Dental care: How to choose toothpaste for our dental care: toothpaste with or without fluoride? let’s explore the subject together.


To make the difference in dental care are first and foremost the toothbrush and dental floss. The toothpaste is aimed at the aesthetic and health maintenance and cleaning of the teeth: it can be a good adjuvant to remove plaque, reduce the predisposition to tooth decay and to make the brushing action more pleasant, also encouraging children to oral care. Generally it can be found in the form of gel or pasta.

Fluoride Toothpaste: what the Italian Ministry of Health says

According the guidelines of the Italian Ministry of Health: “for adults it is preferable to have a toothpaste that contains between 1000 and 1500 ppm of fluoride, while for children from 3 to 6 years old the adequate content should not exceed 500 ppm. toothpaste with fluoride is a primary means of administration in the prevention of caries (Garrison et al., 2007; Walsh et al., 2010; Wong et al., 2011; Tubert-Jeannin et al., 2011). Under 3 years old it is preferable not to use fluoridated toothpastes “.

Two necessary clarifications: on fluoride toothpaste label for children between 3 and 6 years is specified that it should be taken under supervision of an adult who checks that it is not swallowed. Under 3 years of age, it is not recommended because not knowing how to effectively control the swallowing reflex, they tend to accidentally ingest part of the toothpaste, with consequent systemic absorption. Excessive and long-lasting fluoride intake (fluoridated water, toothpaste, fluorinated supplements, formula milk) during pediatric age can cause dental fluorosis, a pathology manifested by enamel stains (Ismail & Asson, 2008; Hujoel et al., 2009; Wong et al., 2010; Berg et al., 2011; Buzalaf & Levy, 2011; Lee & Brearley Messer, 2011; Chou et al., 2013).

Fluoride Toothpaste: differences of opinion

For many years the use of fluoride in caries prevention has been criticized by many parties until being considered useless if not harmful. In Italy some critics have collected their studies and their research in books, such as Lorenzo Acerra “Fluoro. Danger for teeth, poison for the organism”, 2003 and Dr. Giorgio Petrucci, doctor of chemistry and teacher ” The dangers of fluoride: Toccasana or industrial waste? ” (2004), E. L. Iorio in “The physiological oxygen modulation on demand. The last challenge of nutraceuticals” (2015).

“Other than preventing tooth decay, the intake of fluoride, a byproduct of the nuclear industry (whose disposal would be too expensive …), seems to be a serious health risk” critics say. Fluorine is an extremely toxic substance at exceptionally low doses and it is not possible to control the daily intake of fluoride (which depends on: food and beverage intake of the food industry, pesticide residues in food, type of mineral water chosen) , used mouthwash, drinking water, drugs, chewing gum, etc.) and when you brush your teeth with fluoridated toothpaste, fluoride, although in very small quantities, is still swallowed every day. Also for these reasons, they consider the use of fluorine based supplements absolutely inadvisable, also because, absorbed by mouth, fluoride enters the tooth through the blood and alters the structure of the tooth itself, thus favoring dental fluorosis.

Dental care: Certain systemic effects of fluoride documented and risks

The fluoride ion is very similar to metals such as: calcium, magnesium, manganese and therefore it follows that it is a very active inhibitor towards the enzymatic systems that contain these elements. For example: fluoride has an inhibitory effect on the thyroid gland both due to antagonism on the iodine, necessary for thyroid hormones, and for the action on thyroid metabolism linked to calcium. Likewise the action of magnesium in energy production and of manganese, essential for sexual activity, is altered. The fluoride ion has a remarkable affinity also for aluminum and aluminum and is associated with Alzheimer’s disease and its presence in the brain is considered a triggering factor (Wurtman, 1985). Aluminum, introduced into our body through drinking water, drugs, foods, vaccines, etc., and an element very similar to fluoride, together with it creates soluble complexes which are then absorbed by the body (Wilhelm et al., 1996) : in this way aluminum can penetrate the blood-brain barrier (Varner et al 1998).

The fluoride ion inhibits glucose-6-phosphate dehydrogenase, a fundamental enzyme for the detoxification of reactive peroxidant species such as hydrogen peroxide and other radicals deriving from drugs (eg sulfonamides, antimalarials); moreover, the fluoride ion, interacting with the hydrogen bonds of the amino acids of the protein structures and with those present between the nucleotides, is a potential mutagenic agent (Nieuwkoop et al., 2005).

According to research by the NCR (National Research Council), there are risks to the brain (already 1 ppm of fluorine can produce learning deficiencies and concentration difficulties in children) and for the thyroid (already 0.01 – 0.03 mg of fluorine per Kg per day can reduce thyroid function in people with low iodine, this reduction can lead to a decrease in mental acuity, depression and body weight gain). Fluorine is risky for bones as it reduces their resistance and exposes them to fractures (for now the only data available concerns doses over 1.5 ppm) and not only: animal and human studies, including studies by Harvard University have established with certainty the connection between fluoride and bone cancer (osteosarcoma). See also the report prepared by the National Toxicology Program.

Dental care: How is a toothpaste made?

Among the basic components there are: abrasives (for example: Hydrated Silica, Sodium Bicarbonate, Calcium Phospate), whose function is to remove stains or food particles and substances that could cause the enamel to yellow; surfactants, necessary for their detergent and foaming properties and to dissolve other ingredients that are not soluble in water (be careful, however, there are delicate and aggressive surfactants especially for the gums: sodium lauryl sulfate is aggressive!); fluoride if you choose a toothpaste with fluoride.

Then there are the additional active ingredients, natural or synthetic according to your choice, which are usually: – antibacterials to prevent plaque and gingivitis / Ph regulators to create an unfavorable environment for the life of bacteria by preventing plaque and gingivitis; attention because among the most widespread and well-known antibacterials on the market there is Triclosan, a somewhat debated ingredient as it prevents plaque and gingivitis, but its persistence to accumulate in organisms has been certified, traces of it have even been found in breast milk, and even if the quantity is low, it is feared that over time it may strengthen the bacteria against the action of common antibiotics. Among the Ph Regulators there are instead ingredients such as Sodium / calcium Phosphate, Sodium Hydroxide, Sodium Bicarbonate, which act by sequestering calcium and magnesium ions that otherwise would settle on the enamel and are added to keep acidity and alkalinity under control. of products; other additional principles: – preservatives (necessary to avoid deterioration of the products, given the presence of water in the composition of toothpastes; – aromas: it is thanks to these that after washing we perceive a pleasant sensation of freshness. They can be both of natural origin and synthetic; – dyes, marked with the initials CI, which are however completely useless ingredients and which only serve to increase the attractiveness of the products in the eyes of consumers.

A natural fluoride free toothpaste: an alternative to the toothpaste on the market

We believe it is right to give a possible alternative to the fluoride toothpastes that are so abundant on the market, for a wider choice, at least for those who are not subject to continuous caries problems. There are many examples of production with fluoride-free toothpaste on the Italian market.

There are also natural toothpastes without fluoride on the market, however effective. On the other hand, the search for the natural in dentistry is so strong that the term phyto-dentistry has been coined for some time. In dentistry, phytotherapy has been used with anti-inflammatory, antibiotic, analgesic, sedative effect and also as an irrigant in endodontics and periodontology. There are many plants that have a beneficial action on the tissues of the oral cavity and there is a wide range of medicinal plants added to toothpastes and mouthwashes with antimicrobial action. As well as plants that promote tissue healing and contribute to the improvement of bad breath.

INCI contains the components of common toothpastes but the ingredients are natural, with the same actions as synthetics. We at recommend choosing those with a fairly short INCI and obviously we recommend choosing a natural toothpaste, without petrolatum, dyes, sodium lauryl sulfate. For example, we have selected for our customers this certified natural toothpaste with excellent herbal ingredients and natural non-cariogenic sweeteners. In fact, even natural toothpastes, as for synthetic ones, contain basic components and additional ingredients, but not aggressive or even harmful. You can also combine it with our Propolsan natural mouthwash.

If you prefer fluoride toothpaste, remember to take the necessary precautions for you and your children: avoid ingestion, even minimal.

Dr. Laura Comollo

Visit our natural cosmetics department for any clarification or for more information about dental care.

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