Is your Whitening Toothpaste Doing More Harm Than Good?

Before we start, lets go over some basic tooth anatomy so you know what I'm taking about...

Your teeth have three layers:

1. The outer enamel - which is translucent, not white
2. The underlying dentin - which is spongy and yellow
3. The inner pulp - which has blood vessels and nerves (it's red)

Most people believe that they can change the colour of their enamel from yellowish to white by using whitening toothpaste. Actually, it's the underlying dentin that needs to change colour - not your enamel. Your enamel is translucent, so the colour of your dentin shows right through it. The most effective way to whiten your teeth in this case is to bleach the dentin at home or at the dental office.

When we chew and bite our teeth, the enamel flexes and microscopic cracks are present. Foods/drinks that stain can seep through these cracks and stain the dentin a darker yellow over time. When we do whitening treatments, the bleach seeps through these cracks and bleaches the dentin making teeth appear whiter.

Whitening toothpastes are very abrasive - they are meant to tackle surface stains (from tobacco, medications, poor oral homecare, etc) that are rough and removable. If you don't have any rough surface stains, then you're unnecessarily removing microscopic layers off your enamel. Over time, this can lead to significant wear of the enamel and teeth may appear even more yellow...yikes!

In a nutshell, if you have to have whiter teeth but don't have surface stains, go for a professional treatment or an at-home whitening tray. Whitening toothpaste is not an effective or safe way to actually whiten your teeth unless you have surface stains like this:

Keep in mind: doing any whitening treatments may increase tooth sensitivity for a short period of time.

Make Your Toothpaste Work for You

Here is a chart outlining which toothpastes (and/or rinses) are best to use based on your oral condition. If you don't have any conditions or concerns, then the first row applies to you. In the second column beside each oral condition, I listed a good toothpaste/rinse to use. Underneath toothpastes I put the active ingredient that makes it beneficial for each condition. Underneath oral rinses I put what the rinse does to benefit the condition. Remember to follow the instructions included in the packaging when using any products.

Always use CDA (Canadian Dental Association) approved products. A product is CDA approved when it has proven to achieve what it claims to achieve. For example, a toothpaste that claims to reduce tarter is only CDA approved if it has proven to reduce tarter through scientific evidence and research. 

Click here for a list of approved products, or look for this logo on your product:

Recommended Toothpastes

Oral Condition	Toothpaste and Active Ingredient
Healthy Mouth	Normal Crest, Colgate or Aim -Fluoride (small amount)
Caries activity (Cavities)	PreviDent 5000 with or without Boost -Plenty of fluoride MI paste (doesn't replace toothpaste) -Amorphous calcium phosphate (avoid if allergic to milk protein casein)
Exposed dentin or cementum (From gum recession) or Hypersensitivity	PreviDent 5000 -Plenty of fluoride Colgate Pro-Relief -Arginine (longer lasting than potassium nitrate) Sensodyne -Potassium nitrate
Gingivitis (Red, inflamed, and/or bleeding gums)	Crest Pro-Health -Sodium hexametaphosphate*
Periodontal Disease	Colgate Total -Triclosan**
Ulcers AVOID: alcohol, foaming ingredient sodium lauryl sulfate (SLS), and sodium	Salt and water rinse -Promote healing of tissues and kill bacteria Sensodyne -Free from sodium lauryl sulfate
NUG (Necrotizing Ulcerative Gingivitis)	Baking soda and water rinse -Neutralize pH of mouth and kill bacteria
Demineralization	PreviDent 5000 -Plenty of fluoride MI paste (doesn't replace toothpaste) -Amorphous calcium phosphate (avoid if allergic to milk protein casein)
Acid Erosion	Sensodyne Pronamel -Potassium nitrate
Halitosis (Bad breath) AVIOD: products containing alcohol	Colgate Max Fresh -Essential oils (mints)
Xerostomia (Dry Mouth) AVOID: SLS and alcohol	Biotene (toothpaste and/or oral rinse) -Sodium fluoride
Head and Neck Radiation Therapy (Can cause dry mouth)	Biotene (toothpaste and/or oral rinse) -Sodium fluoride Baking soda-water rinse -Neutralize pH of mouth and kill bacteria
Supragingival Calculus (Tarter above the gum line)	Crest Tartar Protection -Disodium pyrophosphate* Crest Pro-Health -Sodium hexametaphosphate* Colgate Total -Triclosan**
Biofilm/Plaque	Normal Crest, Colgate or Aim -Fluoride (small amount) Listerine or Colgate mouthwash Proper oral homecare -Regular brushing and flossing
Material Alba	Disclosing solution – Agent Blue or Disclosing tablets -Shows you where the plaque is hiding Proper oral homecare -Regular brushing and flossing
Extrinsic Stain (Stains on the outside of the tooth that is rough and can be removed)	Baking soda and water rinse -Minor abrasive to remove rough stains Whitening toothpaste (Baking soda=least abrasive) -Hydrated silica or other abrasive agents

*Can cause tooth sensitivity               **Overuse can result in antibiotic resistant bacteria

The Guide to Proper Brushing

Using the proper tooth brushing technique is just as important as picking out the right toothbrush or toothpaste. There are a number of different techniques that are used for different situations, but I'm going to talk about two popular techniques that everyone can use - just pick your favourite one!

The Right Grasp

The right grasp looks like this. You should have a light grasp on the toothbrush. Having a death grip will inadvertently cause you to push harder on your teeth and gums, which can lead to damaging the tissues. Your wrist is going to be moving and rotating the toothbrush while your thumb and fingers hold it.

Getting Started

• Divide your mouth into 4 sections:
1. The outsides of your top teeth
2. The insides of your top teeth
3. The outsides of your bottom teeth
4. The insides of your bottom teeth

• Spend 30 seconds on each section
• Remember: The sides of the bristles are supposed to touch the gums and crowns of your teeth, and the tops of the bristles are only supposed to touch the chewing surfaces of your teeth.
• Brush the chewing surfaces of your teeth with a gentle back and forth scrub
• Don't forget about your tongue! Gently brush in an outwards direction only.

Following these steps will help you ensure that you don't miss any spots, and spend an equal amount of time in each section.

The Bass Technique

Position the bristles at a 45 degree angle against the tooth, with the bristles slightly under the gums. While keeping the bristles at a 45 degree angle, do a light horizontal jiggle back and forth 5 times. Do this with two teeth at a time. This motion helps to move the bristles slightly under the gums and between the teeth.

Make sure that you aren't sliding the bristles horizontally across the tooth (jiggle the bristles instead), and be careful not to push too hard - keep a light grasp!

The Rolling Stroke

Position the sides of the bristles against the gums and crown of the tooth. Then roll the bristles (using your wrist) toward the tooth surface while you sweep the bristles down along the tooth 5 times with two teeth at a time.

If your front teeth are more crooked, turning the toothbrush like this will help:

Now all you have to do is brush your teeth twice a day for at least two minutes each time, and you're on your way to healthier happier teeth!

Why We Love Ultrasoft Toothbrushes

Commonly believed myth: a toothbrush with stiffer and harder bristles will clean my teeth better. Actually, this does more harm than good.

Plaque is a soft deposit that begins to form on the tooth's surface just 2 hours after brushing. It is very easy to remove. In fact, your tongue and saliva remove a lot of it during the day. There is no need to use a hard or medium-bristled toothbrush to "scrub" your teeth clean. "Scrubbing" your teeth contributes to enamel abrasion and gum recession. The tissues of our gums are delicate, and we must be gentle with them.

Using a toothbrush with "ultrasoft" bristles is a good way to help prevent gum recession and enamel abrasion. Once we lose gum tissue, it doesn't grow back. The only way to cover the roots of the teeth again is to get a gum graft (when gum tissue is taken from another part of the mouth, or from donated tissues, and placed over the area of recession). However, if you're unable to find an ultrasoft toothbrush, then a soft-bristled one will do.

An ultrasoft toothbrush combined with using a correct brushing technique is all it takes to prevent this from happening to you. Stay tuned for our next chat on proper brushing techniques.

Allow Me to Introduce Myself

My name is Paula. I am a dental hygiene student going into my second of three years in Ontario. Before I chose dental hygiene, I started with Aviation. I made it through one and a half semesters and discovered that it isn't for me. Pilots who don't choose the military route will often get stuck moving to remote or undesirable locations in order to find a job that won't pay much more than a full time position at a fast food restaurant. If I had the passion for flying then I might have been able to put up with a rough start like that, but I didn't. Right now, a bunch of my friends who have graduated that program just moved up to Yellowknife (up in the Northwest Territories) to work for a small company. I am more of a home body and wouldn't bring much optimism to that "adventure" if I were going with them, so it is probably best I got out when I did. I suppose I could have finished the second semester and at least gotten my private pilot's license, but I just couldn't bring myself to waste more time and money on an education I didn't want to use.

After I left that, I spent the rest of the spring/summer working and deciding what my new career would be. I always thought I would become a doctor, but I was never sure which kind. When browsing through a list of programs offered by a college I wanted to attend, I stumbled upon dental hygiene. Dentistry was never a route I considered, but it seemed to be a good fit for me in all aspects. I would have gone straight into university to get a degree and then become a Dentist, but I didn't have the prerequisites from high school.

So here I am in dental hygiene, planning to finish my degree while working as a Dental Hygienist when I complete this program. After getting my degree I will have all the knowledge and experience I need to go into Dentistry and specialize in Orthodontics. I currently have a 4.00 GPA in my program, so I think I have finally found a field that is perfect for me. Some research I did revealed that becoming an Orthodontist is the highest paying low-stress job you can get.

Right now I am working as a Hygiene Coordinator at the biggest dental office in western Canada. I basically do billing, insurance claims and booking appointments for the dental hygienists. I have become good friends with one of my colleagues Katiy (link to her blog) who convinced me to start this blog, educating people on everything to do with maintaining good oral health.

Of course, I wouldn't be here doing what I love if it weren't for the support I received from my family, friends, and my boyfriend.

Well now that you've gotten to know me, lets start talking oral hygiene!