Currently, the biggest factor determining which toothpaste is best for your teeth is the bioavailability of fluoride (effective fluoride dose). Other added ingredients like xylitol, triclosan, etc. are nice too, but fluoride is the most important factor.
Topical fluoride exposure (direct contact of your teeth with fluoride) is important for the health of your teeth and strengthening them against acids. Fluoride has become even more important today because of the modern diet (and even many alternative diets) and the prevalence of acid producing bacteria in modern society (which are transmissible – more so early on in life). Although researchers are studying alternative means of protecting teeth, right now fluoride is the best way we have of improving the resilience of our teeth so that they can keep pace with how our world has evolved.
Toothpaste is one of the most effective means of delivering fluoride to the surfaces of your teeth, and you want to maximize this benefit by not only doing little things like brushing and flossing in the right order, but by selecting a toothpaste with adequate fluoride.
It is difficult to provide exact recommendations on the optimal fluoride concentration for toothpaste because good data regarding the bioavailability of fluoride for toothpastes is sorely lacking. However, there are some rough guidelines that I have gathered from systematic reviews:
Abrasives (i.e. hydrated silica) and other ingredients like sodium lauryl sulfate can all decrease the bioavailability of fluoride by combining with fluoride ions to form insoluble salts, and the best toothpaste formulation would be free of such ingredients or at least use them in limited quantities. This effect increases the longer your toothpaste is sitting on the shelf. The negative impact of abrasives on fluoride bioavailability is one of the reasons why I am a big fan of low abrasive toothpastes.
How to Choose the Right Toothpaste
Some criteria to look for in a toothpaste that would have good fluoride bioavailability are:
– 1450ppm fluoride concentration (~0.15% w/v NaF)
– Minimal use of abrasives like hydrated silicas
– Sodium Lauryl Sulfate free
Toothpaste formulations are changing all the time and until more comparative studies on fluoride bioavailability are conducted it is difficult to make a definitive recommendation for any one toothpaste. However, Pronamel toothpaste claims to have greater fluoride bioavailability and is in fact SLS-free, low-abrasive, and contains 1450ppm fluoride which are all good things. Tom’s of Maine Clean & Gentle toothpaste also fits the bill. If I had to recommend one toothpaste for maintaining healthy teeth right now it would be either Sensodyne Pronamel or Tom’s of Maine Clean & Gentle.
If you are more concerned with tooth sensitivity than cavities, you’ll find our post on the best toothpaste for sensitive teeth very helpful.