Toothpaste: What’s in it?

(DetoxifySamurai) Toothpaste is something everyone uses each day and night, it cleans our teeth, helps ensure we have fresh breath and is part of our daily routine, but how many of us really know whats in it?  By the end of this post you will.  We will look at what are in the two most popular brands.  Colgate by Colgate-Palmolive and Crest by Proctor and Gamble.  The ingredients listed are from the manufacturer’s own websites.

Theses are the active ingredients in Colgate Total Advanced Deep Clean toothpaste:  Sodium Fluoride .024%, Triclosan 0.30%. The inactive are: Hydrated silica , water, glycerin, sorbitol, PVM/MA copolymer, sodium lauryl sulfate, cellulose gum, sodium hydroxide, carageenan, polypropylene glycol, sodium saccharine, titanium dioxide.

The active ingredients in Crest ProHealth Toothpaste are: Stannous Flouride (percent not listed).  The inactive ingredients are: Glycerin, Hydrated Silica, Sodium Hexametaphosphate, Propylene Glycol, PEG 6, Water, Zinc Lactate, Trisodium Phosphate, Flavor, Sodium Lauryl Sulfate, Sodium Gluconate, Carrageenan, Sodium Saccharin, Polyethylene, Xanthan Gum, Mica*, Titanium Dioxide, Blue 1.

So, what exactly are these ingredients:

Colgate

Fluoride

How frequently have we heard endlessly repeated that fluoride in our toothpaste and water is there to protect our teeth?  I did from when I was very young from television advertisements, dentists, and my school, where they gave us those red tablets that showed us where the plaque was and told us to go home and brush our teeth better, which probably wasn’t a bad suggestion in itself, except they usually admonished us about using a fluoride toothpaste and followed with a minty fluoride rinse.  The only problem with this is they didn’t tell us that fluoride is an industrial waste product, which is classified as a drug by the FDA, it is toxic, has little effect in reduction of cavities and has been proven to be linked to several health issues and even to lowering of IQ in children.  Apparently this information, at least in their mind, was to trivial to mention or they simply were repeating mis-information they had been told.

The most common source of fluoride in toothpaste is sodum fluoride, but stannous fluoride, olaflur (an organic salt of fluoride), and sodium monofluorophosphate are also used.  Fluoride-containing toothpaste can be acutely toxic if swallowed in large amounts which should be very concerning.  Approximately 15mg/kg body weight is the acute lethal dose, even though as small amount as 5mg/kg may be fatal to some children.  Supposedly the risk ingesting enough fluoride to kill you is low enough that the use of ‘full-strength’ toothpaste (1350–1500 ppm fluoride) is advised for all ages but what if you brush normally like most people are there other risks?  The answer is yes.  If we look a little deeper a disturbing picture emerges so lets look at the facts, research, opinion papers, and relationship of fluoride to dental health and its use in our toothpaste and water supply.

Worldwide Fluoridation of water to prevent cavaties

Most developed nations and 97% of western Europe, do not fluoridate their water to prevent cavities.  According to the The Water Fluoridation Status of OECD (Orginization for Nations, the countries with zero percent of fluoridation include: Austria, Finland, France, Germany, Greece Iceland, Italy, Japan, Mexico, Norway, Poland, Sweden, Switzerland, and others .  There are more people drinking fluoridated water in the United States than the rest of the world combined.  Some interesting case are worth a closer look.

• Japan had three experiences with water fluoridation. The first fluoridation program was in Kyoto prefecture (1952–1965), the second was established by US military authorities (after blasting the two largest population centers in Japan with the worlds first atomic weapons in WWII only a few years later they are interested in Japanese dental health?) in Okinawa prefecture (1957–1972), and the last experience was in Mie prefecture (1967–1971). Water fluoridation has not been practiced in Japan since 1972.
• Israel’s largest cities implemented water fluoridation in 1981, this was reversed in July 2013 by the Israeli Supreme Court which ruled on new regulations by the Minister of Health, which will put an end to all fluoridation – mandatory or voluntary.  However, in March 2016 the new Minister of Health announced that all municipal water supplies would be fluoridated again which was to be completed in six months.
• In communist China water fluoridation is banned.  It was tested in one urban center in 1965 and was halted in 1983.  As of 2003 there was no water fluoridation in China.
• In India water fluoridation is not practiced.  Due to naturally-occurring fluoride the government has been obligated to install fluoride removal plants of various technologies to reduce fluoride levels from industrial waste and mineral deposits.

Fluoride in the USA is an industrial waste product.

Until recently, in the US all water fluoridation chemicals were obtained from the wet scrubbing systems of the phosphate fertilizer industry. These “wet scrubbers” were installed as a result of both litigation and regulation to trap the fluoride gases which previously were vented into the atmosphere. The collected liquid in these scrubbers (hydrofluoroslicic acid) is entered into storage tanks and shipped to water departments throughout the country.  In recent years, however, an increasing number of water departments have begun purchasing their fluoride chemicals from China.  A country that is notorious for poor environmental pollution standards.

In 2000, Dr. William Hirzy, the senior vice president of EPA’s Headquarters Union of Scientists and Professionals, stated:  ”If this stuff gets out into the air, it’s a pollutant; if it gets into the river, it’s a pollutant; if it gets into the lake it’s a pollutant; but if it goes right into your drinking water system, it’s not a pollutant… There’s got to be a better way to manage this stuff.”

Although the fluoride compounds found in toothpaste or supplements may be “pharmaceutical grade” it would still be considered a pollutant by the EPA whether it was from wet scrubbing systems or a chemical lab.

Fluoride is classified as a drug.

When you look at the ingredients panel on your box of toothpaste have you noticed that it reads Drug Facts and then lists fluoride as the active ingredient?  Yes fluoride is a drug which is regulated by the FDA.  This was stated as far back as 1963 in a letter from the Dept. of Health, Education and Welfare stated that “Sodium Fluoride used for therapeutic effect would be a drug, not a mineral nutrient.”  This was confirmed in 2000 in a letter from the FDA to a member of the House of Representatives asserting that “Fluoride, when used in the diagnosis, cure, mitigation, treatment, or prevention of disease in man or animal, is a drug that is subject to Food and Drug Administration (FDA) regulation.”

Fluoride has negative health affects including the lowering of IQ.

You may be familiar with Erin Brockovitch who successfully sued Pacific Gas and Electric Company in 1993 alleging contamination of drinking water with hexavalent chromium.  Her successful lawsuit was the subject of a 2000 film, Erin Brockovich, which starred Julia Roberts.  She also expressed her feeling about water fluoridation in a letter to National Academy of Sciences in 2015.  In that letter she discussed the chemical toxicity of fluoride and wrote “Chemists characterize fluoride as a poison. Fluoride is included in toxicology compendiums and it has been labeled a neurotoxin. Fluoride is more toxic than lead and only slightly less toxic than arsenic.”  Regarding dentifrices she observed that fluoride is simply an enzyme inhibitor that weakens or kills bacteria and that in 2013 studies there was only weak evidence of topical effectiveness.

Dr. Phyllis Mullenix, Ph. D. worked at the Department of Neuropathology at the Harvard Medical School and later at the Forsyth Dental Infirmary for Children in Boston.  She was brought to Forsyth to look at the environmental impact and the toxicity of products that are used by dentists and the dental community using new computer pattern recognition system. In particular fluoride, mercury, nitrous oxide, and others.

In 1995 she published an important study in the Neurotoxicology and Teratology on the neurotoxic effects of fluoride in rats.  What she found was that sodium fluoride given to adult rats would develop changes in their behavioral pattern which was hypo-activity or under-activity.  She said they became slower “couch potatoes”.  According to her this was strikingly similar to the pattern that she had seen in substances or drugs that they used to treat acute lymphocytic leukemia in children, which clinically cause IQ deficits.  When a pregnant mother rat was given fluoride the pups were born with a permanent change but they were hyper-active or over-active.  What she also found was that there was major accumulations of fluoride in the brain which she said was a big surprise and very disturbing.  After this information was published she was fired by Forsyth for “reasons that changed over a period of time” and that looking into the safety of fluoride was not “their idea of science”.  In addition all funding was immediate cut for her research.

The U.S. Army Medical Command asked for Dr. Mullenix’s expert opinion in 1999 on fluoridating the water supply at Fort Detrick, Maryland.  In her response she noted that her studies “concluded that the rat study flagged potential for motor dysfunction, IQ deficits and/or learning disabilities in humans.”  Also, that her associate Dr. Hodge during work on the atomic bomb requested funding to determine central nervous
system effects of fluoride. He had clinical evidence that the fluoride component of uranium hexafluoride caused “mental confusion, drowsiness and lassitude among the workmen. Yet, he never got to do those studies, and because the information was classified.

Triclosan

Triclosan (TCS) was patented in 1964 and is used as an antibacterial and antifungal agent found in consumer products, including toothpaste, soaps, detergents, toys, and surgical cleaning treatments.  Its efficacy as an antimicrobial agent, the risk of antimicrobial resistance, and its possible role in disrupted hormonal development remain controversial.

In the Fourth National Report on Human Exposure to Environmental Chemicals (Fourth Report), CDC scientists measured triclosan in the urine of 2,517 participants aged six years and older who took part in the National Health and Nutrition Examination Survey (NHANES) during a period from 2003–2004.  Scientists can estimate the amount of triclosan that has entered people’s bodies by measuring triclosan in urine.  The results showed that triclosan was detected in the urine of nearly 75% of the people tested.

The FDA announced that effective September 2017, it would prohibit the sale of “consumer antiseptic washes” containing triclosan marketed as antimicrobials due to the FDA’s findings of the lack of efficacy, however this did not include toothpaste.  That’s because the best-selling toothpaste brand, Colgate Total, convinced the F.D.A. that the benefit of triclosan in toothpaste outweighs any risks.  Toothpastes that contain triclosan have been “demonstrated to be effective at reducing plaque and gingivitis,” said Andrea Fischer, an F.D.A. spokeswoman.  Before approving the toothpaste in 1997, the agency requested that the Colgate-Palmolive company conduct toxicology studies, and the F.D.A. ultimately decided it was safe and effective.  Apparently the FDA did not see a conflict of interest by letting the company perform on its own safety tests for a product they are seeking approval for and profiting from.

This changed in 2010 when Representative Edward Markey released a letter quoting the FDA’s assertion that, “Existing data raise valid concerns about the [health] effects of repetitive daily human exposure to these antiseptic ingredients [triclosan]”.  Rep. Markey also noted that a review of the substance under the Endocrine Disruptor Screening Program (EDSP) provided evidence of its endocrine disrupting potential.  Triclosan is also banned or restricted in several other countries, including the EU, which recently banned triclosan’s use in products that come into contact with food.

The Natural Resources Defense Council had this to say about Tricolsan:

“The dangers of triclosan (and a related antibacterial chemical, triclocarban) are many. For starters, it’s an endocrine disruptor, meaning it interferes with important hormone functions, which can directly affect the brain in addition to our immune and reproductive systems. Specifically, the chemical disturbs thyroid, testosterone, and estrogen regulation, which can create a host of issues including early puberty, poor sperm quality, infertility, obesity, and cancer. Studies have also shown it can lead to impaired learning and memory, exacerbate allergies, and weaken muscle function. The impacts of prolonged exposure during fetal development, infancy, and childhood can be particularly severe, resulting in permanent damage.”

Both Proctor & Gamble and Johnson & Johnson are either eliminating or phasing out tricolsan from the product lines.  Apparently, Colgate-Palmolive didn’t get the memo.

Look for Triclosan as an ingredient in antibacterial items which are considered over-the-counter (OTC) drugs such as soaps, and toothpastes then avoid it for more natural alternatives.

Hydrated Silica

A form of silicone dioxide which is also known as silicic acid.  It is made from the mineral opal and its derivative know as silica gel is used as a desiccant to absorb moisture.  In its pure form it is an odorless, tasteless, white gelatinous substance that is manufactured for toothpaste.  Most toothpastes use hydrated silica as the grit that polishes teeth and the whiting ingredient in whitening toothpastes.  Why is  this a problem?  A look at the Mohs scale of mineral hardness provides the answer.  Quartz or silica has a hardness of 7 while Apatite, the major component of tooth enamel and bone mineral, is softer at 5.  The silica will wear away tooth enamel if overused or remineralization of the tooth via saliva is insufficient to regenerate the tooth’s enamel.  To avoid the abrasion problem look for components that scrub and polish teeth without the potential effects of silica. Other ingredients with a hardness of 3 or 4 would be calcium carbonate (calcite) or white clay.

Glycerin

Glycerin, also called Glycerol in its more pure form, is generally obtained from plant and animal sources where it occurs as triglycerides.  These triglycerides are treated with alcohol to produce the glycerol which is then used in medical, pharmaceutical and personal care preparations, mainly as a means of improving smoothness, providing lubrication, and as a humectant to prevent the loss of moisture. It is found in cough syrups, elixirs and expectorants, toothpaste, mouthwashes, skin care products, shaving cream, hair care products, soaps, and water-based personal lubricants.

The Environmental Working Group (EWG) classifies the risk as low for non-reproductive organ system toxicity, bio-accumulation and multiple, added exposures.

One study by Operative Dentistry in 2005 evaluated glycerin as one of eight treatment agents tested on 80 sound and 80 de-mineralized enamel and dental fragments.  The results were that there was a tendency for lower micro-hardness values during treatment for all agents tested including glycerin and that glycerin (and the others tested) may change the micro-hardness of sound and de-mineralized dental tissue, even in the presence of saliva, which is responsible for the re-mineraliztion of teeth.

Sorbitol

Sorbitol is a sugar substitute and has approximately 60% of the sweetness of table sugar (sucrose) with most of it produced from corn syrup.  Since 88% of corn in the USA is genetically modified (GMO) it is almost guaranteed that GMO corn is used in the production of most Sorbitol production.  There are naturally occurring instances of it stone fruits and berries from 100-200 species of trees and shrubs in the sorbus category.  It is often used in diet foods, mints, cough syrups, and sugar-free chewing gum, mouthwash and toothpaste.  For the more adventurous individuals a mixture of sorbitol and potassium nitrate can be used to make rocket fuel.

An The American Journal of Gastroenterology performed a study in 1985 regarding sorbitol intolerance in adults and found that at high levels intolerance manifested as abdominal pain, bloating and diarrhea in children.  Based on their observations, they concluded that a large number of adults could be suffering from sorbitol-induced nonspecific abdominal symptoms and diarrhea. These symptoms could lead to an extensive diagnostic work-up and lifelong diagnosis of irritable bowel syndrome.

PVM/MA Copolymer (Maxcel MP995)

This ingredient comes straight out a Chinese chemical lab and is made by the Chemaxcel Corporation.  The company describes it this way, “PVM/MA Copolymer-SP/PP is generated by the hydrolysis of the Copolymer of Methyl Vinyl Ether/Maleic Anhydride. It is soluble in water, alcohols, phenols, forms a bioadhesive solution which can form highly polar tack-free films, performs excellent wet adhesive strength and bioadhesive, helps to control the formation and growth of tartar in the mouth.”  The way it does this is by binding to triclosan which makes it adhere to your teeth and gums longer where it can kill bacteria instead of being rinsed away.  It is also used in hair spray and classified as a “viscosity controlling hair fixing film forming emulsion stabilizing binding anti-static”.  Although this is classified as not expected to be potentially toxic or harmful to non-reproductive organs and non-bioacummulative by the Environmental Working Group its use is obsolete when more natural alternatives are available.

Sodium Lauryl Sulfate (SLS)

Sodium Lauryl Sulfate also know as Sodium Laureth Sulfate (SLS), or Sodium Lauryl Ether Sulfate (SLES) is a surface active agent or surfactant commonly found in toothpaste.  The properties of the SLS make it useful as a detergent which is a common component of many cleaning, personal hygene, cosmetic, and commercial cleaning products such as laundry detergents, engine degreasers, floor cleaners, and car wash soaps; a penetrant in varnish and paint removers; in the formulation of injection-molded plastic explosives; and a reference toxicant in aquatic and mammalian toxicological testing.  Its effectiveness is derived from its ability to remove oily stains and residues. 

For over 40 years beginning in 1948 it was registered as a pesticide by the EPA, Office of Prevention, Pesticides and Toxic Substances.  It was only delisted in 1989.  It was again petitioned to be used as a pesticide in 2006 to be used “as a non-selective herbicide to applied (sprayed) on weeds in the proximity of crops for organic production.”  Its effectiveness was based on its ability to work on contact and “kill susceptible insects by washing away the protective coating on the surface of the insect and by disrupting normal membrane functions inside the insect, causing cell contents to leak and resulted in the rapid death  of the sprayed insects.” Another attempt to use it as a pesticide was a patent application to the USPTO in 2009. 

The Environmental Working Group has shown the following concerns from research studies:

• Organ System Toxicity
• Irritant to skin, eye and lungs
• Environmental Eco-Toxicity

1,4-Dioxane contamination

Some products containing SLES contain traces (up to 279 ppm) of 1,4-dioxane, which is formed as a by-product during the ethoxylation step of its production.  The U.S. Environmental Protection Agency classifies 1,4-dioxane as a probable human carcinogen and a known irritant.  Under Proposition 65, 1,4-dioxane is classified in the U.S. state of California to cause cancer. The FDA encourages manufacturers to remove 1,4-dioxane, though it is not required by federal law.  The CDC indicates on its International Chemical Safety Cards that Dioxane is a “confirmed animal carcinogen” and that the substance “may have effects on the central nervous system, kidneys, and liver.  This substance is possibly carcinogenic to humans.”

The results of a study by The Chemical Abstract Service of the American Chemical Society earned SLS a Slightly Toxic rating when used orally.

The Journal of Medical Sciences conducted a study of SLS on the skin of rabbits for eight weeks and found that it where it was applied it produced hair loss, skin congestion, erosions and crusts where the skin was wrinkled and dried.  The rabbits were observed to be dull, depressed, emaciated with their feed intake markedly decreased.  Conclusions from the study were that SLS has the ability of stripping off the oil layer then irritating and eroding the skin, leaving it rough and pitted.  In addition, SLS can penetrate, enter the blood stream and be retained in the eye, brain, heart and liver with potentially harmful long-term effects.  Possibly the most serious of using SLS (SDS) is its tendency to react with other commonly used ingredients to form NDELA (N-nitrosodiethandamine), a potent carcinogen nitrosamine.

There was one study I could find that concluded that SLS is not a threat to human health and that “claims made to the contrary should be regarded as false and misleading” said five of six authors who “were, at the time of the writing of this manuscript, employed by and receiving salaries and research support from [company] which manufactures household cleaning products that contain Sodium Lauryl Sulfate.”  Not surprisingly the one author who was not employed by the company “received personal fees from  [and was funded by, the company] for her contributions to this manuscript as a scientific writer.”  No surprise there.

Cellulose Gum, (Carboxymethyl cellulose (CMC))

CMC is used in food as a thickener various products including ice cream, bread, chewing gum, margarines and peanut butter. It is also a constituent of many non-food products, such as toothpaste, laxatives, diet pills, water-based paints, detergents, textile sizing, and various paper products and in pharmaceuticals as a thickening agent in lubricating eye drops, and in the oil-drilling industry.  The major source fiber is either softwood pulp or cotton linter (seed hair).

A study done in 2016 by Georgia State university and published in the Cancer Research journal suggest that in mice low-grade inflammation in the intestine is promoted by consumption of dietary emulsifiers, which alter the composition of gut microbiota and correlates with metabolic syndrome. It demonstrates that regular consumption of dietary emulsifiers such as carboxymethyl cellulose (CMC) promotes “colitis-associated cancer” by exacerbating tumor development.  Articles have been written about the study  in The Sun, the Daily Mail, and Sunday Express.   The FDA allows CMC to be classified as dietary fiber on food labels since it is not significantly absorbed or digested.  If you feel you need fiber in your toothpaste, a natural source would be less risky.

Sodium Hydroxide (NaOH)

Also know as lye or caustic soda has a wide variety of uses.  Sodium hydroxide is used in many industries, mostly as a strong chemical base in the manufacture of pulp and paper, textiles, drinking water, soaps and detergents and as a drain cleaner.  Food uses of sodium hydroxide include washing or chemical peeling of fruits and vegetables, chocolate and cocoa processing, caramel coloring production, poultry scalding, soft drink processing, and thickening ice cream.  At one time it was used to rapidly decompose farm animal carcasses and road kill.  Due to its caustic properties the pure form needs to be handled with care.  So, what is it doing in your toothpaste?  The hydroxide portion of the compound when dissolved will react with acids to form water and therefore increase the pH by eliminating some of the acid. The FDA has it listed as Generally Recognized as Safe (GRAS) as an additive at maximum concentrations.  The Environmental Working Group fact sheet classifies it as expected to be toxic or harmful.  The CDC’s NIOSH fact sheet lists it as and irritant to eyes, skin, and mucous membranes.

Carrageenan (CGN)

Extracted from edible seaweed, Carrageenans are widely used in the food industry for their gelling, thickening and stabilizing properties and are considered a dietary fiber.  It is used in ice cream, sauces, soy milk, diet sodas, pet food, shoe polish, personal lubricants, shampoo and toothpaste as a stabilizer to prevent ingredient separation.   Oral feeding studies indicate that it passes through the GI tract and is not accumulated in the body organs such as the colon or liver.  In November of 2016 the National Organic Program (NOP) removed it from their list of food additives allowed in organic food production and items containing it can no longer be labeled as “organic.”  There are many studies on the additive and  conclusions about its effects vary. A study at the University of Iowa, College of Medicine noted that the widespread use of Carrageenan in the Western diet should be reconsidered because its use in animal and experimental models demonstrated carcinogenic properties and cancer-promoting effects of its use.  An article in Food and Cosmetics Toxicology found it produces ulceration in the large intestines of some animals but not others and that limited observation of humans finds it to be unlikely to be associated with ulcerative-colitis.   Another study from the Albany Medical College concluded that except for minor changes, no evidence was obtained for any direct effect on the liver or gastrointestinal tract.  With other studies weighing in on either side of the issue its effects are inconclusive.

Propylene Glycol

Propylene glycol is a synthetic liquid substance that absorbs water and is primarily used in the production of polymers such as plastics. It is used in a variety of items such as pharmaceuticals, e-cigarette, antifreeze, and edible items such as coffee-based drinks, liquid sweeteners, ice cream, whipped dairy products and soda.  The Food and Drug Administration (FDA) has classified propylene glycol as an additive that is “generally recognized as safe” for use in food.  The Environmental Working Group classifies it as a skin irritant and as expected to be toxic or harmful to non-reproductive  organs.  When ingested it is metabolized into pyruvic acid, acetic acid, lactic acid, and the hazardous substance pronpionaldehyde which is classified by Science Lab data sheet as very hazardous in case of ingestion and hazardous in case of skin contact.  According to the NIH compound summary no information is available on the acute (short-term), chronic (long-term), reproductive, developmental or carcinogenic effects of propionaldehyde in humans and the EPA has not classified it for carcinogenicity. In Europe, where the authorities are much more cautious, propylene glycol is limited to mostly non-food uses. What food uses are allowed are very limited.  The safety issue may be more directly related to exposed amounts over time.  Since it can be found in a wide variety of products minimizing exposure would be the safest option.

Sodium Saccharin

Saccharin is an artificial sweetener.  Products that use saccharin, such as Sweet’N Low®, are made from coal tar that is about 300–400 times as sweet as sucrose or table sugar, but has a bitter or metallic aftertaste, especially at high concentrations. It is used to sweeten products such as drinks, candies, cookies, medicines, and toothpaste.  It was first discovered in 1879 at John Hopkins University and commercialized not long after but its use was not widespread until its use in the 1960s and 1907s among dieters.  Due to a study linking it to bladder cancer in rats the package carried a warning label from 1977 to 2000 when it was removed due to allegedly improved testing methodologies and in 2010 the EPA too it off its list of hazardous chemicals.  The Center for Science in the Public Interest had a different opinion on the change noting that Studies indicate that saccharin causes cancer in the urinary bladder, lungs, ovaries, uterus, and other organs in animals and also increases the potency of other cancer-causing chemicals.  Also, mentioning that delisting saccharin will probably mean that more people — including children — will consume more foods with saccharin and have an increased risk of cancer and listing several other credible scientists who agreed from such organizations as the National Cancer Institute, National Academy of Sciences, and the Frederick Cancer Research Center, among others.  When the subject is cancer caution should always be the rule.

Titanium Dioxide (TiO2)

This compound is used as a pigment and it is widely used to provide whiteness and opacity to products such as paints, plastics, papers, inks, foods, and toothpastes.

An study from the American Association for Cancer Research about Titanium Dioxide nanoparticles with mice concluded that TiO2 nanoparticles are genotoxic, which means that it induces not only DNA damage but also chromosomal damage causing mutations, which may lead to cancer.  The data also provided evidence that, after oral administration, TiO2 nanoparticles induce DNA breaks in bone marrow cells.  Additionally, after oral administration in mice, TiO₂ particles were shown to translocate to systemic organs such as liver and spleen as well as lung and peritoneal tissues.

Another study from Nanoscale in 2015 on animals indicated significant nanoparticle accumulation in the brain and negative effects on neuron cell viability and functioning.  Cell mitochondria (energy producers) damage was also observed along with neurological dysfunction.

An Arizona State University research paper found that nanoparticles are found in a wide variety of products  with the highest in the personal care category found in toothpaste and suncreens.

In 2015 Dunkin’ Donuts decided to remove titanium dioxide from its powdered sugar donuts after a public interest group raised possible heath concerns regarding its use.  Look for more natural alternatives.

Crest

In addition to the ingredients above found in Colgate toothpaste, Crest brand also contains the following.

Sodium Hexametaphosphate (SHMP)

It is used as an active ingredient in toothpastes as an anti-staining and tartar prevention ingredient.  It is also used in foods as a preservative and to prevent the oxidation of fats including artificial maple syrup, canned milk, imitation cheese, packaged egg whites, roast beef, fish fillets, fruit jelly, frozen desserts, salad dressing, breakfast cereal, ice cream, beer, and bottled beverages.  The FDA classifies it as generally recognized as safe (GRAS).   A report in the International Journal of Toxicology noted that SHMP was not genotoxic in bacterial systems nor were they carcinogenic in rats. No reproductive or developmental toxicity was seen in studies using rats exposed to SHMP.  However, in in chronic studies using animals, growth inhibition, increased kidney weights (with calcium deposition), bone decalcification, parathyroid hypertrophy and hyperplasia, hepatic focal necrosis, and muscle fiber size alterations.  Rats  fed 10% Sodium Hexametaphosphate had pale and swollen kidneys.  The report admitted that SMP was corrosive but could be used safely at low concentrations.  Here is the full report. Another study validated these findings concluding that the main physiological effect of phosphate is vascular damage and calcification.  The exposure in toothpaste would be via oral absorption and possible ingestion. The problem here is if your exposure to SHMP is high enough without the proper balance of other minerals in your body, it can negatively impact your bones, kidneys, and heart.

Polyethylene Glycol (PEG 6)

Polyethylene glycol is a compound with many applications from industrial manufacturing to medicine.  In toothpaste is is use as a dispersant to prevent settling or clumping and binds water and helps keep xanthan gum uniformly distributed throughout the toothpaste.  Depending on manufacturing processes, PEGs may be contaminated with measurable amounts of ethylene oxide and 1,4-dioxane. The International Agency for Research on Cancer classifies ethylene oxide as a known human carcinogen and 1,4-dioxane as a possible human carcinogen. Ethylene oxide can also harm the nervous system.  While carcinogenic contaminants are the primary concern, PEG compounds themselves show some evidence of genotoxicity according to articles in Mutagenises in 1988 and  2002.  PEG increases the permeability of the skin which allows greater absorption of the product including any harmful ingredients.  Acta Odontologica Scandinavia performed a study on skin reaction and irritation potential on four toothpastes.  Although this study was carried out on skin and hence not directly applicable to the oral cavity, these and previous results may indicate that a toothpaste without propylene glycol and SLS may be preferred by susceptible persons.

Zinc Lactate

Zinc lactate is a complex of zink with lactic acid and is used as a component of toothpaste. It can also be used as a dietary supplement and can be found in mouthwash, facial cleansers, breath fresheners, body wash and liquid hand soaps.  In 2013 a proposal by the NICNAS to the Australian Governments Department of Health recommended that preparations containing more than 2.5 per cent zinc lactate with strong warnings and use of distinctive packaging. The basis for this recommendation is that it has moderate to high acute oral toxicity and eye irritancy.  The maximum permitted concentration of the chemical in any product intended for human use (or in toothpastes) should not exceed 2.5 per cent, and notes that use in toothpastes at up to that level should not produce adverse health effects. Due to elevated toxicity risk related to children’s use of adult toothpaste however, products should carry a warning label as ‘not recommended for children under 12 years of age’.

Trisodium Phosphate (TSP)

Sodium phosphates have many applications in food and for water treatment. For example, sodium phosphates are often used as emulsifiers, thickening agents, and leavening agents.  Trisodium phosphate is an inorganic compound. It is a white, granular or crystalline solid, highly soluble in water producing an alkaline solution.  The most common use for trisodium phosphate has been in cleaning agents from laundry to concrete driveways and toilet bowl cleaning tablets, it is also used as a lubricant, stain remover, and degreaser.  TSP and related phosphates are approved as food additives in the EU and are commonly used as antioxidant agents.  The United States Food and Drug Administration lists sodium phosphates as generally recognized as safe.  While TSP is not toxic per se, it is severely irritating to gastric mucosa unless used as part of a buffered solution.  It was phased out of household cleaning products in 2011 after the EPA found it was harmful to the environment. The Clean Water Act, published by the EPA, lists TSP as a “Hazardous Substance” while the Center for Disease Control (CDC) recommends to “Avoid All Contact.” The CDC lists these TSP symptoms for skin contact as burns, pain and blisters while ingestion symptoms include: abdominal pain, burning sensation, shock, or collapse.  TSP are found in may products  such as breakfast cereals, baked goods, processed meats, pizza dough, processed cheese and others so keep in mind that your overall exposure may be higher than you think.  Elevated phosphorus levels may be of a concern for individuals with chronic kidney disease taking phosphate binders as directed by their health provider.

Flavor

Flavoring such as peppermint, spearmint, cinnamon, and wintergreen is added to make the brushing experience more enjoyable. It is also functions to mask the flavor of the detergent component, especially SLS.  These flavors may also contain sweeteners such as aspartame and saccharin, and artificial dyes all of which have their own separate dangers.  Be aware that candy flavored toothpastes for children may encourage them to use more than is needed or be dangerous if ingested.

 

Sodium Gluconate

The main property of sodium gluconate is its excellent chelating power, especially in alkaline and concentrated alkaline solutions. It is a white powder that is very soluble in water.  In industrial applications it is used as cleaning agent for metals and glass bottles and as a good plasticiser and water reducer for concrete, cement, mortar and gypsum.  In personal care products gluconates are added to cleansers and shampoos to increase the lather.  They are used in oral and dental care products such as toothpaste to separate calcium and helps to prevent gingivitis.  In its pure form it may cause discomfort if swallowed and may irritate the skin and eyes. Since it contains sodium those on sodium restricted diets should be aware of any restrictions.  The FDA considers Sodium Gluconate GRAS for use in food as a sequestrant.  According to the  Cosmetic Regulations of the European Union, Sodium Gluconate may be used in cosmetics and personal care products marketed in Europe.

Polyethylene

Buzzdental penned an article in March 2014 regarding colored non-biodegradable polyethylene microbeads in Crest toothpaste which get stuck between your teeth and gums.  In September of that year The American Dental Association released a statement that clinically relevant dental health studies do not indicate that the ADA Seal of Acceptance should be removed from toothpastes that contain polyethylene microbeads and that The ADA’s Council on Scientific Affairs will continue to monitor and evaluate new scientific information on this issue as it becomes available.  P&G, Crest’s parent company admitted that the plastic microbread had absolutely nothing to do with improving oral hygiene. Instead, the company cited the plastic beads’ main purpose as aesthetics, describing polyethylene as “a safe, inactive ingredient used to provide color.”  Surprisingly, P&G did agreed to remove them by the end of the year in 2014 commenting “While the ingredient in question is … 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,”

Xanthan Gum

Xanthan gum is used in toothpaste wherein it serves as a binder to keep the product uniform.  It is a largely indigestible polysaccharide that is produced by bacteria called Xanthomonas Camestris.  It is commonly used in ice cream, baked goods, lotions, jellies, medicines, and salad dressings.  An early study by the Food Additives and Containment Journal in 1987 by volunteers consuming 15 times the acceptable daily intake for 23 days and had no significant effect on plasma biochemistry, haematological indices, urinalysis parameters, glucose tolerance and insulin tests, serum immunoglobulins, triglycerides, phospholipids and HDL cholesterol.  The data indicate that the ingestion of xanthan caused no adverse dietary nor physiological effects in any of the subjects.  It was highly effective as a laxative however, when large amounts of 15 grams/day were ingested.  According to a study in 2009 xanthan gum was shown to retard tumor growth  and prolonged survival of mice inoculated with melanoma cells.  The studies and scientific community generally agree that indications show this to be  a safe ingredient.  If you still would like an alternative Agar-Agar (Kanten in Japanese) is a plant based substitute. Made from seaweed it is flavorless and can act as a thickening and stabilizing agent.

Mica

Powdered white mica is a mineral used in a number of cosmetics, including toothpaste, for its sparkle. It is also used as a mild abrasive to aid in polishing of the tooth surface and also adds a cosmetically pleasing glittery shimmer to the paste.  Abrasives constitute at least 50% of a typical toothpaste.  These insoluble particles help remove plaque from the teeth.  The removal of plaque and calculus helps minimize cavities and periodontal disease.  They also cause a small amount of enamel erosion which is termed “polishing” action.  The polishing of teeth removes stains from tooth surfaces, but has not been shown to improve dental health over and above the effects of the removal of plaque and calculus.

Blue #1

Blue and several other coloring agents, which are synthesized from petroleum, are banned in many countries in Europe, but you can still find them in various products in the US including candy, cereal, drinks, and toothpaste. 

Research has found that these color additives cause cancer, which is concerning since use of food dyes has gone up fivefold since 1955. Food dyes are not only carcinogenic, but they can change the brain development of children, causing hyperactivity and potential behavioral problems.  Blue #1 was specifically mentioned as causing hypersensitivity reactions.

A six week study in 2007 by researchers at the University of Southampton Schools of Psychology and Medicine which was funded by a £0.75m grant from the Food Standards Agency and published in the Lancet online, has shown evidence of increased levels of hyperactivity in young children consuming mixtures of some artificial food colors and the preservative sodium benzoate.  The study involved studying levels of hyperactivity in 153 three-year-olds and 144 eight-year-olds living in the city of Southampton. The children were selected from the general population to represent the full range of behavior, from normal through to hyperactive, and not for any previous behavioral problems or known sensitivities to particular foods.

This significant new research provides a clear demonstration that changes in behavior can be detected in three-year-old and eight-year-old children.

Hyperactivity is a behavior indicated by increased movement, impulsivity and inattention. The results of the Southampton study show that when the children were given the drinks containing the test mixtures, in some cases their behavior was significantly more hyperactive. These results replicate and extend previous FSA-funded research by the team in Southampton.

Professor of Psychology, Jim Stevenson, who led the research, comments: “We now have clear evidence that mixtures of certain food colors and benzoate preservative can adversely influence the behavior of children. There is some previous evidence that some children with behavioral disorders could benefit from the removal of certain food colors from their diet. We have now shown that for a large group of children in the general population, consumption of certain mixtures of artificial food colors and benzoate preservative can influence their hyperactive behavior.

These dyes serve no purpose except to make products more appealing but most consumers don’t understand the risks they are taking by their use.

Alternatives

The conclusion is that you should seek out toothpastes that do not contain many or all of the above ingredients.  There are several non-fluoridated brands currently on the market to choose from.  These companies have listened to consumers and produced new or re-formulated products. Alternatively, you can make your own toothpaste.  That way you will know exactly what you are using to get your teeth clean and keep them healthy.  Isn’t that what toothpaste should be about.

Sources:

• Wikipedia
• EPA, Office of Prevention, Pesticides and Toxic Substances, Lauryl Sulfate Salts
  
• Technical Evaluation Report, ICF Consulting
• The Chemical Abstract Service of the American Chemical Society
• Environmental Health Insights, Human and Environmental Toxicity of Sodium Lauryl Sulfate (SLS)
• Environmental Working Group: Skin Deep Cosmetic Safety Databse
• Mohammad. A.M. Wadaan and Mohammad Mubarak , 2005. Skin Lesions Induced by Sodium Lauryl Sulfate (SLS) in Rabbits. Journal of Medical Sciences, 5: 320-323.
• NY Times
• The Natural Resources Defense Council, The dirt on antibacterial soaps
  
• University of South Hampton, Schools of Psychology and Medicine
• International Journal of Occupational and Environmental Health, Toxicology of Food Dyes
• Titanium Dioxide Nanoparticles Induce DNA Damage and Genetic Instability In vivo in Mice
• Nanoscale
• Arizona State University, School of Sustainable Engineering and the Built Environment
• Operative Dentistry
• The American Journal of Gastroenterology
• Journal of Cancer Research, Georgia State University, (NIH Funded)
• Center for Science in the public Interest
• International Journal of Toxicology
• Food Additives and Containment Journal
• The British Journal of Nutrition
• The Journal International Immunopharmacology
• Australian Governments Department of Health
• Central Nervous System Damage from Flourides