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How to choose a toothpaste and should you use a mouthwash?


Choosing the correct toothpaste is key to your daily oral health routine. There is a wide variety of toothpastes and some are designed for specific conditions. This article will explain the differences to help you choose the best one for you.

Dentists mostly recommend toothpaste containing 1450 parts per million fluoride. Small amounts of fluoride are naturally found in water but rarely in therapeutic concentrations. It is clinically and scientifically proven that fluoride (in the right concentration) protects teeth from decay by becoming incorporated into the enamel and dentine and making the tooth more resistant to acid attack; that's why it is the main active ingredient of most toothpastes. Some patients, for a variety of reasons, avoid fluoride and there are fluoride free toothpastes available but for the prevention of caries (tooth decay) dentists do not generally recommend them.

Young children typically swallow toothpaste and so to avoid ingesting high amounts of fluoride it is often recommended that they use ones containing lower doses of fluoride. However, the lower amount of fluoride may not be enough to prevent decay so it is probably easier to just reduce the amount of toothpaste placed on the toothbrush.

There are also so called "whitening" toothpastes which are popular as a bright, white smile is much sought after. They are generally more abrasive than regular toothpastes and they scrub away superficial stains as well as enamel which will after a while expose dentine (the main tooth structure) which is more yellow in colour; so paradoxically the more you brush the yellower your teeth will become! So try to avoid whitening toothpastes and instead use a toothpaste which repairs and protects the enamel. For people who suffer from acid erosion, Sensodyne Pronamel is useful as it contains no abrasive particles and toothpastes like Sensodyne Repair & Protect and Regenerate contain calcium and phosphate (minerals from which enamel and dentine are made) which help to replace lost tooth minerals.

If you suffer from hot/cold/sweet sensitivity consider using a de-sensitising toothpaste like Colgate Sensitive Pro-Relief. These types of toothpaste act by blocking open dentine tubules which lead to the nerve tissue. However, if sensitivity persists then you should visit a dentist to exclude decay or any serious tooth problem.

Patients who suffer from frequent tooth decay can use toothpastes which contain more than 1450ppm fluoride. Colgate produce a range of toothpastes which contain 2800ppm and 5000ppm fluoride but these are only suitable for older patients.

You can use electric as well as manual toothbrushes with any type of toothpaste but do read the manufacturer's recommendations as to frequency of use and age recommendations.

When using any toothpaste remember:

Brush, spit and don't rinse!

This allows a little fluoride to remain on the tooth surface which is more likely to be absorbed and thus make it more resistant to acid attack.

Recently, an innovative new toothpaste has been developed by British researchers. It is called BioMin and comes in a fluoride and non-fluoride variety. Like other toothpastes it helps to make teeth more resistant to acid attack but its unique ingredients mean that less fluoride is necessary and the protection is more effective.

Take a look at this video for more information on Biomin:


Adding a mouthwash to your oral hygiene routine may be beneficial in certain circumstances. However, mouthwashes are not a substitute for mechanical cleaning.

Mouthwash can freshen your breath, help to heal sore gums or add extra fluoride protection if you suffer from tooth decay.

Whenever possible, choose an alcohol-free mouthwash (AF). If you are looking to relieve minor gum irritations, mouthwashes containing chlorhexidine or hydrogen peroxide are useful and also have antibacterial properties. If irritations won't heal within a week please visit your dentist.

Use a mouthwash at a different time to brushing; for example two hours after brushing your teeth. This is because most toothpastes contain sodium lauryl sulfate which inactivates chlorhexidine. A fluoride containing mouthwash will be more beneficial at a different time to brushing as the duration of fluoride exposure will be longer than if you used it straight after brushing (otherwise it's like brushing your teeth twice).

When using mouthwash, just like with toothpaste, spit and don't rinse.

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