Despite Claims, Toothpaste Alone Can't Stop Enamel Loss, Sensitivity

"...Tooth wear is a multifactorial condition, and the toothpaste alone cannot treat it," says co-author Thiago Saads Carvalho, DDS, MSc, PhD (pictured above)

Despite aisles full of toothpastes promising to stop dental erosion and protect sensitive teeth, new research suggests toothpaste alone can do neither.

Researchers from the University of São Paolo, in Brazil, and the University of Bern, in Switzerland, teamed up to analyze 9 toothpastes. They wanted to know if the toothpastes succeeded in mitigating enamel surface loss, since enamel loss plays a key role in tooth erosion and hypersensitivity.

In all 9 cases, the toothpastes caused tooth enamel loss, rather than prevented it. The tests were done in vitro using human enamel samples and an artificial saliva group. The authors conclude that toothpaste shouldn’t be seen as a standalone treatment for dental erosion or sensitivity, but rather as one piece of the puzzle.

In an email, study authors Samira João-Souza, DDS, MSc, and Thiago Saads Carvalho, DDS, MSc, PhD, told Dentist’s Money Digest their findings support the need for regular dental check-ups, so that emerging dental problems can be caught and treated early.

“More importantly, patients should maintain their oral hygiene at a good standard, and this is possible by using fluoride toothpastes,” João-Souza and Carvalho said. “In this sense, any marketed toothpaste that contains fluoride can be used, but if they have any questions in this regard, they can ask their dentists.”

That said, when it comes to choosing toothpastes for specific clinical purposes, the co-authors said toothpaste isn’t a panacea.

“In our study, we investigated many characteristics/ingredients of the toothpastes that may influence erosive tooth wear,” they said. “But tooth wear is a multifactorial condition, and the toothpaste alone cannot treat it.”

The researchers analyzed a number of physical and chemical factors in their tests of the toothpastes. Each toothpaste led to some degree of enamel surface loss (SL), though it varied based on a number of factors.

“The results of this experiment indicate that enamel SL occurs independent of whether the toothpastes have a desensitizing or anti-erosive claim, and that lower SL is associated with the presence of tin, higher concentration of calcium and phosphate, higher percentage weight of solid particles, smaller particle size, and lower wettability,” the authors wrote. They added, however, that additional studies in needed in a more clinically relevant setting than the current in vitro tests.

João-Souza and Carvalho said dentists can’t overlook diet as a major causative factor in many cases, with highly acidic food and drink a main culprit. Harsh toothpastes and aggressive brushing can also be a factor.

The issue of diet has become a top-line concern in the dental industry, but the authors noted that it was not always prevalent.

“We have observed a steady increase in the number of publications on this topic: where in 1970 almost 40 studies had been published, in 1980, almost 50, but the number doubled in 2000, and in 2012 almost 250 studies were published,” they noted.

“This is a reflection that dental erosion is an increasingly more important topic in research and in the clinic, and that there is a constant demand for knowledge from both dentists and patients,” they said.

The study is titled, “Chemical and physical factors of desensitizing and/or anti-erosive toothpastes associated with lower erosive tooth wear.” It can be read in full at Scientific Reports.