Periodontal Disease - Prevention

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Fluoride. Most commercial toothpastes contain fluoride, which both strengthens tooth enamel against decay and enhances remineralization of the enamel. Fluoride also inhibits acid-loving bacteria, especially after eating, when the mouth is more acidic. This antibacterial activity may help control plaque.

Triclosan. Colgate's Total toothpastes contain a fluoride and triclosan, an extremely potent anti-bacterial substance. The toothpaste also contains a substance that keeps triclosan active in the mouth for 12 hours. Total was the first FDA approved toothpaste for the prevention of tooth decay, gingivitis, and plaque. Still the benefits of this toothpaste are limited and are most pronounced in people with severe gingivitis. Of some concern are studies reporting development of bacteria resistant to triclosan. Anyone with periodontal disease should not rely on this product alone.

Metal salts. Metal salts such as stannous and zinc serve mostly as anti-bacterial substances in toothpastes. Stannous fluoride gel toothpastes do not reduce plaque, however, even though they have some effect against the bacteria that cause it, but slightly reduce gingivitis. Such toothpastes can cause staining that requires professional cleaning. Crest Plus Gum Care contains a stabilized form of stannous fluoride. Studies conducted by the manufacturer suggest that is has antibacterial activity and that it might be more effective than Colgate's Total in reducing gingivitis and bleeding.

Enzymes called glucanases

Plant extracts (such as sanguinarine). Viadent toothpaste and mouthwash contain an anti-bacterial herbal extract called sanguinarine. The two products provide minimal results when used individually, but if the mouthwash and toothpaste are used together they have produced plaque reductions of 17 - 42% and reductions of gingivitis of 18 - 57% during a 6-month period. However, some questions have been raised about the safety of prolonged use of sanguinarine.

Peroxide and baking soda. Toothpastes with these ingredients appear to offer no benefits against gum disease. In fact, tooth whiteners are usually made with carbamide peroxide, which breaks down into hydrogen peroxide, and brushing with hydrogen peroxide is not recommended. Studies indicate that overuse of this solution may actually damage cells and soften tooth surfaces. People who smoke or drink alcohol, however, might avoid products with hydrogen peroxide in them.

Antibacterial sugar substitutes (xylitol), and detergents (delmopinol)