Month: November 2022

Toothpastes erode our teeth. There is a scale that helps us to know how much.

A recurring question when we go to the Oscar Gallo dental clinic is what type of toothbrush and toothpaste to use.

Tooth erosion is the loss of tooth enamel caused by acid attack. Enamel is the hard, protective layer of the tooth without nerve endings, which protects the sensitive dentin underneath. When the enamel is worn away, the dentin underneath is exposed, which can cause pain and sensitivity.

Erosion often appears as gaps in the teeth and general wear of the tooth surface and biting edges. This can expose the dentin underneath, which is a darker, yellower color than the enamel. Because dentin has nerve endings, your teeth may also be more sensitive to heat and cold, or to acidic foods and drinks.

Although tooth enamel is the hardest substance in the body, the dentin underneath can be exposed, for example, by wear of the enamel itself or gingival recession. Because of concerns about abrasion of these tissues, the effect of dentifrice abrasives on these tooth structures has been investigated and monitored for decades.

To help quantify the abrasiveness of dentifrices, a standardized scale called Relative Dentin Abrasiveness (RDA) was established. This scale assigns toothpastes an abrasiveness value, relative to a standard reference abrasive that is arbitrarily given an RDA value of 100. All toothpastes at or below 2.5 times the reference value, or 250 RDA, are considered safe and effective. In fact, clinical evidence supports that lifetime use of proper brushing technique with a toothbrush and toothpaste at or below 250 RDA produces limited dentin wear and virtually no enamel wear.

The Mohs hardness (Mohs Hardness) of dentin is 2.5, the Mohs hardness of sodium bicarbonate (NaHCo3) is 2.5. The RDA value of sodium bicarbonate is 7. That means that any toothpaste that has an RDA value greater than 7 has the potential to reduce dentin. The Mohs hardness of toothbrush bristles is 2.5. In addition, research shows that 50% of the damage occurs in the first 20 seconds of brushing.

The RDA test method and upper limit of 250 have been adopted by the American National Standards Institute / American Dental Association (ANSI / ADA).

These are RDA values for common toothpaste:

• 0-70 = low abrasive
• 70-100 = medium abrasive
• 100-250 = highly abrasive

With all this we can organize different toothpastes according to their RDA abrasiveness.

Non abrasive pastes:

• Elmex Sensitive Plus (30)
• Sensodyne Pro-Enamel (34)
• Rembrandt Original (53)
• Clinpro (62)
• Colgate Classic (65)
• Colgate Total (70)

Medium abrasive pastes:

• Rembrandt Plus (94)
• Colgate Optic White (100)

Very abrasive pastes:

• Sensodyne Whitening (110)
• Oral B ProHealth (140)
• Colgate Whitening (140)
• Oral B Whitening (200)

Another factor to take into account is the hardness of the toothbrush, which as a general rule should be medium.

When you visit Oscar Gallo Güemes’ office, be sure to ask about which toothpaste and which type of toothbrush is best suited for your dentin.

For each patient there is an optimal toothbrush and toothpaste.

The OCU analyzes eleven toothpastes and only four of them obtain a high score for their low content of abrasive components that, in excess, can damage the enamel and dentin after continuous use.

For a toothpaste to fulfill its mission, it has to have among its components the so-called abrasives. It is a solid material whose function is to clean and polish the teeth. The most commonly used are calcium carbonate, dicalcium phosphate, calcium pyrophosphate and silica. These abrasives should be used, according to experts, in a proportion of between 10 and 50%, and depending on their concentration, the toothpaste will have one level of abrasiveness or another.

According to an analysis of eleven anticaries toothpastes carried out by the Organization of Consumers and Users (OCU), although all of them obtain good results in cleaning and eliminating dental stains, only four get a good overall rating. The reason: the excessive abrasiveness of half of the toothpastes analyzed.

There are several methods for assessing the abrasiveness of a toothpaste, although one of the most widely used is the RDA (Relative Dentin Abrasiveness), which measures dentin wear by brushing with toothpaste against a reference standard. A toothpaste is considered to have a low abrasiveness when its RDA is less than 80. These are recommended for sensitive teeth, delicate gums and those intended for children. A medium abrasiveness should be between 80 and 100 RDA and corresponds to normal toothpastes, while between 100 and 150 is considered a high abrasiveness and is reserved for whitening and anti-tartar toothpastes.

The level of abrasiveness of the formulation should be as low as possible so that it does not end up damaging the enamel and dentin after continuous use.

According to the products analyzed by the OCU, four obtain a good score for their low abrasiveness, as well as for the amount of fluoride they contain and their ability to clean and remove stains. These are Colgate Triple Action toothpaste (76 points), to which the Consumers and Users Organization awards the category of ‘master purchase’; Parodontax Extra Fresh Complete Protection (66 points); Binaca Fresh Mint-Triple Protection (73 points), and Elmex Anti-caries (63 points).

As for fluoride, the results of laboratory tests, conducted by the OCU in collaboration with other European consumer organizations, point to an excessive amount in two toothpastes, which exceed the maximum concentration of 1,500 ppm, when it should be between 1,000 and 1,500 ppm. Specifically, these are Apivita Total -although it has an optimum level of abrasiveness, it exceeds the recommended amount of fluoride- and Signal Anticaries Protection, which the OCU considers to be of “poor quality” due to both the excess of fluoride and its abrasiveness.

According to the consumer organization, a good toothpaste should meet the following requirements:

• It must clean teeth properly, removing food debris, dental film, plaque and stains.
• It must leave a fresh, clean feeling and freshen breath.
• It should not be abrasive to enamel and dentin.
• It must be safe, pleasant and comfortable to use.
• It must be affordably priced.

Translated with www.DeepL.com/Translator (free version)