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Choosing a Toothpaste: What’s the Big Deal?

Course Number: 565

Choosing Something Other than an Antimicrobial Dentifrice: Why?

If the risk of gingivitis for the average patient is nearly 100% and the evidence for the efficacy of the adjunctive use of stabilized stannous fluoride dentifrices in the prevention and reduction of disease is convincing, why wouldn’t someone choose to use one? For some, there may be a concern that stannous fluoride will get in the way of tooth whitening. First generation SnF2 products were indeed sometimes associated with extrinsic stain. This issue has been successfully overcome via formula stabilization and new abrasive systems and should no longer be a reason to shy away from SnF2 products. Today, stabilized SnF2 dentifrices have been shown in clinical trials that compared them with non-SnF2 control pastes to not contribute to surface stains, and in fact may whiten teeth.93,100

On the right side of Figure 3 are the non-SnF2 fluorides in common use today: sodium fluoride (NaF) and sodium monofluorophosphate (MFP). Both have well-confirmed evidence of anti-caries efficacy.47,48 The most basic NaF and MFP anti-caries toothpastes – and likely at the lowest price point – are those which contain no other active ingredients and claim no other therapeutic or unique cosmetic benefits. Currently marketed examples include Colgate Cavity Protection, Crest Cavity Protection, and Aquafresh ® Cavity Protection.