Will toothpaste develop "drug resistance"? Do you need to change it frequently?

Are you used to using the same toothpaste all the time, or do you change it frequently? As a representative of the former, when I was reminded a few days ago that "toothpaste needs to be changed frequently to avoid drug resistance", my first reaction was... it seems to make sense! However, in the spirit of seeking truth, I still consulted relevant experts. However, I didn't know until I asked. It turned out that there are so many unknown truths about toothpaste!

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01

Does toothpaste resistance exist?

Is it necessary to change it frequently?

Currently, toothpastes available on the market are mainly divided into two types: ordinary toothpaste and functional toothpaste[1]. The main function of ordinary toothpaste is cleaning, and its ingredients include abrasives, detergents, and wetting agents. Among them, abrasives account for 30-55%. Its main function is to polish the tooth enamel through the mechanical friction of the toothbrush, remove plaque and tartar attached to the surface of the teeth, make the mouth clean and refreshed, and also have a certain whitening effect. Since ordinary toothpaste does not contain drugs, there is no problem of drug resistance.

Functional toothpaste is a kind of ordinary toothpaste with certain functional ingredients added, such as drugs or chemical preparations with anti-caries, whitening, antibacterial and anti-inflammatory effects. Compared with ordinary toothpaste, they have some special effects, but long-term use of the same functional toothpaste may also cause some oral problems. For example, long-term use of toothpaste with peroxide-assisted whitening ingredients can easily cause enamel damage, expose dentinal tubules, and lead to tooth sensitivity [2].

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Therefore, there is no problem of drug resistance when using ordinary toothpaste, so you can be more dedicated; but when using functional toothpaste, you should pay attention to replacing it regularly to prevent excessive intake of added ingredients and cause oral problems, so you might as well be evenly distributed.

02

Popular "fresh breath" toothpastes on the market

Can the problem of bad breath be solved?

Most of the "bad breath" we talk about is oral halitosis, including untreated caries, poor restorations, pulp necrosis or suppurative pulpitis, and odors produced by dental plaque and bacterial fermentation. In addition, non-oral factors such as constipation, poor liver function, kidney disease, and protein indigestion can also cause halitosis.

The "fresh breath" toothpaste that is popular on the market now mainly suppresses bad breath by removing the pathogenic microorganisms that cause bad breath, the toxins they produce, and the odorous compound gases in the mouth, thereby achieving the effect of freshening breath, which is a "symptomatic treatment". To completely solve the problem of bad breath, you still have to first figure out whether the main cause of the "bad breath" is oral or non-oral, and then treat the specific cause, so that you can truly "cure the root cause."

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03

Can whitening toothpaste really make teeth whiter?

There are three main principles by which whitening toothpaste makes teeth look whiter: first, the abrasive contained in the toothpaste physically rubs against the tooth surface to remove stains attached to the surface; second, adding chemical bleaching agents such as peroxide to oxidize the stains on the tooth surface to achieve a whitening effect; third, adjusting the visual effect, for example, by adding blue pigment to make it temporarily adhere to the tooth surface to make the teeth look whiter.

Obviously, only the first two types really whiten teeth, but the whitening effect is not very thorough. As long as you stop using toothpaste, your teeth will return to their original color. Article 77 of the "Regulations on the Supervision and Administration of Cosmetics" that came into effect on January 1, 2021 clearly stipulates that toothpaste is a common cosmetic. After efficacy evaluation, it can only be claimed that toothpaste has the effects of preventing caries, inhibiting dental plaque, resisting dentin sensitivity, and alleviating gum problems, and cannot promote whitening effects [3]. Therefore, if you hope that whitening toothpaste can help whiten your teeth, the result will definitely be disappointing, and this kind of publicity can only be called "nonsense".

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04

Why do many toothpastes contain fluoride?

Fluoride toothpaste is a regular toothpaste with an appropriate amount of fluoride added. On the one hand, fluoride ions can increase the integrity of tooth enamel crystals. On the other hand, by replacing fluoride ions into the hydroxyapatite crystals of tooth enamel, fluoride apatite that is insoluble in acid can be formed, thereby enhancing the tooth's anti-caries ability. For ordinary adults, it is still recommended to use fluoride toothpaste.

However, excessive intake of fluoride also has side effects. For people living in high-fluoride areas, the local drinking water and food carry more fluoride. After entering the human body through diet, it can meet the needs of preventing tooth decay, so there is no need to use fluoride toothpaste. In addition, children are prone to fluorosis when using fluoride toothpaste, so we generally do not recommend children under 3 years old to use fluoride toothpaste.

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05

At what age can a baby use toothpaste to brush his teeth?

Brushing teeth with toothpaste can effectively prevent tooth decay in children, but it is recommended to use gauze or finger toothbrush to clean the mouth before the teeth grow fully, so as to avoid damaging or bleeding the sensitive gums of young children. Wait until the children's teeth are basically grown, and then use toothpaste and toothbrush to help them brush their teeth.

In addition, children's tooth enamel is relatively soft and easily damaged by the chemicals in toothpaste. At the same time, toothpaste contains a certain amount of preservatives, which will be swallowed by children when brushing their teeth due to their imperfect swallowing function. Therefore, it is recommended to use children's toothpaste, and it is best to choose fluoride-free or low-fluoride toothpaste to avoid fluoride poisoning. If you only swallow a small amount of toothpaste occasionally, it will not have a significant impact on your health and you don't need to worry too much.

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06

How much toothpaste should you squeeze out each time you brush your teeth?

The main function of toothpaste is to increase the friction between the toothbrush and the teeth, thereby enhancing the cleaning ability. For ordinary people, a pea-sized (about 5 mm in diameter) of toothpaste is enough to help clean the surface of the teeth. Moreover, too much toothpaste will cause the foam to foam too quickly, making people mistakenly believe that bacteria can be found wherever the foam passes, which will unconsciously shorten the brushing time and affect the brushing effect. The long strip of toothpaste that is often squeezed out in advertisements is just to show the texture of the toothpaste more fully. When brushing your teeth, you should still control your hands to avoid waste and unpleasantness.

References:

[1] Liu Ting. Clinical efficacy study of two whitening toothpastes[D]. Dalian Medical University, 2016.

[2] Wang Peng. Anti-inflammatory toothpaste should be changed frequently[J]. Family Science and Technology, 2007(06):30.

[3] Regulations on the Supervision and Administration of Cosmetics, State Decree No. 727

Author: Yuan Zhiqin, Associate Professor, Beijing University of Chemical Technology

Review | Xiong Bin Associate Professor, College of Chemistry and Chemical Engineering, Hunan University

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