From the Amereican Dental Association ( ADA):

Good Morning America Segment on Microbeads in Toothpaste

ABC’s Good Morning America (GMA) contacted the ADA for a segment that aired today on microbeads (polyethylene) in toothpaste. All of the varieties of Crest ProHealth® toothpaste which have earned the ADA Seal of Acceptance contain microbeads.

The ADA provided a press statement to the GMA producer indicating, “According to the American Dental Association, clinically relevant dental health studies do not indicate that the ADA Seal should be removed from toothpastes that contain polyethylene microbeads. Products with the ADA Seal have been independently evaluated for safety and effectiveness by the ADA Council on Scientific Affairs.”

Local news stations, including ABC 7 Chicago, have previously reported on microbeads from health and environmental angles. Procter & Gamble (P&G), the manufacturer of Crest ProHealth®, includes information for the public on their website and has indicated they plan to remove microbeads from toothpaste.

According to P&G, “While the ingredient in question is completely safe, approved for use in foods by the FDA and part of an enjoyable brushing experience for millions of consumers with no issues, we understand there is a growing preference for us to remove this ingredient. So we will. Crest will continue to provide consumers with effective and enjoyable products which are designed to their preferences.”

The following suggested talking points may help you discuss the issue with your patients should they ask you about microbeads in toothpaste:

• Microbeads have been in the news lately. You may have heard about it in connection with toothpaste.
• Microbeads are most often used as scrubbing beads in exfoliating skin care products.
• The FDA has approved microbeads as a food additive, and small quantities, which appear as colored specks, are in some of Crest’s toothpastes, including Crest Pro Health, which has the American Dental Association Seal of Acceptance.
• According to the ADA, clinically relevant dental health studies do not indicate that the ADA Seal should be removed from toothpastes that contain microbeads.
• Products with the ADA Seal have been independently evaluated for safety and effectiveness by the ADA Council on Scientific Affairs.
• While there is no clinical evidence that microbeads in toothpaste are harmful to your dental health, Crest is voluntarily withdrawing the ingredient from toothpaste in response to growing consumer preference.
• As your dentist, my goal is to help you achieve optimal dental oral health. Whenever you have questions about any dental care product, feel free to talk with me.
• Brushing two minutes twice a day with fluoride toothpaste and flossing daily are important ways to take care of your dental health.

Some concerns have been raised about the safety of triclosan, an ingredient in Colgate Total toothpaste. At present it is believed to be safe in the amounts used, though the EPA is looking into data concerning the endocrine effects, developmental and reproductive toxicity, chronic toxicity and carcinogenicity. There are also concerns about the possibility of Triclosan contributing to making bacteria resistant to other bacteria.

Triclosan has been shown to be effective in preventing gingivitis.  Colgate’s website refutes some of the research claims about carcinogenicity and endocrine effects, and offers the extensive research which supports the use of Triclosan in toothpaste. It remains to be seen then, whether further research will continue to  vindicate its use in toothpaste.

This information comes from the United States Environmental Prtoection Agency factsheet on Triclosan,  the the U.S. Food and Drug Adminstration Factsheet, and Colgates’s website.

Very few communities in New Jersey have water fluoridation.  As such, the benefits of fluoride for the prevention of tooth decay must be obtained through other means. For children, this is in the form of an ingestible source, typically a vitamin with fluoride added, or simple fluoride drops. To avoid excess fluoride consumption the following recommendations have been made. It breaks down into three columns of possible external sources of fluoride consumption, such as bottled water, or areas where fluoride occurs naturally in drinking water.

It should be noted iingestible fluoride is only of benefit when the teeth are being formed and the fluoride can become incorporated within the enamel .  After teeth have erupted, ingestible fluoride is of no use, and only topical applications of fluoride are of benefit, such as toothpaste and/or fluoride applications or rinses.

We have been amalgam free for over twenty years now.  Ever since I attended a lecture given by John Kanca on bonding and avoidance of amalgam fractures back in 1992, I put my stock of mercury and silver on the shelf and used the composite resin: tooth colored, bonding materials.  With one exception, most of the different brands have held up very well. I dropped amalgam from use, not from any fear about toxicity or safety, but for biomechanical reasons.  I do believe amalgam is safe when properly placed by a clinician.  However, there is no question amalgams weaken teeth  and can set them up for fractures. Bonding composite  can be more conservative, and can help hold a tooth together better.  However, even bonding (resins/composites) have their limitations, and there is concern about bis-phenol A in the oral environment.  Gold still remains the most biocompatible  material, and has the longest longevity. Of course, not many people want to show off the “bling” in their mouths, and would rather show it off on their wrist, ears, lapels, etc.

The future of dental restorative materials may  fall by the wayside,  With stem cell harvesting, the future may bring the genetic manipulation to the forefront and relegate tooth repair to the rear.