Ingredients Deep Dive: Oral Care
I used to be a Crest Extra Whitening girl my entire life. I dabbled in natural toothpaste options in the last couple years, but it wasn’t until this year that I really dove in to understand what ingredients are in typical oral care routines and why they are hazardous to our health. Here are some ingredients to avoid and my low tox picks!
Common Oral Care Ingredients to Avoid
1. Toothpaste
a. Sodium Lauryl Sulfate (SLS)
What It Is: A surfactant (foaming agent) that helps create lather.
Why It’s Controversial: Some people report mouth irritation, canker sores, and dryness linked to SLS. In higher concentrations, SLS can disrupt the mucous lining of the mouth.
Brands That Use It: Many major commercial brands (e.g., Crest, Colgate) traditionally contain SLS unless they’re specifically marked “SLS-free.”
b. Triclosan
What It Is: An antimicrobial chemical once widely used in toothpaste, soaps, and other personal care products.
Why It’s Controversial: Studies suggest triclosan could disrupt hormones (acting as an endocrine disruptor) and contribute to antibiotic resistance.
Brands That Used It: Colgate Total was a notable toothpaste containing triclosan. Colgate gradually phased it out in recent years.
Litigation or Controversy:
A 2014 class action lawsuit targeted Colgate-Palmolive for allegedly not disclosing triclosan’s potential risks.
The FDA later banned triclosan in certain over-the-counter products (like hand soaps), citing insufficient proof of safety and effectiveness.
c. Fluoride
What It Is: A mineral used to prevent tooth decay.
Why It’s Controversial: While endorsed by most dentists for cavity prevention, high concentrations or chronic overuse can lead to fluorosis (discoloration of teeth). There are concerns about broader health impacts (thyroid function, bone density).
Brands That Use It: Nearly all major conventional toothpastes (Crest, Colgate, Sensodyne, etc.).
Litigation or Controversy:
Various environmental groups have filed petitions and lawsuits over water fluoridation practices.
2. Mouthwash
a. Alcohol (Ethanol)
What It Is: Used as a solvent and antimicrobial agent in many mouthwashes.
Why It’s Controversial: Can cause dryness, irritation, and—in some older studies—was loosely linked to oral cancer risks (though conclusive evidence remains debated). It also may disrupt the oral microbiome when used excessively.
Brands That Use It: Many standard mouthwashes (e.g., original Listerine) contain high levels of alcohol (sometimes up to 20-27%).
Litigation or Controversy:
On Listerine: Putative class action lawsuit filed in 2023 alleges that certain Listerine mouthwash products contain undisclosed per- and polyfluoroalkyl substances (PFAS), claiming Johnson & Johnson failed to warn consumers about potential health risks, and this litigation remains pending in court. (as of Dec 2024)
b. Chlorhexidine
What It Is: A prescription-strength antibacterial compound sometimes included in medicated mouthwashes.
Why It’s Controversial: Potential side effects include staining of teeth, tongue swelling, or taste disruption. Long-term use may also impact the balance of healthy oral bacteria.
Brands That Use It: Mostly prescription mouthwashes (e.g., Peridex, Periogard).
c. Artificial Colors and Sweeteners
What They Are: Synthetic dyes (like Blue #1, Yellow #5) and sweeteners (sorbitol, sucralose, saccharin) for taste and appearance.
Why They’re Controversial: Some artificial dyes have been linked to hyperactivity or allergic reactions in susceptible individuals. Sweeteners can cause digestive upset or raise metabolic concerns.
Brands That Use Them: Most standard bright-colored, sweet-tasting mouthwashes use artificial colors/sweeteners (e.g., Scope, various Listerine flavors).
3. Dental Floss
a. PTFE (Polytetrafluoroethylene, also known as Teflon) Coating
What It Is: A synthetic polymer used to make some floss “glide” more easily between tight spaces. It’s part of a broader class of chemicals sometimes referred to as PFAS (per- and polyfluoroalkyl substances).
Why It’s Controversial: Some researchers argue that PTFE floss can shed microscopic particles or chemical residues that may enter the bloodstream or digestive tract. PFAS chemicals have been studied for potential links to hormone disruption, immune system changes, and other health concerns, although evidence and consensus vary.
Brands That Use It: Common “glide” or “easy-slide” flosses, such as Oral-B Glide, often feature PTFE or similar coatings.
Litigation or Controversy:
Ongoing consumer concern focuses on the potential ingestion of PFAS from daily flossing.
Certain brands of floss have faced criticism, though large-scale lawsuits are relatively new or emerging. Some claims revolve around failure to disclose potential PFAS content.
4. Teeth Whitening Strips
a. Hydrogen Peroxide or Carbamide Peroxide
What They Are: The primary bleaching agents that remove stains from teeth.
Why They’re Controversial: Overuse or misuse can cause tooth sensitivity, gum irritation, or even enamel damage. The concentration of these peroxides in at-home strips is lower than in-office treatments, but sensitivity complaints are common.
Brands That Use Them: Crest 3D Whitestrips, numerous store-brand whitening strips, and other DIY whitening kits.
b. Plastic Strip Materials (Polyethylene Film)
What They Are: The flexible plastic film that holds the bleaching agent against your teeth.
Why They’re Controversial: Environmental groups raise concerns about single-use plastics and microplastic residue. From a health standpoint, contact with the oral mucosa is generally short-term, but some question whether chemicals can leach out.
My Low Tox Oral Care Swaps
Tongue Scraper: I use a copper tongue scraper FIRST THING every single morning and night.
Oil Pulling: I oil pull with organic coconut oil most mornings for about 5 minutes. This is incredible for your oral microbiome and for teeth whitening. Make sure you’re spitting this in the trash after - it will clog your sink. This option is already in liquid form if putting hard coconut oil in your mouth icks you out.
Floss: Risewell makes my favorite teflon-free floss. Boka and Cocofloss are also good options.
Mouthwash: I know it seems odd to use mouthwash before brushing, but this is the correct time to use it! Risewell is my favorite alcohol-free mouthwash.
Toothbrush: I have used a Sonicare since I was a child and I’ve never had a bad review at the dentist. It is simply far superior to manual brushing. I also have a Suri in my master bathroom because it magnetizes to the wall and is much prettier than the Sonicare. I typically use the Sonicare in the morning and the Suri at night.
Toothpaste: Risewell, Boka, and Himalaya are my 3 favorite brands. I’ve tried almost all low tox toothpaste on the market / on Amazon and these were the only ones that didn’t suck.