and anise extracts, contribute to the cooling or refreshing sensation associated with oral care products.^[6]^[43] Sweeteners enhance the palatability of toothpaste by counterbalancing any residual bitter or medicinal tastes, making the product more appealing for regular use. Sodium saccharin is the most commonly used artificial sweetener in these formulations, often at levels of 0.2% to 0.5% by weight, due to its intense sweetness without contributing calories. Other options include sorbitol, glycerol, and xylitol, which provide mild sweetness and help maintain moisture; xylitol, in particular, improves taste while also offering separate therapeutic benefits against caries, though its primary role here is sensory.^[43]^[64] Preservatives are incorporated to inhibit microbial growth in the water-containing toothpaste matrix, ensuring product stability and safety over its shelf life. Sodium benzoate and parabens such as methylparaben and ethylparaben are frequently employed at low concentrations, typically around 0.1% to 0.3% by weight, to prevent contamination by bacteria, yeast, and mold without affecting the formula's efficacy. These agents are particularly crucial in multi-use tubes where repeated exposure to oral bacteria could compromise the product.^[43]^[65] Colorants contribute to the visual appeal of toothpaste, aiding consumer recognition and encouraging consistent use by providing an attractive, uniform appearance. Synthetic dyes like FD&C Blue No. 1 (also known as Brilliant Blue FCF) are commonly added in trace amounts, often less than 0.1% by weight, to impart shades of blue or green that evoke freshness and cleanliness. Titanium dioxide may also be used as a white pigment to enhance opacity.^[43]^[66]

Benefits and Efficacy

Plaque Removal and Caries Prevention

Toothpaste facilitates plaque removal through mechanical action primarily driven by abrasives, such as hydrated silica or calcium carbonate, which polish the tooth surface and dislodge biofilm during brushing.^[67] These particles provide the necessary friction to disrupt and remove accumulated plaque without excessive enamel wear when formulated appropriately.^[68] Surfactants, like sodium lauryl sulfate, complement this by reducing surface tension, allowing better penetration into plaque matrices and enhancing dispersion of debris through foaming, which improves overall cleaning efficacy.^[43] Chemically, fluoride ions in toothpaste, typically as sodium fluoride or stannous fluoride, strengthen enamel by promoting remineralization and forming fluorapatite, a more acid-resistant mineral that protects against demineralization caused by acids produced by Streptococcus mutans.^[41] This bacterium ferments dietary sugars into lactic acid, lowering oral pH and initiating caries; fluoride inhibits its acid production and enamel dissolution at low concentrations.^[69] By buffering pH and repairing early lesions, fluoride directly counters the cariogenic process initiated by S. mutans.^[70] Clinical studies demonstrate that regular use of fluoride toothpaste reduces dental caries by 20-40% in both children and adults, aligning with guidelines from health authorities emphasizing twice-daily brushing.^[3] This preventive effect is most pronounced when combined with proper brushing techniques, such as the Bass method, which optimizes plaque disruption along the gumline and synergizes with toothpaste's abrasive and fluoridating actions for superior biofilm control.^[71] Effective plaque removal through this integrated approach can achieve significant reductions in biofilm accumulation compared to brushing alone.^[72]

Gingival Health and Freshness

Toothpaste plays a crucial role in maintaining gingival health by incorporating antimicrobial agents that target pathogens like Porphyromonas gingivalis, a keystone bacterium associated with gingivitis and periodontal disease. Triclosan, a common antimicrobial in dentifrices, demonstrates strong inhibitory effects against P. gingivalis by disrupting bacterial cell membranes and reducing biofilm formation, thereby lowering gingival inflammation and bleeding indices in clinical settings.^[73] Similarly, stannous fluoride formulations exhibit antimicrobial activity against P. gingivalis, contributing to decreased plaque adhesion to gingival tissues and improved overall gum condition over 24 weeks of use.^[74] These agents help prevent the progression of gingivitis by limiting bacterial colonization at the gingival margin, promoting a healthier oral microbiome. Beyond pathogen control, toothpaste aids gingival health through plaque reduction, which indirectly supports gum integrity by minimizing mechanical irritation and bacterial load on soft tissues. Clinical trials indicate that regular brushing with specialized toothpastes, such as those containing zinc citrate, can achieve varying plaque reductions, correlating with decreased gingival bleeding and inflammation.^[75] For instance, a randomized study on plaque-identifying toothpastes reported a 49% mean plaque score reduction from baseline in the test group, leading to measurable improvements in gingival indices and reduced risk of gum disease exacerbation.^[76] Such reductions foster long-term gingival stability when combined with consistent oral hygiene practices. Toothpaste also enhances oral freshness by addressing halitosis through ingredients that neutralize volatile sulfur compounds (VSCs), the main contributors to bad breath originating from gingival and subgingival bacteria. Zinc compounds, such as zinc citrate, chemically bind to VSCs like hydrogen sulfide and methyl mercaptan, effectively reducing their concentration and providing odor control.^[77] Essential oils, including thymol and eucalyptol found in some dentifrices, exert antibacterial effects on VSC-producing microbes, further diminishing malodor while supporting gingival health.^[78] These mechanisms not only combat immediate odor but also contribute to a cleaner gingival environment. The breath-freshening effects of toothpaste vary between temporary and sustained durations depending on the active ingredients. Flavorings and surfactants offer immediate, short-term freshness lasting 1-2 hours post-brushing by masking odors and stimulating saliva flow.^[79] In contrast, zinc-based toothpastes provide prolonged efficacy, with studies showing VSC reductions persisting up to 12 hours after a single application, offering sustained protection against halitosis recurrence.^[80] This extended action is particularly beneficial for gingival health, as it inhibits bacterial regrowth in interdental and subgingival areas throughout the day.

Evidence from Clinical Studies

Clinical studies have consistently demonstrated the effectiveness of fluoride-containing toothpastes in preventing dental caries, with meta-analyses providing robust evidence. The 2010 Cochrane systematic review, which analyzed 70 trials involving over 44,000 participants, found that fluoride toothpastes reduce caries development by an average of 24% in children and adolescents compared to non-fluoride alternatives. This finding was reaffirmed in the 2019 update, which included 96 trials and over 65,000 participants across all ages, confirming a preventive fraction of approximately 21-24% for caries in primary and permanent dentitions, particularly at concentrations of 1000-1500 ppm fluoride.^[81] Professional dental organizations endorse regular use of fluoride toothpastes based on this evidence. The American Dental Association (ADA) recommends brushing twice daily with a toothpaste containing 1000-1500 ppm fluoride for optimal caries prevention in adults and children over six years old, emphasizing that such formulations are safe and effective when used as directed.^[3] Similarly, the Fédération Dentaire Internationale (FDI) advocates for over-the-counter toothpastes with 1000-1500 ppm fluoride, used twice daily, as a cornerstone of preventive oral care, supported by high-quality clinical trial data.^[82] Regarding claims of superior performance, clinical evidence highlights limitations in premium or specialized formulations. Meta-analyses, including those from Cochrane, show that caries prevention efficacy is primarily driven by fluoride concentration rather than additional ingredients or branding, with no significant superiority demonstrated for premium toothpastes over standard fluoride variants at equivalent ppm levels.^[81] Long-term studies validate specific claims for whitening and sensitivity relief in toothpastes formulated for these purposes. A 2018 systematic review and meta-analysis of 23 randomized controlled trials found that whitening dentifrices provide statistically significant but modest color improvement (ΔE ≈ 1-2 units) over 4-6 weeks compared to non-whitening controls, with sustained effects up to 6 months in adherent users, though results vary by stain type and do not match professional bleaching.^[83] For dentin hypersensitivity, randomized trials demonstrate that stannous fluoride toothpastes reduce sensitivity scores by approximately 40-50% after 8 weeks, outperforming potassium nitrate formulations.^[84] These outcomes underscore the importance of evidence-based claims, as not all premium products deliver additive long-term benefits beyond standard fluoride action.

Types and Variants

Specialized Formulations

Specialized toothpaste formulations are engineered to address specific oral health challenges beyond general cleaning and fluoride protection, incorporating targeted active ingredients to enhance efficacy for conditions like staining, sensitivity, or tartar accumulation. These products often undergo clinical testing to substantiate their claims, with regulatory bodies such as the American Dental Association evaluating their safety and performance. Whitening toothpastes are formulated to remove or prevent stains on tooth surfaces, primarily through two mechanisms: abrasive agents for extrinsic stains and chemical agents like peroxides for deeper, intrinsic discoloration. Abrasive-heavy varieties, such as those containing hydrated silica or alumina, mechanically polish away surface stains from coffee, tea, or tobacco without altering the tooth's intrinsic color, though excessive abrasivity can risk enamel wear if not balanced properly.^[5]^[85] In contrast, peroxide-based formulations, typically using low concentrations of hydrogen peroxide (around 1-3%), oxidize organic chromogens within the enamel to lighten intrinsic stains, providing a bleaching effect that complements mechanical action but requires careful use to avoid gingival irritation.^[86] Clinical studies confirm these toothpastes can improve tooth shade by 1-2 units on standardized scales after consistent use, though results vary by stain type and individual factors.^[87] Anti-sensitivity toothpastes target dentinal hypersensitivity, a condition where exposed dentin tubules allow stimuli like cold or touch to trigger pain, by incorporating agents that interrupt nerve signaling or occlude tubules. Potassium nitrate, commonly at 5% concentration, is a primary ingredient that depolarizes nerve endings in the pulp, temporarily blocking the transmission of pain signals to reduce discomfort from thermal, tactile, or chemical triggers.^[88]^[89] This neural mechanism provides relief within days of twice-daily use, with clinical studies showing significant hypersensitivity reduction after two weeks of use compared to placebos in randomized trials.^[88] Some formulations also include tubule-sealing agents like stannous fluoride for added durability, enhancing long-term protection against dentin exposure.^[90] Anti-tartar toothpastes aim to inhibit calculus formation, the hardened plaque deposit that contributes to gingivitis and periodontal disease, by disrupting the mineralization process. Pyrophosphates, such as tetrasodium pyrophosphate at 2-5% levels, bind to calcium ions in saliva and plaque, preventing the crystallization of hydroxyapatite crystals that form tartar and thereby significantly reducing supragingival calculus buildup over six months in clinical evaluations, with reductions of up to 34% reported in systematic reviews.^[91]^[92] These agents work by sequestering free calcium, inhibiting crystal growth without affecting enamel remineralization, as demonstrated in longitudinal studies comparing pyrophosphate dentifrices to controls.^[93] Zinc citrate may be combined for synergistic antimicrobial effects, further limiting plaque maturation into calculus.^[94] Multi-benefit toothpastes integrate multiple active ingredients to address 3-5 oral health needs simultaneously, such as cavity prevention, gum protection, whitening, sensitivity relief, and tartar control, offering convenience for comprehensive daily care. For instance, formulations combining fluoride (e.g., 1100-1450 ppm sodium fluoride), stannous fluoride for antibacterial action, potassium nitrate for desensitization, and pyrophosphates for anti-calculus effects have shown superior plaque reduction and gingival health improvements in six-month trials compared to single-benefit pastes.^[95]^[96] These products often include triclosan or essential oils for gingivitis control, demonstrating improved overall efficacy in reducing multiple risk factors compared to single-benefit pastes, though their performance depends on ingredient compatibility and user adherence.^[97] Such all-in-one options are particularly valued for simplifying routines while maintaining evidence-based benefits across targeted areas.

Natural and Herbal Options

Natural and herbal toothpastes have gained popularity as alternatives to conventional formulations, emphasizing plant-derived ingredients and eco-friendly practices to promote oral health without synthetic chemicals. These products often incorporate extracts and oils known for their antimicrobial properties, appealing to consumers seeking sustainable and minimally processed options. The rise in demand reflects broader trends toward natural personal care, driven by concerns over chemical additives in traditional toothpastes.^[98] Common ingredients in natural toothpastes include neem (Azadirachta indica), tea tree oil (Melaleuca alternifolia), and activated charcoal, each contributing antibacterial effects to combat oral pathogens. Neem extract exhibits strong antimicrobial activity against cariogenic bacteria such as Streptococcus mutans, helping to reduce plaque accumulation and gingival inflammation.^[99] Tea tree oil serves as a natural antiseptic, effectively inhibiting harmful bacteria while preserving beneficial oral flora, with studies demonstrating its efficacy in lowering microbial counts in dental biofilms.^[100] Activated charcoal, derived from natural sources like coconut shells, adsorbs surface stains and toxins, providing mild polishing and antibacterial benefits through its porous structure that binds oral bacteria.^[101] Fluoride-free natural options frequently utilize hydroxyapatite (HAP), a biomimetic mineral that mimics tooth enamel composition, to support remineralization without fluoride. Clinical trials have shown that HAP-containing toothpastes achieve comparable remineralization of early carious lesions and prevention of demineralization as low-fluoride formulations, with an 18-month study reporting no significant difference in caries incidence between HAP users and those using 1,450 ppm sodium fluoride toothpaste.^[102] The global herbal toothpaste market, encompassing these natural variants, was valued at USD 2.14 billion in 2023 and is projected to reach USD 3.84 billion by 2030, growing at a compound annual growth rate (CAGR) of 8.7%, reflecting increasing consumer preference for such products.^[98] In terms of efficacy, herbal toothpastes demonstrate comparable short-term plaque reduction to conventional non-herbal types, with meta-analyses indicating standardized mean differences in plaque scores of up to 1.95 in favor of herbal formulations over 4-6 weeks of use.^[103] However, without fluoride, they offer less robust caries prevention, as fluoride remains the gold standard for strengthening enamel and inhibiting demineralization in high-risk individuals; herbal alternatives primarily rely on antimicrobial action rather than direct remineralization.^[104] Certifications such as USDA Organic ensure that at least 95% of ingredients are organically produced, free from synthetic pesticides and GMOs, providing verification of purity and sustainability in natural toothpaste production.

Children's and Sensitive Toothpaste

Children's toothpaste formulations prioritize safety and palatability to promote effective oral hygiene habits from an early age while minimizing risks associated with young users. Fluoride concentrations in these products are typically set at 1000 to 1100 parts per million (ppm) to provide caries prevention benefits without exceeding safe intake levels that could contribute to dental fluorosis during enamel formation.^[105] To appeal to children and encourage consistent brushing, manufacturers often incorporate engaging flavors such as bubblegum or fruit, which are common in American Dental Association (ADA)-accepted products for this age group.^[7] The ADA, along with organizations like the Centers for Disease Control and Prevention (CDC) and American Academy of Pediatrics (AAP), recommends applying a smear- or rice grain-sized amount of fluoride toothpaste for children under 3 years old, transitioning to a pea-sized amount for ages 3 to 6, with supervision to ensure most is spit out rather than swallowed.^[11] This guidance balances fluoride's protective effects against the potential for over-ingestion, which is a primary concern in preventing fluorosis.^[106] Toothpastes designed for sensitive teeth address dentin hypersensitivity, a condition where exposed dentin tubules allow stimuli like cold or touch to trigger pain, through specialized active ingredients. Stannous fluoride, present in concentrations around 0.454%, forms a smear layer that occludes these tubules, providing both desensitizing and anticaries benefits, as demonstrated in clinical studies evaluating its efficacy over extended periods.^[107] Similarly, arginine, often combined with calcium carbonate in an 8% formulation, rapidly seals open dentin tubules by promoting a mineral-rich barrier that mimics natural enamel repair, offering quick relief from sensitivity.^[108] For individuals with allergies or sensitivities, allergen-free toothpaste variants exclude common irritants such as sodium lauryl sulfate (SLS), artificial colors, and certain preservatives, opting instead for milder surfactants and natural flavorings to reduce the risk of oral irritation or allergic reactions. These options are particularly relevant for children or those with enamel issues, ensuring compatibility without compromising cleaning efficacy.

Safety and Health Concerns

Fluoride Consumption Risks

Excessive ingestion of fluoride from toothpaste, particularly in young children whose teeth are still developing, can lead to dental fluorosis, a condition characterized by changes in tooth enamel appearance such as white streaks or spots.^[109] Mild cases primarily affect aesthetics without impacting tooth function, resulting from chronic low-level overexposure during the ages of 6 months to 3 years when permanent teeth form beneath the gums.^[110] The risk is heightened when children swallow toothpaste routinely, as it contains concentrated fluoride (typically 1,000–1,500 ppm), contributing significantly to total fluoride intake alongside sources like fluoridated water.^[111] Acute fluoride toxicity from toothpaste ingestion is rare but possible, especially in cases of accidental overconsumption. For adults, ingestion of 5–10 grams of sodium fluoride—equivalent to swallowing multiple tubes of toothpaste—represents a potentially lethal dose for a 70-kg individual.^[112] Symptoms of toxicity can emerge at doses as low as 5 mg fluoride per kg body weight, including gastrointestinal distress such as nausea, vomiting, abdominal pain, and hypersalivation.^[113] In children, even smaller amounts (e.g., a full adult-sized tube) can cause similar acute effects, though fatalities are uncommon with prompt medical intervention involving supportive care like calcium administration to bind fluoride.^[114] While fluoride toothpaste at concentrations of 1,000–1,500 ppm effectively prevents caries with minimal risk for most users, levels exceeding 1,500 ppm offer no substantial additional benefit in caries reduction for the general population and elevate the risk of fluorosis, particularly in children.^[115] Higher concentrations are reserved for high-risk adults under professional guidance, as the incremental anticaries effect diminishes while systemic exposure risks, including potential gastrointestinal upset from swallowing, increase.^[116] To mitigate these risks, prevention strategies emphasize supervised brushing and portion control for children. For children under 3 years, apply only a rice-sized smear of toothpaste to minimize ingestion, progressing to a pea-sized amount for ages 3–6, with direct adult supervision to ensure spitting rather than swallowing.^[117] Educating children that toothpaste is not food, storing it out of reach, and practicing spitting with water can further reduce accidental consumption.^[114] These measures align with guidelines from health authorities to balance fluoride's benefits against ingestion hazards.^[110]

Chemical Contaminants and Allergens

Toothpaste formulations have occasionally been affected by unintentional chemical contaminants, most notably diethylene glycol (DEG), a toxic solvent sometimes used as a cheaper substitute for glycerin. In 2007, several brands of toothpaste imported from China to Panama and other countries were recalled after testing revealed DEG contamination levels up to 4%. This incident followed a 2006 Panama outbreak where DEG in cough syrup led to over 100 deaths from acute kidney failure, highlighting supply chain vulnerabilities in excipients, though no fatalities were directly linked to the contaminated toothpaste itself.^[118]^[119]^[120] Titanium dioxide (TiO2), used as an opacifying and whitening agent in some toothpastes, has raised safety concerns due to its nanoparticle form potentially being absorbed through oral mucosa. In 2022, the European Union banned TiO2 as a food additive (E171) over genotoxicity risks, classifying it as a potential carcinogen by inhalation. However, it remains approved for use in cosmetics, including toothpaste, in both the EU and US, where the FDA considers it safe at concentrations up to 7.5% as of 2025, provided particle sizes minimize bioavailability. Ongoing studies and regulatory reviews continue to evaluate long-term effects from chronic exposure.^[121]^[122] Triclosan, an antibacterial agent once commonly added to toothpaste for plaque control, faced regulatory scrutiny due to concerns over endocrine disruption and antibiotic resistance. In 2016, the U.S. Food and Drug Administration (FDA) banned triclosan from over-the-counter consumer antiseptic washes, citing insufficient evidence of benefits outweighing risks such as hormonal interference observed in animal studies. However, triclosan remains permissible in toothpaste at concentrations up to 0.3%, where it is deemed effective against gingivitis without the same exposure levels as in soaps.^[123]^[124]^[125] Common allergens in toothpaste include sodium lauryl sulfate (SLS), a surfactant used for foaming that can irritate oral mucosa in sensitive individuals. SLS has been associated with recurrent aphthous stomatitis, manifesting as painful oral ulcers, particularly in those prone to the condition, which affects 2-10% of the general population. Clinical trials indicate that SLS-free toothpastes significantly reduce ulcer frequency, duration, and episodes compared to SLS-containing variants, suggesting irritation rather than true allergy in many cases, though patch testing confirms allergic contact reactions in a subset of users.^[126]^[127]^[128] Polyethylene glycol (PEG), employed as a humectant and solvent in toothpaste to prevent drying and aid ingredient dispersion, raises concerns over potential impurities from its manufacturing process. PEG compounds can contain trace levels of ethylene oxide, a known carcinogen, and 1,4-dioxane, a probable human carcinogen, if not properly purified during ethoxylation. Regulatory bodies like the Cosmetic Ingredient Review emphasize that while PEG itself exhibits low toxicity, these impurities necessitate strict quality controls to minimize risks, especially in products applied daily to mucous membranes.^[129]^[130]^[131]

Long-Term Effects and Debates

One notable long-term concern with toothpaste ingredients involves sodium lauryl sulfate (SLS), a surfactant used for foaming and cleaning. SLS has been associated with temporary taste impairment, where it alters gustatory perception by suppressing sweet taste receptors and amplifying bitter sensations, leading to phenomena like orange juice tasting unpleasantly soapy after brushing. This effect stems from SLS's disruption of taste bud cell membranes, persisting for several minutes to hours but resolving without lasting damage in most cases.^[132]^[60] Whitening toothpastes, designed to remove surface stains through abrasive particles or chemical agents, raise debates over their potential for accelerated enamel erosion with prolonged use. Formulations with high relative dentin abrasivity (RDA) values—typically above 100—can cause up to twice the abrasion compared to low-RDA (below 70) toothpastes, as measured in brushing abrasion tests on dentin and enamel specimens. Clinical simulations indicate that daily application of high-RDA whitening products over months may thin enamel layers, increasing sensitivity and vulnerability to decay, though regulatory limits cap RDA at 250 to mitigate risks.^[133]^[134] Ongoing debates surround the comparative efficacy of herbal versus conventional toothpastes, particularly in plaque control and gingivitis prevention. A 2023 systematic review of randomized trials found mixed results, with some herbal formulations (containing ingredients like neem or clove) demonstrating equivalent or superior reductions in plaque index (up to 20-30% greater in select cases) compared to fluoride-based conventional options, while others showed no statistically significant differences in gingival health outcomes after 4-6 weeks of use. These inconsistencies highlight variability in herbal extract standardization and call for larger, long-term studies to resolve efficacy claims.^[135]^[136] Excessive or prolonged toothpaste use, especially with antimicrobial additives like triclosan or chlorhexidine, can disrupt the oral microbiome's balance, favoring dysbiosis over time. Research indicates that such agents non-selectively reduce beneficial bacteria (e.g., Streptococcus salivarius) alongside pathogens, potentially diminishing microbial diversity by 10-20% after months of daily application and increasing susceptibility to conditions like candidiasis. This shift underscores the need for microbiome-friendly formulations to preserve symbiotic oral flora.^[137]^[138]

Regulation and Standards

Global Regulatory Frameworks

In the United States, the Food and Drug Administration (FDA) classifies toothpaste as an over-the-counter (OTC) drug when it makes anticaries claims, requiring such claims to be supported by substantial clinical evidence demonstrating efficacy in preventing tooth decay. Under the FDA's OTC Monograph M021 for anticaries drug products, stannous fluoride is permitted at concentrations ranging from 0.351% to 0.474%, with an available fluoride ion concentration of at least 290 ppm when used with calcium-based abrasives to ensure safety and effectiveness. In the European Union, toothpaste falls under the scope of Regulation (EC) No 1223/2009 on cosmetic products, which establishes harmonized standards for safety, labeling, and ingredient restrictions to protect consumer health.^[139] This regulation limits triclosan, an antimicrobial agent, to a maximum concentration of 0.3% in toothpaste when used as a preservative, based on safety assessments by the Scientific Committee on Consumer Safety (SCCS), while prohibiting its use in mouthwashes and requiring the warning "Not to be used for children under 3 years of age" on toothpaste packaging. For triclocarban, a similar preservative, the maximum concentration is 0.2% in toothpaste (excluding mouthwash), with the warning "Not to be used for children under 6 years of age."^[140] Recent amendments, such as Regulation (EU) 2024/996, further restrict triclosan and related compounds like triclocarban in cosmetics, phasing out non-compliant products by October 31, 2025, to address endocrine-disrupting concerns.^[141] The World Health Organization (WHO) provides global guidelines promoting the use of fluoride toothpaste as a key intervention for caries prevention, particularly in developing countries where dental disease burdens are high and access to professional care is limited.^[142] WHO recommends twice-daily brushing with fluoride toothpaste containing 1,000–1,500 ppm fluoride for optimal efficacy, emphasizing low-cost formulations to support public health programs in low- and middle-income settings and reduce caries incidence by up to 24% in children.^[143] Regulatory approaches vary internationally, with Japan permitting the use of nanomaterials such as nano-hydroxyapatite in toothpaste based on decades of domestic research and approvals, positioning it as a standard remineralizing agent. In the EU, the SCCS has approved nano-hydroxyapatite up to 29.5% in toothpaste for safety in oral care products as of 2025.^[144]^[145]

Testing and Quality Control

Testing and quality control in toothpaste manufacturing involve standardized protocols to verify product safety, efficacy, and uniformity across batches. These processes ensure that toothpastes meet physical, chemical, and biological requirements, preventing potential health risks from contaminants or degradation while confirming performance claims such as cleaning and enamel protection. Rigorous laboratory assessments are conducted at various production stages, from raw material inspection to finished product validation, adhering to international and pharmacopeial standards.^[146] A key aspect of quality control is the evaluation of abrasivity through Relative Dentin Abrasivity (RDA) testing, as outlined in ISO 11609. This standard specifies methods to measure the abrasive potential of dentifrices on tooth dentin, using dentin slabs—typically human or bovine dentin sections—that are brushed with toothpaste slurries under controlled conditions. The abrasion is quantified either by profilometry, which assesses surface roughness changes, or by radioactive dentin methods that track material loss via isotopic labeling, ensuring RDA values remain below thresholds like 250 for safety. Low RDA scores indicate minimal risk of enamel or dentin wear during regular use.^[146]^[67] Microbiological assays are essential for assessing preservative efficacy, particularly under United States Pharmacopeia (USP) Chapter <51> guidelines. This antimicrobial effectiveness test challenges toothpaste samples with standardized inocula of bacteria (e.g., Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli) and fungi (e.g., Candida albicans, Aspergillus brasiliensis) at high concentrations, then monitors microbial reduction over 7, 14, 28, and sometimes 42 days. Effective preservatives must achieve at least a 1-log reduction for bacteria and no increase for fungi by day 14, and a 3-log reduction for bacteria by day 28, confirming the product's resistance to contamination in multi-dose packaging.^[147] Stability testing follows International Council for Harmonisation (ICH) Q1A(R2) guidelines to determine shelf life and ensure product integrity under environmental stresses like temperature, humidity, and light. Toothpaste formulations are subjected to long-term storage at 25°C/60% relative humidity and accelerated conditions at 40°C/75% RH, with periodic sampling for attributes such as viscosity, pH, fluoride content, and active ingredient potency. Data analysis supports shelf lives typically ranging from 2 to 3 years, beyond which efficacy may diminish due to ingredient degradation.^[148] Claim substantiation relies on in vitro and in vivo trials to validate therapeutic assertions, such as anticaries protection under FDA's OTC Monograph M021. In vitro models simulate enamel demineralization using pH-cycling with toothpaste slurries to measure remineralization via calcium/phosphate uptake, while in vivo studies, like intraoral cariogenic plaque models, assess bacterial reduction or lesion prevention over weeks in human participants. These trials provide quantitative evidence, such as statistically significant plaque score reductions, required for regulatory approval of claims like "helps prevent cavities."^[149]

Environmental and Ethical Considerations

One significant environmental concern with toothpaste is the use of microplastic abrasives, such as polyethylene microbeads, which are intentionally added to some formulations for polishing teeth but contribute substantially to ocean pollution. These tiny particles, typically less than 5 millimeters in size, pass through wastewater treatment systems and enter aquatic environments, where they persist due to their resistance to degradation, accumulating in marine ecosystems and harming wildlife through ingestion and bioaccumulation.^[150] ^[151] In response to this issue, the European Union implemented a ban on intentionally added microplastics in consumer products, including toothpaste, effective October 17, 2023, under Commission Regulation (EU) 2023/2055, targeting synthetic polymer particles to curb environmental pollution. This regulation phases out such additives over time, with full implementation for many products by 2035, prompting manufacturers to shift to natural alternatives like cellulose or silica-based abrasives.^[152] ^[153] Another key environmental impact stems from palm oil-derived humectants, such as glycerin and propylene glycol, commonly used in toothpaste to maintain moisture and prevent drying. These derivatives are sourced from palm kernel oil, the production of which has been linked to widespread deforestation in tropical regions like Indonesia and Malaysia, where palm plantations have cleared rainforests, threatening biodiversity and contributing to greenhouse gas emissions.^[154] ^[155] To address these sustainability challenges, there is a growing push for Roundtable on Sustainable Palm Oil (RSPO) certification, which ensures that palm oil is produced without deforestation, protects peatlands, and respects workers' rights, with certified sustainable palm oil now accounting for about 20% of global production as of 2024. Major toothpaste brands, including Colgate-Palmolive, have committed to sourcing RSPO-certified derivatives as an interim measure toward fully sustainable supply chains.^[156] ^[157] Fair trade initiatives, such as those promoting organic and certified mint oil, work to mitigate risks in the supply chain by enforcing standards for fair wages and safe working conditions for farmers.^[158] Finally, efforts to enhance sustainability include the adoption of biodegradable packaging for toothpaste, such as tubes made from plant-based polymers or paper composites, which decompose naturally and help reduce plastic waste entering landfills and oceans. In 2025, the market for plastic-free cosmetic packaging, including toothpaste, is driven by consumer demand for clean beauty and ethical practices, with brands increasingly using alternatives like bamboo and compostable materials to achieve significant waste reductions.^[159] ^[160]

Production and Packaging

Manufacturing Processes

The manufacturing of toothpaste involves a series of precise industrial steps designed to ensure product consistency, stability, and safety. The process begins with the careful preparation and weighing of raw materials, including abrasives like hydrated silica or calcium carbonate, humectants such as glycerin and sorbitol, binders, surfactants, flavorings, and active ingredients like fluoride compounds. These components are sourced and tested for purity before being introduced into the production line to meet regulatory standards for oral care products.^[161] A critical stage is the high-shear mixing of powders, liquids, and active ingredients, typically conducted in large stainless-steel vacuum mixers to prevent the incorporation of air bubbles that could compromise texture and shelf life. Liquid ingredients are first combined in a vat under vacuum conditions, followed by the gradual addition of dry powders through high-shear agitators that generate intense mechanical forces for thorough dispersion. This vacuum environment minimizes oxidation and foam formation, ensuring a smooth paste without entrapped air. The mixture is then subjected to homogenization, where high-pressure forces reduce particle sizes to less than 10 microns, achieving a uniform emulsion essential for even distribution of actives and abrasives across the product.^[162]^[163]^[164] Following homogenization, the semi-finished paste is transferred to filling stations equipped with rotary machines that dispense the product into collapsible tubes—typically made of plastic, laminate, or aluminum—at speeds of 100 to 200 tubes per minute. These automated systems use precision pumps and nozzles to achieve accurate fill weights, often ranging from 50 to 150 grams per tube, while maintaining hygiene through enclosed operations. After filling, tubes are crimped, capped, and labeled in a continuous inline process.^[165]^[161] Quality control is integrated throughout, with rigorous checks on key parameters such as viscosity, which is maintained between 100,000 and 200,000 centipoise (cps) to ensure the paste's extrudability and stability without being too runny or stiff. Viscosity is measured using specialized rheometers during and after mixing to verify consistency, alongside tests for pH (typically 6-8), microbial content, and active ingredient potency. Any deviations trigger adjustments or batch rejection, upholding product efficacy and consumer safety.^[166]^[161]

Packaging Innovations

The collapsible toothpaste tube, first introduced in 1892 by American dentist Dr. Washington Sheffield, revolutionized packaging by allowing easy dispensing and storage of the paste while minimizing exposure to air. Initially made from metal such as aluminum or lead, these tubes provided a portable alternative to jars and pots, enabling consumers to squeeze out controlled amounts without scooping. Over time, materials shifted to flexible plastics like polyethylene, improving durability and cost-effectiveness.^[13]^[14] Modern advancements in tube design emphasize recyclability, with high-density polyethylene (HDPE) becoming a standard material due to its compatibility with existing recycling infrastructure. In 2019, Colgate-Palmolive pioneered a fully recyclable HDPE laminate tube that combines varying thicknesses to protect the product while meeting Association of Plastic Recyclers (APR) critical guidance protocols for sorting and reprocessing. Similarly, Unilever introduced HDPE tubes certified by RecyClass for European recyclability standards, ensuring they can be processed alongside HDPE bottles without contamination. These innovations address the environmental challenge of traditional multilayer tubes, which often end up in landfills.^[167]^[168] Pump dispensers represent a key usability improvement over manual squeezing, delivering metered doses that prevent over-extrusion and minimize residual paste in the container. Unlike traditional tubes, where incomplete emptying leads to product loss, pumps employ airless or piston mechanisms to extract nearly all contents, enhancing efficiency for households. This design also supports refillable systems, further promoting longevity.^[169]^[170] A notable aesthetic and functional innovation is striped toothpaste, patented in 1955 by inventor Leonard Lawrence Marraffino and subsequently acquired by Colgate-Palmolive for commercialization. The method involves multi-nozzle filling during manufacturing, where colored pastes are injected into separate compartments within the tube, then dispensed through aligned orifices to create distinct stripes without mixing. This technique, detailed in U.S. Patent 2,789,731, allows for visual appeal and functional separation of ingredients like whiteners or flavors.^[171] In the 2020s, sustainability-driven innovations have gained traction, including refill pouches and toothpaste tablets that drastically cut plastic use. Refill pouches, often made from compostable or recyclable films, allow consumers to top up reusable dispensers, reducing packaging waste by up to 75% compared to single-use tubes. Brands like Life Supplies have popularized these since around 2020, pairing them with aluminum or recycled plastic bottles for a closed-loop system. Toothpaste tablets, chewed to form a paste, eliminate tubes entirely and use minimal, recyclable packaging like glass jars or paper pouches, conserving water (traditional pastes contain up to 40% water) and extending shelf life without preservatives. This format aligns with the growing waterless personal care market, projected to expand at a double-digit compound annual growth rate through 2030.^[172]^[173]

Market Trends and Distribution

The global toothpaste market was valued at USD 20.14 billion in 2025 and is projected to grow from USD 20.14 billion in 2025 to USD 29.06 billion by 2032, at a CAGR of 5.4% during the forecast period (Fortune Business Insights, 2025).^[174] This steady expansion reflects broader trends in personal care, with toothpaste comprising nearly half of the overall oral care segment worldwide.^[175] A key trend shaping the industry is the increasing demand for natural and herbal toothpastes, which captured approximately 10-15% of the market share in 2024, appealing to consumers seeking chemical-free alternatives with ingredients like neem and charcoal.^[98] Additionally, e-commerce has gained prominence post-2020, accounting for about 15% of sales as online platforms offer convenience and personalized recommendations, particularly among younger demographics.^[176] These shifts highlight a move toward sustainable and digitally accessible products, though traditional formulations remain dominant. Leading companies include Colgate-Palmolive, which commands approximately 45% of the global market share through its extensive brand portfolio, and Procter & Gamble (P&G), focusing on innovative whitening and sensitivity lines.^[174] Regional preferences vary significantly; for instance, in the Middle East, miswak-infused toothpastes hold notable popularity due to cultural ties to the traditional chewing stick for oral care.^[177] Distribution is primarily through supermarkets and hypermarkets, which handle about 60% of sales by providing wide availability and promotional opportunities, supplemented by pharmacies for specialized products and growing direct-to-consumer channels via e-commerce.^[178] This multichannel approach ensures broad reach, with offline retail still prevailing in developing regions while online grows rapidly in urban areas.

References

[1]
About Fluoride | Oral Health - CDC
May 15, 2024 · Fluoride repairs and prevents damage to teeth caused by bacteria in the mouth. Bacteria in the mouth produce acid when a person eats or drinks.
[2]
An introduction to toothpaste - its purpose, history and ingredients
Furthermore, toothpastes contain abrasives to clean and whiten teeth, flavors for the purpose of breath freshening and dyes for better visual appeal. Effective ...Missing: composition | Show results with:composition
[3]
Fluoride: Topical and Systemic Supplements
Jun 14, 2023 · Topical fluorides strengthen teeth already present in the mouth, making them more decay resistant, while systemic fluorides are those that are ...Missing: composition | Show results with:composition
[4]
Sensitive teeth: What treatments are available? - Mayo Clinic
Use a fluoride toothpaste and avoid abrasive toothpastes. Floss at least once a day. See your dentist regularly. If you grind your teeth, ask your dentist ...
[5]
Whitening | American Dental Association
Aug 16, 2022 · The most common ingredients used in bleaching are carbamide peroxide and hydrogen peroxide, which are used at different concentrations depending ...
[6]
https://jada.ada.org/article/S0002-8177(14)63665-5/pdf
[7]
Toothpastes | American Dental Association
Sep 26, 2025 · Toothpastes contain both active and inactive ingredients. Toothpastes may contain a number of active ingredients to help improve oral health.Missing: composition | Show results with:composition
[8]
Timeline for Community Water Fluoridation - CDC
May 15, 2024 · 1956. Crest, the world's first fluoride toothpaste, is released nationally. Fluoride toothpastes become very common in developed countries by ...
[9]
The use of hydroxyapatite toothpaste to prevent dental caries - NIH
Nov 22, 2021 · In 1970, the Japanese company Sangi LTD purchased the rights to synthetic HAP from NASA and launched the first ever HAP toothpaste (Apadent, ...<|control11|><|separator|>
[10]
Use of Toothpaste and Toothbrushing Patterns Among Children and ...
Feb 1, 2019 · CDC, AAP, AAPD, and ADA recommend that children aged 3–6 years brush their teeth twice daily using a pea-sized amount of fluoride toothpaste.
[11]
Who Invented Toothpaste? - HistoryExtra
Nov 27, 2024 · The Egyptians rubbed a powder on their teeth made from ingredients like the ashes of ox hooves, eggshells, myrrh and crushed pumice. The ...
[12]
History of Toothpaste - Delta Dental of Arkansas
Mar 13, 2019 · Around 3,000 BC, the ancient Egyptians developed a dental paste made of oxen hooves, myrrh, eggshells, pumice and water. Talk about legacy ...When Was Toothpaste Invented... · Who Invented Toothpaste? · How To Keep Smiling
[13]
https://www.deltadentalar.com/resources/blog/delta-dental/2019/03/13/history-of-toothpaste
[14]
History of Oral Hygiene Tools - History Of Dentistry And Medicine
They included crushed bone, eggshell or oyster shell, salt, alum, chalk, pumice, even soot or charcoal. In most instances vinegar, wine or honey were added ...
[15]
Mastic Gum: Oral Health Benefits Deserve Consideration by Dental ...
Jul 15, 2023 · Hippocrates, the “father of medicine,” used mastic for the prevention of digestive problems, colds, and as a breath freshener. “Roman emperors ...
[16]
[PDF] Medieval recipes about toothpastes by Abulcasis
Medieval recipes about toothpastes by Abulcasis. Prof. Dr. Luisa Maria Arvide Cambra. University of Almeria, Spain. lmarvide@ual.es.
[17]
https://www.arjonline.org/papers/arjel/v6-i1/5.pdf
[18]
Oral Hygiene During the Regency
Feb 8, 2019 · From the late eighteenth century, the majority of home-made tooth powders were a blend of soda ash, chalk, and castile soap or borax powder.Missing: essential | Show results with:essential
[19]
Tooth Care And Tooth Powder - Victorian And Edwardian Beauty ...
Mar 1, 2015 · In the Victorian and Edwardian era, teeth were usually cleaned with tooth powder; with precipitated chalk as the foundation of nearly all tooth powders.Basic Tooth Powder With... · Baking Soda Tooth Powder... · Dental Floss (health And...
[20]
History | Colgate-Palmolive
1873: Colgate starts selling aromatic toothpaste in jars. 1879: Gerhard Mennen establishes a pharmacy in Newark, New Jersey, which later becomes the Mennen ...
[21]
A Brief History of Toothpaste - Spear Education
Nov 20, 2012 · 1873: The first commercially produced, nice-smelling toothpaste was launched by Colgate and sold in a jar. 1892: Dr. Washington Sheffield is ...
[22]
Aristocratic Dental Cream Gets Squeezed | a CTHumanities Project
Lucius communicated his observations to his father and shortly after, in 1892, Washington Sheffield unveiled America's first toothpaste tube. Taking all ...
[23]
A century and counting. Colgate then and now.
In 1896, Colgate sold its first toothpaste in a collapsible tube, called Colgate Ribbon Dental Cream. After sodium fluoride toothpaste had become available ...
[24]
ACS celebrates development of Crest toothpaste with Historic ...
Apr 4, 2024 · Crest introduced fluoride in 1955, developed by IU and P&G, using stannous fluoride, and was the first ADA-recognized effective toothpaste.
[25]
https://www.acs.org/pressroom/newsreleases/2024/april/acs-celebrates-development-of-crest-toothpaste.html
[26]
Triclosan - American Chemical Society
May 4, 2010 · It was first described by E. Model and J. Bindler in 1964. It is used in consumer products ranging from toothpaste to deodorants to toys.
[27]
[PDF] Antibacterial Triclosan Banned by FDA for Medical Use
Despite banning its use in liquid soaps in 2016, FDA allows the pesticide in toothpaste, while wide use continues in products under the jurisdiction of the U.S. ...
[28]
What is Triclosan and Why is it Banned? - News-Medical
Jul 2, 2019 · The United States Food and Drug Administration (FDA) banned the incorporation of triclosan and 18 other antimicrobial chemicals from household soap products.
[29]
Companies drop 'triclosan' after US FDA ban - Times of India
Mar 16, 2019 · Consumer product companies in India are phasing out the controversial anti-bacterial 'triclosan' from soap and toothpaste products.
[30]
Nano-hydroxyapatite and its applications in preventive, restorative ...
The Sangi Co. Ltd had the idea in 1978 to launch toothpaste that could repair the tooth enamel, which contains for the first time nano-hydroxyapatite (Apadent).
[31]
Semiconductor Research Leads to Revolution in Dental Care
Jan 29, 2024 · Sangi Co. Ltd. of Tokyo acquired the patent and developed the first hydroxyapatite-based remineralizing toothpastes in the 1980s. Hundreds of ...Missing: 2000s | Show results with:2000s
[32]
Hydroxyapatite Toothpaste: Should Dental Hygienists Recommend ...
Dec 17, 2022 · Beginning in 2006, the hydroxyapatite toothpaste was marketed to replace fluoride for its remineralization properties in Europe.Missing: Asian | Show results with:Asian
[33]
The Benefits of Probiotics on Oral Health: Systematic Review of the ...
Sep 16, 2023 · Our study aimed to explore the use of PBs to improve oral health, focusing on issues such as cavities, gum disease, bad breath, mucositis, and ...3. Results · Table 2 · 4.1. Caries And Associated...Missing: toothpaste 2020s<|separator|>
[34]
Designs for Health launches probiotic toothpaste - Cosmetics Design
Mar 18, 2017 · The company's PerioBiotic toothpaste has been launched throughout the United States and features its patent-pending Dental-Lac ingredient, a ...
[35]
CBD Oral Care Products | Colgate®
Sensitivity relief; Reduces risk of cavities; Encourages tooth remineralizing; Restores pH balance. CBD Toothpaste vs. Regular Toothpaste. Some studies suggest ...
[36]
Dentists launch CBD toothpaste - Nutritional Outlook
Sep 23, 2020 · CBDent, a toothpaste featuring CBD, was designed by dentists using vegan and Leaping Bunny-certified, cruelty-free ingredients, ...Missing: date | Show results with:date
[37]
Lasting stripes | New Scientist
Apr 3, 2007 · Colgate-Palmolive's US patent number 4,969,767, granted in 1990, describes a scheme for adding stripes of two colours. Here, the central pipe is ...Missing: multi- chamber
[38]
The Role of Fluoride on Caries Prevention - StatPearls - NCBI - NIH
Mar 19, 2023 · Sodium fluoride toothpaste at concentrations of 2,800 ppm can be indicated from 10 years of age, and 5,000 ppm from 16 years of age.
[39]
Revisiting Fluoride in the Twenty-First Century: Safety and Efficacy ...
Jul 4, 2022 · If topical fluoride is available during the remineralization phase, fluorapatite is formed, and this, in turn, will create an acid-resistant ...
[40]
FORMULATION INGREDIENTS FOR TOOTHPASTES AND ... - NIH
Fluoride diffuses with the acid from plaque into the enamel pores and forms fluoroapatite (FAP). FAP incorporated in the enamel surface is more resistant to a ...
[41]
Prevention of Caries and Dental Erosion by Fluorides—A Critical ...
Jan 5, 2022 · Stoichiometric hydroxyapatite is slightly more soluble than stoichiometric fluoroapatite, due to the exchange of hydroxide by fluoride, with the ...
[42]
Gingivitis efficacy of a 0.454% w/w stannous fluoride dentifrice - NIH
A dentifrice containing 0.454% w/w SnF2 was shown to be superior to a standard dentifrice in controlling gingivitis and supra-gingival plaque, over a 24-week ...Missing: relief | Show results with:relief
[43]
Stannous Fluoride in Toothpastes: A Review of Its Clinical Effects ...
Feb 20, 2025 · This article reviews the topic of stannous fluoride as an anti-caries additive in toothpastes. It is based on a literature survey carried ...
[44]
Comparison of new formulas of stannous fluoride toothpastes ... - NIH
As a result, stannous fluoride formulations are promoted to help the treatment of gingivitis, erosion, hypersensitivity and oral malodour in addition to the ...
[45]
Efficacy of an anhydrous stannous fluoride toothpaste for relief ... - NIH
Stannous fluoride (SnF 2 )‐containing toothpastes have been shown to be effective in relieving dentine hypersensitivity (DH) with twice‐daily use.<|control11|><|separator|>
[46]
The effect of xylitol on dental caries and oral flora - PMC - NIH
Thus, xylitol inhibits S. mutans growth essentially by starving the bacteria. Xylitol can inhibit the growth of harmful oral bacteria such as S. mutans, but ...
[47]
Antimicrobial Effect of Low-Fluoride Toothpastes Containing ... - NIH
Aug 18, 2023 · This study evaluated the antimicrobial effect of toothpastes containing 200 ppm fluoride (200F), xylitol (X, 16%), erythritol (E, 4%), ...
[48]
The combined enamel remineralization potential of arginine and ...
Jun 22, 2018 · Incorporation of 2% arginine in NaF toothpaste significantly increased the remineralization of enamel caries-like lesion when compared to NaF toothpaste.
[49]
Arginine: A New Paradigm in Preventive Oral Care - PMC
A review of the scientific literature suggests that arginine improves remineralization after the addition of arginine to dentifrices. The strategy combining ...
[50]
Clinical Perspective: Arginine as an Anticaries Agent
This study showed that, after 2 years of use, a 1.5% arginine toothpaste was at least as effective as a 0.24% sodium fluoride (1100 ppm fluoride) toothpaste in ...
[51]
Effect of Casein Phosphopeptide-amorphous Calcium Phosphate ...
Calcium sodium phosphosilicate paste showed maximum remineralizing potential compared with CPP-ACP and fluoridated toothpastes.
[52]
The effect of casein phosphopeptide-amorphous calcium ... - PubMed
CPP-ACP containing Tooth Mousse remineralized initial enamel lesions and it showed a higher remineralizing potential when applied as a topical coating.
[53]
Antibacterial and Remineralization Efficacy of Casein ... - NIH
Aug 28, 2019 · One of the novel remineralization methods is the utilization of calcium phosphate particles dissolved in casein milk protein, that creates ...
[54]
The Abrasiveness of Toothpastes - Water Tower Dental Care
Dec 21, 2017 · Glycerine, sorbitol, and polyethylene are just a few of the ingredients that toothpaste humectants can contain. They make up anywhere from 20-40 ...<|separator|>
[55]
Investigation of the constituents of commercially available toothpastes
Apr 24, 2024 · Active ingredients such as sodium fluoride, zinc citrate, arginine, potassium nitrate, potassium citrate, sodium monofluorophosphate, stannous ...
[56]
Xanthan - an overview | ScienceDirect Topics
The rigid helical conformation of xanthan gum results in its viscosity being relatively insensitive to differences in ionic strength and pH.
[57]
The Yin and Yang of Sodium Lauryl Sulfate Use for Oral and ... - NIH
Sodium lauryl sulfate (SLS) is an anionic surfactant, which has a wide range of usage in the health sector and in dental pharmaceutical products, especially in ...
[58]
What is Sodium Lauryl Sulphate, and why is it used in toothpaste?
May 20, 2025 · SLS is used as a foaming agent and a surfactant. The foaming action of SLS helps to spread the toothpaste around the mouth, making it easier to clean the teeth.
[59]
[PDF] What's in your toothpaste? - VivaRep™
Oct 11, 2019 · Common humectants include polyethylene glycols, sorbitol, glycerol and even aloe vera gel. Some humectants may have additional benefits ...
[60]
Toothpaste Guide: The Truth About Fluoride, Foaming, and More
Toothpastes are generally basic in nature. With a pH value ranging between 7 and 9, they balance the acidic environment in the mouth, helping prevent enamel ...Missing: adjustment | Show results with:adjustment
[61]
[PDF] EP003903764A1* - EP 3 903 764 A1 - European Patent Office
Nov 3, 2021 · l Sodium saccharin; in a proportion from 0,2 to 0,5% m/m of ... TOOTHPASTE COMPOSITION is worthy of the privilege of patent of invention.
[62]
Cytotoxicity of the Ingredients of Commonly Used Toothpastes and ...
In addition to toothpastes, zinc lactate, paraben, and sodium benzoate are also added as antimicrobial agents and food preservatives. Some studies have ...
[63]
Whitening toothpaste containing activated charcoal, blue covarine ...
Jan 14, 2019 · The use of blue covarine and other pigments of optical effect, such as FD&C Blue No. 1, in whitening toothpastes modifies the perception of ...
[64]
Toothpaste Abrasion and Abrasive Particle Content - PubMed Central
Mar 12, 2023 · Currently, the most common method is the measurement of the relative dentin abrasion (RDA) according to the radiotracer (Rt) method and the ...
[65]
[PDF] ANTICAVITY TOOTHPASTE DESIGN
Mar 14, 2008 · ... flavors, flow modifiers, humectants, preservatives, sweeteners, and surfactants. Table 4 and Table 5 summarize the main inactive ingredients ...
[66]
Fluoride resistance in Streptococcus mutans: a mini review - PMC
Jul 6, 2017 · It is believed that the anti-caries effects of fluoride are due to its ability to protect dental hard tissues and inhibit bacterial growth and ...
[67]
Streptococcus mutans and Dental Caries - Michigan Publishing
Jun 24, 2025 · Caries are developed when S. mutans take advantage of excess sugars found on the tooth surface, triggering acid production, and thus loss of tooth surface.
[68]
Toothbrush + Toothpaste = Synergy - - Dentalcare.com
Several investigations have found that combining dentifrice with toothbrushing did not provide meaningfully greater plaque removal versus “dry brushing” (ie, ...Missing: technique | Show results with:technique
[69]
The Structures–Reactivity Relationship on Dental Plaque ... - MDPI
Aug 10, 2023 · It is well known that brushing the teeth is the most effective technique for plaque removal, and toothpaste complements it by acting as a ...
[70]
Antimicrobial efficacy of antiplaque agents of common toothpastes ...
Toothpastes containing triclosan had the most antimicrobial activity against P. gingivalis . Moreover, toothpastes containing tin compounds had the most ...
[71]
Efficacy of Antimicrobial Agents in Dentifrices: A Systematic Review
Oct 14, 2022 · Currently, there are several components present in dentifrice formulations with antimicrobial properties, such as triclosan and fluoride agents.
[72]
Oral Hygiene Improvements by a Novel Zinc Toothpaste—Results ...
Sep 18, 2024 · In comparison to the control, the test demonstrated reductions of 13.4%, 17.0% and 55.3% for gingivitis, dental plaque and gingival bleeding, ...
[73]
Randomized Trial of Plaque-Identifying Toothpaste: Decreasing ...
Oct 19, 2016 · In an intention-to-treat analysis, the plaque-identifying toothpaste reduced mean plaque score by 49%, compared with a 24% reduction in placebo ...Missing: studies | Show results with:studies
[74]
In vitro effects of novel toothpaste actives on components of oral ...
Results: The models showed that zinc ions were able to react chemically with hydrogen sulfide to remove this odorous component of halitotic breath. This ...
[75]
Revisiting Standard and Novel Therapeutic Approaches in Halitosis
Toothpastes containing stannous fluoride, zinc or triclosan have a beneficial effect on reducing oral malodor for a limited period of time [110,111,112]. In a ...
[76]
How to deal with morning bad breath: A randomized, crossover ...
Studies have shown that brushing the tongue with toothpaste could reduce the levels of VSCs for at least 1 h, and this was more effective than only brushing the ...Missing: freshening sustained
[77]
Effect of a single brushing with two Zn-containing toothpastes on ...
Aug 6, 2025 · This randomized, double-blind, 12 h clinical study tested the effect of a single brushing with two Zn-containing toothpastes on volatile ...
[78]
Fluoride toothpastes of different concentrations for preventing dental ...
Mar 4, 2019 · This Cochrane Review supports the benefits of using fluoride toothpaste in preventing caries when compared to non‐fluoride toothpaste. Evidence ...
[79]
The Use of Topical Fluoride for Caries Prevention | FDI
Prescription fluoridated toothpastes at a higher concentration (2500−5000ppm) should be made available and recommended for twice daily use in high caries risk ...Missing: ADA | Show results with:ADA
[80]
Efficacy of Dental Bleaching with Whitening Dentifrices: A ...
Oct 30, 2018 · Significant differences in tooth color change were found between the groups using whitening dentifrices and those using nonwhitening dentifrices ...
[81]
[PDF] A study to investigate the effect of a sensitivity toothpaste in ...
Apr 7, 2020 · The long term effect of stannous fluoride containing toothpastes in reducing tooth sensitivity has been reported in a number of published ...
[82]
A Critical Review of Modern Concepts for Teeth Whitening - PMC
Aug 1, 2019 · It has been stated by Demarco et al. that whitening toothpastes work only by their abrasive effect and not by bleaching [43]. In contrast, ...
[83]
Effects of a commercial whitening toothpaste containing hydrogen ...
Hydrogen peroxide (HP) and citric acid (CA), key contributors to toothpaste acidity, can lead to dental loss. This study aimed to compare the amount of abrasion ...
[84]
Comparison the effect of charcoal-containing, hydrogen peroxide ...
Nov 19, 2021 · The present study investigated the effects of four kinds of whitening toothpastes with different mechanisms of action, including an abrasive ...
[85]
Evaluation of the clinical efficacy of potassium nitrate desensitizing ...
Potassium Nitrate has been used as a desensitizing agent to treat dentinal hypersensitivity. The effectiveness of a potassium nitrate is evaluated both in the ...
[86]
Potassium containing toothpastes for dentine hypersensitivity - PMC
The exact mechanisms by which potassium containing toothpastes desensitises dentine is yet to be elucidated, but the toothpaste companies marketing these ...
[87]
Effect of potassium nitrate on tooth sensitivity during in-office bleaching
The only known desensitizing agent of neural action is potassium, which acts by either reducing receptor excitability or interrupting neural transmission ...<|separator|>
[88]
Dentinal Tubule Occluding Effect of Potassium Nitrate in ... - NIH
Potassium nitrate is effective in occluding dentinal tubules when applied twice daily in toothpaste form than mouthwash form.
[89]
Clinical and Microbiological Efficacy of Pyrophosphate Containing ...
Nov 17, 2020 · In conclusion, the use of pyrophosphate-containing toothpaste effectively inhibited plaque accumulation, however, there was no significant ...
[90]
Pyrophosphates in toothpaste: a retrospective and reappraisal
Nov 27, 2020 · During the last 50 years, an increasing number of toothpastes have been marketed that include pyrophosphates as anti-tartar (calculus) agents.
[91]
Tartar Control - Choosing a Toothpaste: What's the Big Deal?
The intent of these products is to prevent or slow the crystallization of plaque with anti-calculus ingredients like zinc salts, pyrophosphate, and sodium ...
[92]
Pyrophosphates in toothpaste: a retrospective and reappraisal
Aug 6, 2025 · Anti-calculus Action. Pyrophosphate and carboxylate inhibit calculus formation by preventing calcium phosphate deposition in plaque. View.
[93]
Anti-gingivitis Active Ingredients - Choosing a Toothpaste
Two antimicrobial, gingivitis-fighting agents have been successfully added to toothpastes to target plaque and gingivitis: triclosan and stannous fluoride.
[94]
Multi-function toothpastes for better oral health - ResearchGate
Aug 8, 2025 · The effectiveness and functionality of toothpaste is enhanced by adding a variety of safe and compatible ingredients that may reduce ...
[95]
A Randomized Double-Blind Clinical Trial Evaluating Comparative ...
A new stannous fluoride dental gel toothpaste demonstrated significant improvements in plaque, gingival inflammation and bleeding on probing compared with other ...Missing: relief | Show results with:relief
[96]
Herbal Toothpaste Market Size, Share | Industry Report, 2030
The global herbal toothpaste market size was estimated at USD 2.14 billion in 2023 and is projected to reach USD 3.84 billion by 2030, growing at a CAGR of ...Market Size & Forecast · Distribution Channel... · Regional Insights
[97]
New solutions using natural products - PMC - PubMed Central
Aug 21, 2020 · In Nigeria, like in other parts of Africa, the small twigs of neem are used to clean and whiten teeth, in consideration of its antibacterial ...Missing: charcoal | Show results with:charcoal
[98]
[PDF] Antimicrobial Textiles for Long Duration Space Flight
Dec 18, 2018 · Some herbal antimicrobial products are neem, aloe vera, tea tree oil, ... The fabric is double layered made up of natural microfiber charcoal ...
[99]
Herbal Mouthrinses for Prevention of Dental Caries in Children and ...
Herbal mouthrinses (HMR) are generally formulated with extracts of sanguinarine, propolis, neem, green tea, charcoal, clove, and miswak. ... The use of Aloe vera ...
[100]
Caries-preventing effect of a hydroxyapatite-toothpaste in adults - NIH
Jul 18, 2023 · The aim of this 18-month double-blinded, randomized, clinical trial was to compare the caries-preventing effect of a fluoride-free, hydroxyapatite toothpaste ( ...
[101]
Effectiveness of herbal oral care products in reducing dental plaque ...
Feb 11, 2020 · For short-term reduction in dental plaque, current evidence suggests that HTP is as effective as compared to NHTP; however, evidence is from low quality ...
[102]
Comparative effectiveness of herbal and conventional toothpaste on ...
With the evidence available, it can be concluded that herbal dentifrices and fluoride dentifrices have similar antimicrobial activity against cariogenic ...
[103]
Fluoride Use in Caries Prevention in the Primary Care Setting
Dec 1, 2020 · This clinical report aims to clarify the use of available fluoride modalities for caries prevention in the primary care setting and to assist pediatricians.
[104]
Fluoride for Children: Parent FAQs - HealthyChildren.org
Apr 24, 2025 · The AAP recommends using a smear or grain-of-rice–sized amount of fluoride toothpaste twice a day when the first tooth appears and until age 3 ...
[105]
Efficacy of an occluding toothpaste on dentinal hypersensitivity over ...
Jul 13, 2021 · Stannous fluoride (SnF2) has long been used in anti-DH toothpaste formulations. Clinical studies demonstrate the efficacy of SnF2 toothpastes ...
[106]
Clinical efficacy of toothpaste containing 8.0% arginine and calcium ...
The arginine–calcium carbonate technology blocks the pathway to pain by occluding and sealing open dentin tubules. The acid resistance of the occluded layer ...
[107]
About Dental Fluorosis | Oral Health - CDC
May 15, 2024 · Dental fluorosis is mostly mild and cosmetic meaning it does not affect tooth function and is not painful.
[108]
Fluorosis Facts: Information for Parents & Caregivers
Aug 26, 2014 · Parents will want to ensure that children do not swallow toothpaste or mouthrinse, which contain more concentrated amounts of this important ...
[109]
[PDF] Fluoride Ingestible Drug Products | FDA Scientific Evaluation
Oct 31, 2025 · In terms of benefits, the use of ingestible fluoride drug products appears to reduce tooth decay in permanent teeth but not primary teeth. An ...
[110]
Amounts of Fluoride in Self-Administered Dental Products
Jun 1, 1986 · Five to 10 g of sodium fluoride is considered a certainly lethal dose for a 70-kg adult. ... acute toxicity and is known as the safely tolerated ...Missing: LD50 | Show results with:LD50
[111]
Fluoride Toxicity: Practice Essentials, Pathophysiology, Etiology
Jan 17, 2024 · Fluoride toxicity is characterized by a variety of signs and symptoms. In the United States, poisoning most commonly follows ingestion ...
[112]
My Child Ate Toothpaste: What Should I Do? - Poison Control
Feb 8, 2024 · Prevention Tips · Teach children that toothpaste is medicine. · Store toothpaste out of reach and sight of children. · Watch children as they learn ...
[113]
Recommendations for Using Fluoride to Prevent and Control Dental ...
Aug 17, 2001 · Because frequent exposure to small amounts of fluoride each day will best reduce the risk for dental caries in all age groups, the work group ...
[114]
Fluoride toothpastes of different concentrations for preventing dental ...
This Cochrane Review supports the benefits of using fluoride toothpaste in preventing caries when compared to non‐fluoride toothpaste. Evidence for the effects ...
[115]
Oral Health Tips for Children - CDC
May 15, 2024 · For Children · Brush their teeth twice a day with fluoride toothpaste. · Help your child brush their teeth until they have good brushing skills.Overview · What Parents And Caregivers... · For Babies<|control11|><|separator|>
[116]
List of Problem Chinese Imports Grows - NPR
Jul 10, 2007 · The same chemical found in the toothpaste was blamed for the deaths of 51 people in Panama after they ingested tainted cough medicine. China has ...
[117]
[PDF] Panama 2006 - Another tragic case of DEG poisoning
Toothpaste containing DEG – no deaths. Panama. 2007. Toothpaste containing DEG – no deaths reported. Nigeria. 2008/9. Teething formula contaminated with DEG ...
[118]
Outbreak of acute renal failure in Panama in 2006: a case-control ...
Laboratory analyses confirmed the presence of diethylene glycol (DEG) in biological samples from case patients, 8% DEG contamination in cough syrup samples and ...Missing: toothpaste | Show results with:toothpaste
[119]
Triclosan: What It Is & Effects - Cleveland Clinic
Oct 10, 2022 · Triclosan's first use was as a pesticide in the 1960s. It's now an ingredient in commercial and industrial equipment such as conveyor belts ...
[120]
Triclosan Exposure, Transformation, and Human Health Effects - PMC
In September 2016, TCS was banned by the FDA in soap products (liquid, gel ... Endocrine disrupting effects of triclosan on the placenta in pregnant rats.
[121]
Why a Chemical Banned From Soap Is Still in Your Toothpaste
Sep 7, 2016 · Studies in animals have shown that triclosan and similar chemicals can disrupt the normal development of the reproductive system and metabolism.
[122]
Effect of sodium lauryl sulfate on recurrent aphthous stomatitis
SLS-free dentifrice, when compared to SLS-containing statistically significantly, reduced the number of ulcers, duration of ulcer, number of episodes, and ulcer ...Missing: allergy prevalence
[123]
The Treatment of Chronic Recurrent Oral Aphthous Ulcers - PMC
Chronic recurrent oral aphthous ulcers are the most common type of inflammatory efflorescence of the oral mucosa, with a prevalence of 2% to 10% in Caucasian ...
[124]
Inflammatory reaction of the anterior dorsal tongue presumably to ...
SLS is a known irritant and also has allergenic potential. The authors report 3 patients with oral pain secondary to inflammation of the dorsal anterior tongue.
[125]
Safety Evaluation of Polyethylene Glycol (PEG) Compounds ... - NIH
According to the Cosmetic Ingredient Review (CIR) expert panel, the presence of impurities during or after the process of mixing these compounds is of concern ...
[126]
EWG Skin Deep® | What is POLYETHYLENE GLYCOL
This ingredient's score is higher if there is potential contamination from toxic impurities. The score will be lower if used in products that meet EWG's ...
[127]
The Dirty Dozen: PEG Compounds and their contaminants
PEG is used in many cosmetic cream bases. It can be contaminated with 1,4-dioxane, which may cause cancer.Missing: toothpaste | Show results with:toothpaste
[128]
Orange Juice And Toothpaste - Rivertown Dental Care
Oct 5, 2016 · However, SLS affects the membranes of our tongue cells, blocking our sweet taste buds and enhancing our bitter taste. This results in the ...Missing: impairment | Show results with:impairment
[129]
Effect of Whitening Toothpastes with Different Active Agents on ... - NIH
May 12, 2023 · According to ISO 11609, the abrasivity of a dentifrice slurry is low when RDA = 0–70, medium when RDA = 71–100, and high when RDA = 101–150. As ...
[130]
Relative dentin and enamel abrasivity of charcoal toothpastes
Oct 27, 2022 · If a toothpaste is twice or half as abrasive, it achieves an RDA value of 200 or 50, respectively. Usually only the RDA, but not the REA value, ...
[131]
[PDF] Comparative Efficacy of Herbal vs Fluoride Toothpastes in Reducing ...
Dec 12, 2023 · Efficacy of herbal and non-herbal toothpaste in the reduction of plaque, gingivitis and salivary neutrophil count-a randomized clinical study.<|separator|>
[132]
Efficacy and Safety of Natural Versus Conventional Toothpastes and ...
Since bacterial plaque accumulation is the primary cause of gingivitis, several natural ingredients have demonstrated effective antibacterial activity [26,27].
[133]
How does toothpaste affect the good bacteria in your mouth?
ingredients that could actively support a healthier oral microbiome rather than ...Missing: trends 2020s
[134]
Effects of sodium lauryl sulfate and postbiotic toothpaste on oral ...
Jun 26, 2024 · SLS was found to kill bacteria in both preformed biofilms (mature biofilms) and developing biofilms (immature biofilms), and disturbed the ...
[135]
[PDF] Regulation (EC) No 1223/2009 of the European Parliament and of ...
Nov 30, 2009 · This regulation applies to cosmetic products, not medicinal or biocidal products, aiming to simplify procedures, ensure health protection, and ...
[136]
Safety of Triclocarban and Triclosan as substances with potential ...
Nov 4, 2022 · The use of triclocarban as a preservative in dermally applied cosmetic product is safe up to a maximum concentration of 0.2% for both children (0.5-18 years) ...Missing: 2010 | Show results with:2010
[137]
December regulatory roundup – Ceway Blog - News
Jan 1, 2025 · Effective 31 December 2024, Regulation (EU) 2024/996 introduces new restrictions on the preservatives Triclocarban and Triclosan for new products placed on the ...
[138]
Oral health - World Health Organization (WHO)
Mar 17, 2025 · Adequate exposure to fluoride is an essential factor in the prevention of dental caries. Twice-daily tooth brushing with fluoride-containing ...
[139]
[PDF] Fluoride toothpaste - World Health Organization (WHO)
The recommended concentration in toothpaste is between 1000 and 1500 ppm for all age groups. Adequate topical use of fluoride has a beneficial effect on oral ...
[140]
SCCS Issued Preliminary Opinion on Hydroxyapatite (nano)
Apr 15, 2025 · The SCCS considers hydroxyapatite (nano) safe when used at concentrations up to 29.5% in toothpaste, and up to 10% in mouthwash.
[141]
Nano Medical Hydroxyapatite - Oral Science
Nano Medical Hydroxyapatite · Remineralizes and repairs tooth surface Causes remineralization comparable to a fluoride toothpaste and inhibits caries ...Missing: 2000s markets
[142]
ISO 11609:2017 - Dentistry — Dentifrices — Requirements, test ...
In stockISO 11609:2017 specifies requirements for the physical and chemical properties of dentifrices and provides guidelines for suitable test methods.Missing: RDA dentin slabs<|control11|><|separator|>
[143]
〈51〉 Antimicrobial Effectiveness Testing - USP-NF ABSTRACT
Antimicrobial preservatives are added to nonsterile products to protect from growth and to sterile multi-dose units to inhibit growth from repeated withdrawals.
[144]
https://health.ec.europa.eu/publications/sccs-scientific-opinion-hydroxyapatite-nano-submission-iv_en
[145]
Anticaries Drug Products for Over-the-Counter Human Use; Use of ...
Oct 15, 2001 · This test directly measures the effectiveness of a fluoride dentifrice in an animal model in vivo after limited brushing and gives a more ...
[146]
What are microplastics? - NOAA's National Ocean Service
Jun 16, 2024 · Microplastics can come from a variety of sources including larger ... toothpastes. These tiny particles easily pass through water ...
[147]
https://doi.usp.org/USPNF/USPNF_M98790_03_01.html
[148]
EU bans microplastics added to consumer products - DW
Oct 17, 2023 · The new ban, which covers all synthetic polymer particles less than five millimeters that are organic, insoluble and resist degradation, will impact a vast ...
[149]
Commission Regulation (EU) 2023/2055 - Restriction of ...
Jul 18, 2025 · The purpose of banning microplastics, which includes glitter, is to reduce the environmental pollution and risk to the environment that they ...Missing: abrasives toothpaste
[150]
Palm oil derivatives with essential functionality in toothpaste
Aug 21, 2019 · Humectants such as and glycerin and propylene glycol, and synthetic detergents (a mixture of surfactants) are two key palm oil derivatives used ...
[151]
Palm oil is unavoidable. Can it be sustainable? - National Geographic
Today the RSPO certifies roughly one-fifth of the global supply. Many consumer goods manufacturers that rely on palm oil—Unilever, Nestlé, Procter & Gamble—have ...
[152]
Delivering Deforestation-Free Sustainable Palm Oil: A response to ...
Sep 23, 2021 · Approximately 19% of all palm oil produced globally is certified to RSPO standards, which work to protect primary and secondary forests from ...
[153]
Policy on Responsible and Sustainable Sourcing of Palm Oil
As an interim measure, Colgate will strive to procure only palm oil, PKO and palm oil derivatives certified by the Roundtable on Sustainable Palm Oil (RSPO) or ...
[154]
Child Labor in India - Humanium
Jun 2, 2020 · You might be surprised to know that in India there are over 8.3 million child laborers who are between the ages of 5 and 14.Missing: mint farming concerns
[155]
Organic and Fair Trade Mint Oil: India | Perfumer & Flavorist
May 27, 2009 · Working conditions are safe and hygienic. Enforced child labor shall not be used (remembering that, in India and Africa, farms are family ...
[156]
Plastic-Free Cosmetic Packaging Market 2025 Driven by Clean
Aug 11, 2025 · Brands are adopting alternatives such as glass, metal, bamboo, paper, and biodegradable materials to reduce plastic waste. Regulatory ...
[157]
Eco-Friendly Toothpaste Packaging Trends - Oralgos
Sep 24, 2025 · Discover 2025 trends in eco-friendly toothpaste packaging, from biodegradable tubes to zero-waste designs shaping the future of oral care.
[158]
Toothpaste Manufacturing Process: A Complete Guide - Lidercare
The toothpaste manufacturing process includes ingredient preparation, mixing, quality control, filling, packaging, and distribution.
[159]
Toothpaste Manufacturing and Production Equipment - Making.com
Making toothpaste is a very straightforward process; just mix together water, abrasives, humectants, thickening and foaming agents, sweeteners, and flavors in ...
[160]
Toothpaste Manufacturing Process - a Step by Step Guide - Jochamp
Jul 28, 2024 · The first step in the mixing process is to put the liquid ingredients, such as sorbitol, glycerin, and water into a large stainless steel vat and mix.<|control11|><|separator|>
[161]
High-Shear Mixers for Toothpaste Manufacturing
Ultrasonic high-shear mixers provide high-intensity shear forces that provide thorough wetting of powders, uniform homogenisation of colloidal slurries and ...
[162]
Tube Filling Machine - NM 2003 - Norden Machinery
Tube filling machine for plastic, laminate and aluminium tubes 200 ppm ... The Nordenmatic 2003 filling machine can produce up to 200 tubes per minute with ...
[163]
https://jochamp.com/toothpaste-manufacturing-process/
[164]
Colgate-Palmolive Ships World's First Recyclable Toothpaste Tube
Colgate engineers figured out how to combine different grades and thicknesses of HDPE laminate into a tube that meets recycling standards, protects the product ...
[165]
Unilever Introduces Recyclable HDPE Toothpaste Tubes
The design of the recyclable tube has been approved by RecyClass, which sets the recyclability standard for Europe, as well as laboratories in Asia and North ...
[166]
Innovative Features of Airless Pump Toothpaste Dispenser That ...
Many are refillable, reducing plastic waste and encouraging the use of larger, more economical refill packs. Choosing airless pump dispensers helps reduce ...Missing: 10-15% | Show results with:10-15%<|separator|>
[167]
https://www.colgatepalmolive.com/en-us/news/first-of-its-kind-recyclable-toothpaste-tube
[168]
Patents related to striped toothpaste - IPBiz
Nov 7, 2010 · In 1990 Colgate-Palmolive was granted a patent (USPTO 4,969,767) for two differently-colored stripes. In this scheme, the inner pipe has a cone- ...Missing: gel | Show results with:gel
[169]
https://apackaginggroup.com/blogs/news/innovative-features-of-airless-pump-toothpaste-dispenser-that-make-them-a-must-have-for-modern-bathrooms
[170]
Toothpaste Tablets: Benefits, Opportunities, and What's Next
Sep 9, 2025 · From a branding perspective, tablets offer differentiation in a crowded category while aligning with consumer demand for eco-conscious products.
[171]
http://ipbiz.blogspot.com/2010/11/patents-related-to-striped-toothpaste.html
[172]
Toothpaste Market Size, Share, and Growth Forecast for 2025 - 2032
The market, valued at US$ 24.4B in 2025, is set to reach US$ 33.0B by 2032, driven by rising demand for toothpaste and oral care to fight plaque and tartar.Missing: Nielsen | Show results with:Nielsen
[173]
Toothpaste Market Size, Share & Trends Research Report, 2030
Oct 31, 2025 · Toothpaste Market size is projected to grow from USD 29.32 billion in 2025 to USD 32.45 billion by 2030, exhibiting a CAGR 2.05%.Missing: Nielsen | Show results with:Nielsen<|separator|>
[174]
Toothpaste Market Size, Share, Trends & Growth Report [2032]
The global toothpaste market size is projected to grow from $20.14 billion in 2025 to $29.06 billion by 2032, at a CAGR of 5.38% during the forecast period.Missing: Nielsen | Show results with:Nielsen
[175]
Middle East & Africa Oral Care Market Size and Share
Sep 10, 2025 · By product type, toothpaste led with 46.30% of the Middle East Africa oral care market share in 2024, while mouthwashes/rinses are advancing at ...
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Toothpaste Market Size, Share, Trends & Forecast to 2033
The global toothpaste market size was valued at USD 21.53 billion in 2024 and is projected to grow at a CAGR of 3.43% during 2025-2033.