According to the World Wildlife Fund, around 3.5 billion throwaway plastic toothbrushes – usually made from polypropylene and nylon which can take up to 500 years to break down in landfill – are bought each year around the world. The vast majority will end up as plastic pollution. 

But several more sustainable alternatives are emerging, particularly brushes made from bamboo and cornstarch, or others that have replaceable heads to minimise plastic waste. But how green are they, really?

Bamboo brushes

Brushes made with bamboo handles are everywhere these days. You can buy them at Coles ($4), Woolworths ($8 for four), or Kmart ($6 for two) as well as direct from specialist online subscription services like Bamkiki and Toothcrush. Bamboo is generally considered to be an eco-friendly alternative to plastic as it’s fast-growing and breaks down relatively easily in compost.

Toothcrush has broken down its product’s environmental cred compared to plastic toothbrushes – taking into account CO2 emissions from transport and recyclability of packaging – and claims that an annual Toothcrush subscription is 18 times less damaging to the environment than someone who buys four plastic toothbrushes per year.

One word of caution: each of these brands’ toothbrushes have nylon bristles. They are still used on most brushes on the Australian market, and are still a form of plastic waste that takes centuries to decompose. See ‘recycling’ section below.

Cornstarch brushes

Another increasingly popular material is cornstarch, like the toothbrush from Swedish brand The Humble Co ($3.38 from Smile Boosters). 

Like bamboo, it’s biodegradable, but it’s less porous and so less likely to become “smelly” like bamboo can, according to Bare by Bauer, who also sells a cornstarch toothbrush for $4.50 plus shipping. 

Cornstarch brushes are also available at Kmart in a two-pack for $6.00. Their version comes with charcoal-infused bristles, said to act as an antibacterial agent to keep the brush cleaner.

Boar bristle toothbrushes

One for the hardcore eco warriors, boar bristle toothbrushes are a fully biodegradable alternative to nylon bristles. 

However, they involve ‘harvesting’ the bristles from an animal, something that’s unlikely to sit well with anyone concerned for animal welfare (or who simply doesn’t love the idea of putting pig hair in their mouth). 

They can be hard to find but there are a few on the market, mostly sold overseas. One manufacturer is Gaia Guy.

Replaceable heads 

Electric toothbrush fans have been replacing the plastic heads on their brushes since they were first invented, but now regular manual toothbrushes are getting in on the head-swap action. 

The Colgate Infinity starter pack, which includes two replaceable plastic heads, sells for $30 at stores including Woolworths and Big W (replacement heads are $8.40 for a two-pack). 

It has a sturdy aluminium handle; something that should please anyone who finds bamboo handles a bit flimsy, and Colgate says it means using 80% less plastic than fully-plastic alternatives when you stick with it over time.

Oral B’s version is called ‘Clic’ and also retails for $30 at Woolworths. It claims to waste 60% less plastic than a fully-disposable toothbrush when used over two years.

Bamboo electric toothbrush heads 

A Good Company in Sweden has even found a way to make electric toothbrushes more environmentally friendly, creating a line of bamboo heads that fit conventional electric toothbrushes including Oral B and Philips Sonicare. A pack of four starts at $32 plus shipping.

Sonicare-compatible bamboo electric toothbrush heads are also available from sites such as Booheads (two-pack from $14.91) and The Sustainable Tomorrow (two-pack from $13.92).

What about recycling? 

Here’s the tricky bit. If you simply throw your bamboo or cornstarch toothbrushes into your regular bin, you’ve basically wasted their biodegradable properties. 

“If they are disposed of in landfill they will degrade in an anaerobic environment and create the pollutant methane,” says Dr Peter Cass, Principal Research Scientist of Polymeric Biomaterials Chemistry at the CSIRO.

A much more earth-friendly option is to dispose of them in your home compost where they will break down into organic matter – eventually. 

“They will also degrade in the environment… but this will take considerably longer and require a moist environment,” says Dr Cass says.

But what about those bristles? 

Nylon is still a plastic and can’t be added to compost. Most bamboo toothbrush manufacturers suggest you snap the heads off your brushes or pull the bristles out with pliers before you add the handle to your compost bin.

Many also indicate their bristles are ‘recyclable’ – but not so fast. It’s virtually impossible to find somewhere in Australia that will happily recycle them, particularly because they’re so small.

“Nylon is Code 7 ‘other’ plastic, which can be recycled depending on the capabilities of local recyclers, but not always. More importantly, bristles are far too small for them to be captured in the right waste stream during the recycling process,” says Liam Taylor, communications manager of Planet Ark. “Best advice would be to remove bristles and put them in the waste bin.” 

So you’re still creating plastic waste with bamboo toothbrushes, just not as much as with 100% plastic toothbrushes.

Repurpose your toothbrush 

Rather than throwing away your toothbrush – plastic, bamboo or cellulose – as soon as it gets shaggy, consider giving it a second life. 

“Toothbrushes actually make great tools for cleaning a host of diverse items and small or hard-to-reach areas and crevices,” says Taylor. 

Use them to clean jewellery, grout, shoe soles, faucets, computer keyboards and even cheese graters. Just make sure you’ve given them a good wash first – no one wants bits of left-behind food stuck in their laptop keys.

Still attached to plastic? This recycling service could help

Can’t give up the sturdiness and convenience of your plastic toothbrush but want a way to give it an earth-friendly end-of-life? 

Terracycle offers an  that turns toothpaste tubes and caps, manual toothbrushes, electric toothbrush heads, toothbrush and toothpaste tube plastic packaging and floss containers into hard plastic that can be reused by manufacturers. There’s also a separate program for .

The post Eco-friendly alternatives to plastic toothbrushes appeared first on ÌÇÐÄVlog.

On this page:

• What's in HiSmile teeth whitening kits?
• Does HiSmile work?
• Is HiSmile safe or will it damage your teeth?

That’s the hard sell from HiSmile, an at-home teeth-whitening product that once boasted of a $10 million advertising budget for social media marketing alone, with celebrities and influencers including Kylie Jenner, Kim Kardashian and mixed martial artist Conor McGregor spreading the good word to their millions of followers. 

But does HiSmile really work and, more importantly, is it safe?

ÌÇÐÄVlog tip: If you’re concerned about surface stains on your teeth, visit the dentist for a clean. If you have private health insurance with extras cover, you may not have to pay a gap.

What’s in HiSmile teeth whitening kits?

Each HiSmile teeth whitening kit comes with enough gel for six applications, an LED light, a mouth tray, a shade guide and an instruction manual. 

You attach the LED light to the mouth tray, apply the gel to the tray, put it in your mouth and switch on the light. The light switches off automatically after 10 minutes, whereupon you take out the tray, spit, and rinse your mouth out.

The ingredients in the gel include:

• Phthalimidoperoxycaproic Acid (PAP)
• Potassium Nitrate 
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• Sodium Bicarbonate
• Sorbitol, Water, Propylene Glycol, Glycerin, PEG-8, Cellulose Gum, Hydroxyethylcellulose, Xanthan Gum, Flavour, Sodium Saccharin, Methylparaben, Aloe Barbadensis (Aloe Vera) Leaf Extract, Chamomilla Recutita Flower (Chamomile) Extract, Punica Granatum Seed (Pomegranate) Extract, Propylparaben

HiSmile’s new formula

The ingredients listed above are a new formula which HiSmile released in 2019. 

The original HiSmile formula contained citric acid, sodium chlorite and sodium bicarbonate as the active ingredients. Citric acid can erode tooth surfaces and cause sensitivity, while sodium chlorite can be toxic in high amounts. Sodium bicarbonate was included for its ‘mildly abrasive action’ – it’s included in toothpastes for this purpose, but if it’s just sitting on your teeth it won’t have this effect.

Does HiSmile work?

Whether HiSmile works or not will largely depend on why your teeth are stained, says Professor Laurence Walsh AO, spokesperson for the Australian Dental Association.

“If the stains on your teeth are difficult or ingrained, it’s unlikely to work,” he says.

“But if your issue is with surface stains, such as those from coffee, tea, red wine, berries or sauces, products like HiSmile may reduce their colour, leaving you with less staining on your teeth.” 

HiSmile commissioned a test on 24 people aged 19–55, and reports teeth were on average 3.5 shades whiter after a single 10-minute session. 

HiSmile also reported on the results of a test conducted on human tooth enamel samples, although didn’t provide us with details about the test. This test found that the results after a single session were similar to the test on the 24 people, and after six sessions reported an improvement of over seven shades whiter.

However, explains Professor Walsh, the significance of this depends on several factors.

“How the shade change was measured and from what baseline shade influences the interpretation,” he says. “Some shades such as mid-range yellows are easier to lighten than others (such as browns and greys for instance). 

“A change of 3.5 shades is not especially impressive, given that some toothpastes with improved polishing particles achieve 2 or more shades improvement or more just by removing some external stain or by repelling stains. 

“Professional dental whitening products dispensed by a dentist or treatments provided in a dental office show gains of 6–8 shades typically or more.”

Is HiSmile safe or will it damage your teeth?

HiSmile says its kit is “designed to whiten and brighten teeth without pain or sensitivity”. The test on 24 people for whitening – which is limited by its small size and being short-term – reported no increased sensitivity after a single session, and some people with pre-existing sensitivity reported less sensitivity.

One of the ingredients, potassium nitrate, makes nerves in the dental pulp less likely to fire off and is found in toothpastes for sensitive teeth. It generally needs to be used regularly over a period of time – twice daily for two weeks or more – to have an effect. 

Another key ingredient in HiSmile is hydroxyapatite – also known as calcium phosphate – which is the main component of tooth enamel. While not widely available, it’s found in some toothpastes to help strengthen teeth. 

HiSmile commissioned a study on human tooth enamel samples which found that the hardness of tooth enamel increased after six consecutive sessions, while a hydrogen peroxide treatment weakened tooth enamel. 

Professor Walsh says, “There is no independent evidence that the form of hydroxyapatite used in HiSmile or the formulation of their particular gel will allow remineralisation to occur, or promote it. 

“Hydroxyapatite is highly insoluble and chemically very stable, so simply adding some into a product does not necessarily mean there will be any benefit to teeth,” he says. 

“Remineralisation needs the correct chemical balance of calcium ions, phosphate ions and fluoride ions – in a bio-available form. Hydroxyapatite is the least bioavailable form because of its low solubility.”

Other concerns

Mouth tray 

Because the mouth tray is one-size-fits-all and not specially fitted, you may need to use a lot more gel to coat your teeth. That’s problematic because it could hurt your teeth and gums, and you could end up swallowing more of the gel.

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Consumers who buy HiSmile but are disappointed in the results could be tempted to use more of it or keep the tray in for longer to get the results they’re after. Without a professional monitoring progress and tooth condition, they may end up damaging their teeth. 

HiSmile encourages regular use of its products – it says the results will last three to four weeks, and recommends you do a single treatment every two weeks. You can sign up to a gel refill subscription service, saving money and ensuring a regular supply of whitening gel. 

Other products

Teeth whitening pen

HiSmile also sells a tooth-whitening pen with the same formula as the gel for regular one-minute touch-ups.

“The one-minute application time is effective at clearing up light everyday stains and will help maintain a brighter smile for longer,” says HiSmile spokesperson, Koban Jones. However, he points out, it’s no replacement for the kit.

Toothpastes

HiSmile sells a set of Day & Night Toothpaste, and Pink Toothpaste for sensitive teeth.

None contain fluoride.

Jones says: “Our community has always been vocal about preferring a fluoride-free toothpaste, but due to the massive benefits fluoride provides your teeth, we needed to find an effective substitution.

“We found a specific combination of key ingredients (Xylitol, L’arginine, Potassium Nitrate, Sodium Hexametaphosphate and Hydroxyapatite) would serve as an effective substitute. These ingredients have the ability to inhibit the growth of harmful oral bacteria, prevent the growth of plaque and tartar, and reduce dentinal hypersensitivity.

“Specifically, Xylitol has been proven by numerous studies to affect the ability of certain strains to adhere to the tooth surface, decreasing caries and reducing plaque formation.”

However, Professor Walsh points out, “Fluoride is the major active ingredient for dental caries prevention using toothpastes, and omitting that means that very little benefit will be achieved.

“Many dental products include xylitol. The research on xylitol shows that a large and frequent intake in the diet is needed to have any benefit. Recent large scale clinical research does not show any meaningful impact on dental caries risk in real world applications.” 

The Night toothpaste contains activated charcoal which HiSmile says is an “effective and progressive whitening agent that removes surface stains from teeth”. 

The ADA warns against charcoal toothpastes, because they may be overly abrasive. There are also concerns that charcoal and bentonite clay (which is also found in the night toothpaste) are carcinogenic.

How do the costs compare to other treatments?

Whitening kits

The HiSmile Teeth Whitening Kit, containing three tubes of gel (which the company says is enough for six uses), an LED light, a mouth tray and a shade guide, costs $99.99. A set of three gel refills costs $34.99, which will last 12 weeks if used as directed. Buying the gels on a subscription is a little cheaper, at $29.74 for three refills. HiSmile’s tooth-whitening pen is also available for ($39.99)

Other whitening kits that make very similar claims about their effectiveness and contain gel, a mouth tray and light are available at the supermarket or pharmacy for less than half the price of HiSmile.

Toothpastes

HiSmile also markets a range of other products, such as Day & Night toothpastes ($16.99 for two tubes) and Pink Toothpaste for sensitive teeth ($14.99).

Other toothpastes with micro-polishing particles, which can help reduce superficial stains, cost around $5.

Professional whitening

Going to a dentist for teeth whitening will cost from around $300 to $1000, depending on the technology used and level of treatment required.

Verdict

It’s relatively early days for the new HiSmile formula, and there’s a lack of long-term, independent testing for safety and effectiveness on large numbers of people. 

While the small tests commissioned by HiSmile show some promise, the bulk of evidence for it comes from celebrity endorsements and positive customer reviews on the HiSmile website.

As Professor Walsh says, “The key issue I feel is that the onus of proof on the belief that PAP is safe and is also effective, rests with the manufacturers who choose it – after all there is high level evidence from systematic reviews and meta-analyses of randomised controlled clinical trials to support professional level home bleaching gels with carbamide peroxide and hydrogen peroxide, so that is the level that should be aimed for.

“I believe most people would want to know if a new and unproven ingredient was safe and also effective. To answer that question needs proper studies with the right design (e.g. suitable controls as well as comparison products).”

HiSmile has told us that more testing is on the way, and we look forward to seeing the results.

The post HiSmile teeth whitening kits – do they work? appeared first on ÌÇÐÄVlog.

On this page:

• Salon and kiosk whitening
• Dentist whitening
• DIY teeth-whitening kits
• Teeth-whitening toothpaste
• Causes of stained teeth

Teeth-whitening products are everywhere, from whitening toothpastes, bleaching kits and adhesive strips to salons and kiosks in shopping centres – all promising lighter, brighter teeth at a fraction of the cost you’d expect to pay for a full dental-clinic treatment.

µþ³Ü³ÙÌýhow safe and effective are they? And what do you need to know before you jump into any of these teeth-whitening treatments? 

Salon and kiosk whitening

Teeth-whitening salons offer in-chair treatments that claim to brighten smiles up to nine shades. 

With little or no training and an outlay of a few thousand dollars for an activating light and bleaching equipment, pretty much anyone who has the money can establish a lucrative little earner in hair and beauty salons, shopping-centre kiosks, and even mobile home-based teeth-whitening parties.

Typically costing less than $200, it’s much cheaper than the similar teeth-whitening services that dentists offer.

To whiten teeth, salons typically use a bleaching gel and then expose your teeth to an activating light. But after an increase in injuries associated with teeth-whitening products, teeth-whitening preparations containing more than six percent hydrogen peroxide (18% carbamide peroxide) are now prohibited from sale, supply or use, except by registered dentists in a clinical setting.

To get around this restriction, some salons simply do more applications of the bleaching gel in one session to achieve a whiter shade, instead of using a strong ‘power-bleaching’ solution.

An unregulated industry

The teeth-whitening industry is largely unregulated and the practitioners in salons don’t necessarily have any dental training. 

Practitioners can’t advise on whether the process is appropriate for you (some kinds of discolouration don’t respond to certain treatments), nor are they qualified to check for problems such as cracked enamel, cavities, restorations and exposed root surfaces that need special care. 

Potential problems include lack of proper infection control, careless application and ill-fitting bleaching trays, causing irritation to gums and lips. But in most cases, the worst outcome will be temporarily sore gums and sensitive teeth.

Dentist whitening

The main advantage of dentists over cosmeticians is that they’re qualified to assess the overall state of your teeth, including taking a dental history, which may have a bearing on the treatment they’re prepared to give you. They can also assess and redress any underlying problems that could be causing discolouration.

But they’re also likely to be a lot more expensive – anything from about $300 to more than $1000, depending on the complexity and sophistication of the technology they’ll need to use, and the chairside time required.

Unlike in a salon, dentists are also allowed to do what’s called ‘power bleaching’ with strong hydrogen peroxide bleach (up to 38% hydrogen peroxide). After placing a special protective material on your gums, the dentist puts the gel on your teeth, and may enhance the bleaching effect by using a light or heat source, such as a laser, LED or halogen lamps.

Whiter but more sensitive teeth

In general, the stronger the product and the longer the contact, the whiter the teeth will be. But the teeth are also likely to be more sensitive afterwards. The use of light or heat to enhance the effect of the bleach appears to have a greater whitening effect than bleach alone. But some of this extra effect appears to result from dehydration of the tooth, and the colour will darken slightly as the tooth rehydrates.

You may need more than one treatment

The effects of power bleaching are immediate, but you may need more than one treatment to get the result you want. It’s not uncommon for an initial treatment at the dental surgery to be followed up with further treatment or maintenance at home.

Dentist-supplied home bleaching kits

Your dentist can also give you an at-home bleaching kit, either as a standalone treatment or to supplement in-clinic power bleaching. These kits are likely to be more expensive because the dentist will have to make custom-fitted trays. Customised trays mean that less gel is needed and gum sensitivity is reduced. But the dentist will still make sure the strength of the bleach is right for you. 

DIY teeth-whitening kits

Most whitening products (except toothpastes) contain peroxides, such as urea peroxide or carbamide peroxide. This breaks down to hydrogen peroxide (10% carbamide peroxide releases 3.5% hydrogen peroxide in the presence of water), which chemically bleaches both surface stains and the tooth itself. At a high enough concentration, peroxides can whiten teeth so that they’re lighter than your natural colour.

DIY home tooth-bleaching kits can be easily bought on the internet. The kits generally contain: 

• bleach trays, which may be mouldable (you dip them in boiling water and fit them to your teeth – so-called ‘boil and bite’)
• the bleaching chemical
• a light to accelerate the process (some kits)
• remineralising gel or paste to reduce sensitivity (some kits). 

They may also come as a tooth-whitening pen or adhesive strips. Although whitening pens may seem low-mess and convenient, using them without trays may not be very effective.

“Brush-on gels are the least controlled and are typically poorly performing because of concerns around irritation of gum (gingival) tissues,” says Professor Laurie Walsh from the Australian Dental Association (ADA). 

“They are more likely to be inactivated by normal saliva, which has enzyme systems that break down peroxides to harmless water and oxygen.”

Peroxide levels

When DIY teeth-whitening kits first hit the market, ÌÇÐÄVlog found products with hydrogen peroxide levels as high as 16% (carbamide peroxide 44%). This finding came in spite of recommendations from the ADA that home teeth-whitening products not exceed six percent hydrogen peroxide. 

Regulations now limit the strength of DIY kits to six percent hydrogen (18% carbamide peroxide). Nevertheless, one of the kits recommended by several Australian magazines contains 35% carbamide peroxide and can be readily ordered online from the US.

Peroxide safety

Try to avoid bleach contact with gums as much as possible, and avoid swallowing the bleach. There is some concern, though no conclusive evidence, that peroxides may cause oral cancer, although it’s more likely in people already at risk – smokers and those who abuse alcohol.

Excessive bleaching attempts can damage enamel, as can poorly formulated or over-acidic products. You may end up with more porous enamel, a bluish tinge and/or brittle teeth.

Some people can also experience temporary tooth or gum sensitivity when using home bleaching products.

A better fitting tray

The fit of the bleaching trays is an important aspect of this sort of teeth whitening. If you’re leaving them on for a long time (30 minutes or so), they need to be comfortable, and not cause gagging or excessive salivation. 

The closer they fit, the less bleaching product you need to use. Excessive bleach can ooze out, and while not toxic in small amounts, it can taste unpleasant and may damage soft tissues.

Custom-made trays

Rather than giving you a boil-and-bite tray, some DIY kits get you to make impressions of your teeth, and send them back to the distributor. The distributor then makes and posts out a set of custom-fitted trays for you – much like those a dentist would make. They’re a little more expensive, but you can use them for many years.

Pre-filled trays 

These promise the convenience of not having to muck around with tubes of bleaching gel and so on. But because they’re one-size-fits-most, there needs to be a lot of gel in them to make sure all teeth have contact with the active ingredient. This means that excess gel oozes out and irritates the gums.

Do desensitisers help?

Some home whitening gels include ingredients that can help prevent sensitivity, including potassium nitrate, arginine compounds and calcium phosphate compounds. These are also found in toothpaste for sensitive teeth.

How effective they are very much depends on how it’s applied.

“Including it in the gel only makes sense for products with low levels of peroxide that are worn overnight in trays, because there is enough contact time,” says Professor Walsh.

“Putting a desensitiser into a product applied for only 20 to 30 minutes or so will not give much effect, as the exposure time is far too short. Often people undergoing bleaching find that using a separate desensitising product is easier and more effective.”

But Professor Walsh also warns: “No desensitising product can totally prevent the reaction of the dental pulp of teeth to a bleaching treatment, so people should not expect that. Also, the reaction of teeth to bleaching is not reduced or alleviated by taking painkillers, such as paracetamol.”

Do the blue LED lights in over-the-counter teeth whitening kits really work?

These items of techno whizz-bangery may look the business, but how helpful are they? Some studies find they increase the whitening effect of the gels, while other studies find they don’t.

Professor Walsh says, “Generally these small blue LED lights do not provide much benefit because the gels lack the absorbers (chromophores) for photothermal actions, or the photosensitizers for photochemical or photodynamic activation from visible blue light. 

“In other words, you need the right chemical ingredients to get a benefit from using light. This is why some studies find benefits but others don’t. It’s all about having the correct light absorbing compounds present in the gel.

“Teeth may look whiter initially, but this is often due to a dehydrating effect. As water is taken back up by the teeth, relapse occurs. Clinical studies have shown this relapse occurs with various systems, including those using blue light.”

DIY bleaching tips

If you’re going to go down the DIY home bleaching path:

Talk to your dentist first 

Before you buy any whitening product, we’d recommend talking to your dentist about the particular type of stain that affects your teeth. Doing so will help you avoid wasting money – and effort – on a product that may not work for you.

Be prepared for increased sensitivity 

Greater sensitivity is highly likely, but using the product less often will help, although the whole process will take longer. Ask your dentist about toothpaste or other products that may help reduce sensitivity. 

Don’t over-bleach

Don’t use more product (it won’t help), leave it on too long or do it too often. And you only really need to bleach the front surface of your teeth.

Choose products only from reputable Australian suppliers 

Don’t be tempted to save a few dollars buying unreliable products subject to poor hygiene and quality control. And be aware that products from overseas may exceed the permitted levels of peroxides.

ADA raises concerns with the ACCC

When we asked the ADA for comment on teeth-whitening products, it told us it had raised a number of concerns in a submission to the Australian Competition and Consumer Commission (ACCC) – in particular with regard to DIY home kits, which the ADA found to be the most popular non-dentist route to whiter teeth. 

Issues included:

• the availability of products that exceed the allowable limits of hydrogen peroxide – mainly from overseas but readily available online 
• false and misleading statements about the degree of whitening people could expect
• certain sales and marketing strategies that encourage excessive and potentially hazardous use of whitening products.

Exaggerated whitening effects (“up to 12 shades”) are not only misleading, but they could also lead somebody who is disappointed by the initial result to overuse the products unsafely. For example, they might  overfill the trays with gel, and/or apply whitening agents more frequently and for longer than is recommended.

The ADA is also concerned that some kit suppliers encourage excessive use of the products, such as recommending daily use until you’re happy with the results, and then fortnightly or weekly for ‘maintenance’. Many also sell whitening pens for daily use, marketed as “perfect for touch-ups and on the go teeth whitening”. 

Potential dangers of over-using whitening products

Overusing teeth-whitening products can weaken tooth enamel, leading to a higher risk of cavities. It can also cause other oral and general-health issues.

There have also been no long-term studies of the effects of DIY teeth whitening. Studies that have attempted to simulate the long-term effects of bleaching use dentist formulas and exclude people with certain dental issues for whom whitening may not be safe. Although (legal) DIY kits are not as strong as the products dentists use, they’re often more acidic, which can increase the damage. They’re also used by people with dental issues that dentists wouldn’t do teeth whitening on.

The ADA sent the submission in May 2019 and have not yet received a response.

Teeth-whitening toothpaste

Most tooth-whitening products will use some sort of abrasive to remove stains, but some also use other ingredients.

Abrasive agents 

Abrasives (such as alumina, silica/hydrated silica and dicalcium phosphate) remove surface stains by physically rubbing them off the surface of the teeth. Charcoal has become a popular ingredient in whitening toothpastes, but there’s no evidence that it’s effective and it’s been linked with greater enamel wear and cavities.

Bleaching agents

Hydrogen peroxide is found in some toothpastes but is unlikely to have much effect when in contact with teeth for a short time. As Professor Walsh explains, “stimulation of saliva by brushing will hasten the breakdown of peroxides. This is why such products have limited effects, mostly on dietary stains, but do not change the internal colours of tooth structure”.

Detergents (such as sodium lauryl sulphate) 

These act as foaming agents and help to clean the tooth surface.

Enzymes (such as papain, derived from papaya) 

These slow down the build-up of ‘pellicle’ — the protein-containing layer of saliva that forms on your teeth within a minute of brushing. Surface stains stick to the pellicle layer.

Polyvinylpyrrolidone (PVP) 

This stops stains accumulating on the tooth surface. Interestingly, it was also the main ingredient in the first really successful hairsprays in the 1950s!

Sodium hexametaphosphate 

This acts as a repellent for stains and also displaces them from the surface of teeth.

Other ingredients 

Ingredients such as tetrasodium pyrophosphate, pentasodium triphosphate, citric acid, sodium tripolyphosphate (Triclene) chemically alter the electrical charge on the stains so that they’re less able to stick to your teeth.

Causes of stained teeth

The natural colour of people’s teeth varies from white to yellow, with every shade in between. All teeth contain red and grey colours, and the grey colours increase with age.

Teeth are made up of three layers: tough outer enamel, softer dentine, and the inner pulp. As you get older, the enamel thins through wear and tear, and the darker dentine layer can begin to show through. The dentine structure also changes as it takes up more minerals from the pulp. These two processes can make older teeth look yellow.

As well as genes and aging, tooth colour depends on many other factors, of which general health (when your teeth are forming) and diet and lifestyle (once your teeth have fully formed) are key.

Health

Your health – particularly during your early years when your teeth are still developing – can be the cause of intrinsic stains, which affect the colour of the tooth itself. For instance, certain antibiotic drugs, such as some forms of tetracycline, can affect tooth colour during development, as can severe fevers. 

Damage to the forming tooth can also cause internal discolouration, as can damage to the pulp of a permanent tooth (as a result of receiving a blow during contact sport, for example).

Diet and lifestyle

Lifestyle and diet can cause surface stains. Tea, coffee and smoking are three of the biggest culprits, followed by red wine, coloured berries and soy sauce, and coloured drinks such as colas.

Stain removal

Surface stains

Many whitening products specifically refer to surface-stain removal as one of their methods of whitening. A professional clean at the dentist can also remove surface stains (including those between the teeth), often producing a fresher, whiter appearance.

Deeper stains

Although removing surface stains can restore teeth to their natural colour, this doesn’t necessarily mean your teeth will be whiter. Deeper stains are more difficult to remove and may not respond well to home-bleaching treatments, or even to the special bleaches and whitening treatments that dentists use. If the tooth is very badly stained, some type of veneer might be needed to disguise the area.

So before you spend money on DIY whitening, speak to your dentist about treatment options for the particular type of stain affecting your teeth.

Five tips for teeth-whitening services 

• Avoid staining your teeth with tea, coffee, red wine, cola and smoking for a couple of days after whitening (which may mean giving them up for a few weeks for longer-term treatments). 
• If you don’t want to give up certain drinks, you could try drinking them through a straw to reduce staining.
• Bleach won’t whiten caps, crowns or fillings, so these may need to be replaced if they no longer match the rest of your teeth.
• Your teeth may need re-whitening after a couple of years or so.
• Have realistic expectations – keep in mind that many photos of models and celebrities have been digitally manipulated to make their teeth look whiter, or they may have had veneers fitted in real life. Your teeth shouldn’t be whiter than the whites of your eyes – if they are, they can look unnatural.  

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On this page:

• What's in toothpaste?
• Brushing-up on the different kinds of toothpaste
• Toothpaste investigation 2012
• ÌÇÐÄVlog oral health checklist
• What's on the tube

But all hype aside, what is the difference between the many types of toothpaste …if any?

What’s in toothpaste?

From pulverised bones and crushed oyster shells to the modern-day pearly white paste, the role of toothpaste has always been to remove plaque and prevent cavities. Professor Mike Morgan, Head of Population Oral Health and Periodontics at , says most toothpastes contain essentially the same ingredients and believes very few in the marketplace would actually fail to perform these two tasks.

Toothpaste has two key ingredients, fluoride and a mild abrasive, bound together with thickeners, sweeteners, stabilisers and flavours. 

While the abrasives can vary – such as calcium carbonate and hydrated silica – they fulfill the same purpose: to polish your teeth and dislodge particles of food caught between them. The experts we spoke to say the amount of abrasive in any given tube of toothpaste is limited to protect tooth enamel from erosion.

Since most toothpastes contain pretty much the same key ingredients, does that mean you might as well just opt for the cheapest brand? Morgan argues that you should stick with reputable brands – it’s recently been found that some cheaper toothpastes in the UK don’t actually contain bio-available (absorbable) fluoride, which are much better for your teeth.

Find out how to decipher what ingredients are in your toothpaste.

Brushing-up on the different kinds of toothpaste

Although just two companies, Ìý²¹²Ô»åÌý, control most of the Australian toothpaste market, there are certainly more than two products on the shelves. As if regular toothpaste wasn’t cleaning teeth sufficiently, we now have whitening, tartar control, sensitive and enamel-lock toothpastes as well as products tailored to children.

“As a dentist, I’m quite amazed when I go through the supermarket aisle and look at just how many toothpastes are on the shelf,” says Dr Peter Alldritt, chairman of the Oral Health Committee at the (ADA). “How do people choose?”

Here’s an overview of some of the toothpaste segments:

Teeth-whitening toothpaste 

Teeth-whitening products are the largest segment in the oral care market. When we examined ingredients in a selection of whitening toothpastes in 2012, however, we found none contain a bleaching agent – required to physically alter the colour of teeth. The fine print often qualifies this by promising whiter teeth as a result of stain removal, not an overall whitening treatment.

Children’s toothpaste

From milk teeth to big teeth, sparkling gel to Spider-Man, children’s toothpastes haven’t been left behind in the rush to segment the oral health care market. There are sparkles, coloured stripes and even Wiggles-endorsed products. They’re sugar-free and include fluoride and abrasives just like toothpastes for adults.

But as children are prone to swallow toothpaste, the ADA recommends parents avoid giving toothpaste to babies and toddlers up to 18 months and use only low-fluoride formulas for children 18 months to six years old to prevent fluorosis (caused by ingesting too much fluoride).

Colgate markets its low-fluoride toothpaste as ‘My First’ for children up to six, while Macleans offers ‘Milk Teeth’ for children up to three years of age and ‘Big Teeth’ for children over seven. Colgate also offers a big kids’ paste – for those six and up – with some clever Spider-Man marketing. The ADA’s policy on fluoride does not require a specialised toothpaste for children aged over six, so Alldritt argues those “big kid” products are a case of an intermediate market being created. “It is not a problem for the teeth, but it is confusing for parents with so many choices,” he says.

Products for sensitive teeth

When enamel thins or gums recede, porous dentine – the home of many nerve endings – can become exposed. Sensitive toothpaste is designed to block the dentine tubules and minimise sensitivity when brushing.

Of all the spin-off segments in the oral care market, toothpaste designed for sensitive teeth is the most legitimate, according to both Alldritt and Morgan. While Alldritt is happy to recommend it to patients who need it, he warns it is not a cure for everything and shouldn’t be used to cover up more serious problems, such as decay.

Tartar control and enamel protection

Tartar is the build-up of hardened plaque that can lead to gum disease. Although regular brushing can minimise its build-up, tartar can only be properly removed by a dentist. Of the toothpastes we looked at, almost all contain a tartar suspension agent – the most common being pyrophosphates and xanthan gum – designed to suspend tartar particles in saliva and prevent them from clinging to teeth. Although only three mention tartar control on their packaging, Morgan says most toothpastes will reduce the amount of tartar build-up if used in conjunction with a good toothbrush and regular brushing. Enamel is the outer coating of the tooth. Although generally much harder than the inner dentine, it can be worn down by excessive scrubbing or acidic foods. There are various products that claim to protect teeth enamel such as Colgate Sensitive Enamel Protect and Macleans Advanced with Enamelock formula – but, according to Alldritt, these claims may be a classic example of market trickery. “The best protection for enamel is fluoride,” he says. “Enamel is a fluoride, and when exposed to the fluoride in toothpaste, it is like putting a coat of armour on it.” The ADA  a certain level of fluoride in regular adult toothpaste – and when we examined fluoride levels in toothpastes in 2012, neither of the “enamel-protecting” products contained any more fluoride than Colgate’s regular toothpaste.

Natural toothpaste

Another segment in the toothpaste market is natural, or herbal, toothpastes. Many of the so-called “natural” or “herbal” products ÌÇÐÄVlog looked at back in 2009 were made up of very similar ingredients to their mainstream counterparts, but most were made without fluoride.

Most experts say that fluoride is the one vital ingredient toothpaste should contain. Morgan advises against fluoride-free toothpastes and believes there are just two things to consider in your purchasing decision. “Look for toothpaste that has fluoride in it; after that the decision should really just be driven by price.”

Toothpaste investigation 2012

To test whether different toothpastes were in fact spin-offs of essentially the same thing, in 2012 we investigated the toothpaste market, comparing ingredients in 17 toothpastes from brands such as Coles, Colgate, Macleans, Sensodyne, White Glo and Woolworths. We found that of the 13 adult toothpastes we looked at, there was indeed little difference in the active ingredients.

Although many products have since altered their formulations or names slightly, the same principles apply. The following are the results of our 2012 investigation.

• Colgate Advanced Whitening and Woolworths Homebrand Freshmint Toothpaste (now has a different formulation), contained many of the same ingredients. Both used hydrated silica as the abrasive and the same suspension agent to prevent tartar from clinging to teeth. While exact ingredient proportions weren’t given, both include fluoride, a stabilising agent and titanium dioxide to give the paste an opaque, white appearance. The Woolworths product also had a naturally occurring preservative – and was less than half the price of the Colgate “whitening” toothpaste.

• White Glo Extra Strength Coffee and Tea Drinkers Formula was three times more expensive than the Coles Smart Buy regular toothpaste (no longer on the market), with very little difference in ingredients. Our analysis of ingredients found both used a calcium carbonate abrasive and fluoride, the same sweetener, humectant and a similar stabilising agent. The main difference being that White Glo also had carnauba wax – derived from a Brazilian palm tree – and rosehip oil. Alldritt, who says teeth can only be properly whitened by applying a bleaching agent over a number of hours, strongly doubts the wax would make any real difference when it comes to preventing stains.

The bold claims of these three toothpastes also stood out.

• Colgate Advanced Whitening

“Micro-cleansing crystals for clinically proven whiter teeth”.

Comparing the ingredients with that of regular Colgate, we believe the micro-cleansing crystals must be hydrated silica, which is the abrasive used in many other toothpastes.

• Macleans Extreme Clean Whitening

“Extreme clean with micro-active foam for deep-action whitening”.

No toothpaste without hydrogen peroxide is capable of physically whitening teeth, with or without “deep action”.

• White Glo Coffee and Tea formula

“Micro-wax to prevent staining on teeth enamel.”

The micro-wax is carnauba wax, derived from a Brazilian palm tree. Alldritt doubts a coating of wax would remain on the teeth throughout the day to repel stains from food and drinks.

ÌÇÐÄVlog oral health checklist

According to Alldritt, the most important considerations for maintaining good oral health should be:

• Fluoride: The most important ingredient in toothpaste.
• Regular care: Brushing in the morning and at night with a good toothbrush and soft brushing motion.
• Flossing: Cleaning in between your teeth to prevent small pieces of food from becoming trapped.
• ¶Ù¾±±ð³Ù:ÌýBe mindful that the breakdown of sugars and carbohydrates by the bacteria in your mouth produces acid, which can attack enamel and begin the decaying process.

What’s on the tube

Here’s how to translate the ingredients you’ll find on the toothpaste tube.

• Abrasives might be called calcium carbonate, calcium hydrogen phosphate, sodium bicarbonate, dicalcium phosphate dehydrate, silica or hydrated silica and sodium chloride. For efficient tooth cleaning, toothpaste needs to be mildly abrasive.
• Humectants stop toothpaste hardening when it’s exposed to air. Common humectants are sorbitol, polyethylene glycols and glycerol.
• Binders disperse or swell in the presence of water and are used to stabilise the toothpaste by preventing separation of the solid and liquid phases. Binding agents in natural toothpaste include natural gums such as arabic, tragacanth, xanthan and carrageenan. Other products such as corn starch extract, CMC (sodium carboxymethyl cellulose) and cellulose may be used.
• Detergents lower the surface tension and therefore help loosen plaque deposits and emulsify or suspend the debris removed from the tooth surface during cleaning. Commonly used detergent sodium lauryl sulphate (not actually a detergent, more of a foam creator to help distribute the toothpaste abrasive agents into nooks and crannies), along with sodium lauryl sarcosinate, can irritate the skin. Lauryl polyglucose and lauryl glucoside are milder detergents.
• Flavours will often be labelled as such.
• Preservatives such as hydroxyl-benzoates or methyl-paraben helps restrict microbial contamination. Antibacterial agents can be added to help prevent gingivitis.
• Colour such as titanium oxide for white, chlorophyll for green and CI42090, an artificial blue colour.
• Sweeteners include sorbitol (which is also a humectant), glycerol, xylitol (which can help prevent decay), stevia and sodium saccharin.
• Desensitisers include sodium citrate, casein phosphopeptise, and potassium nitrate can relieve sensitivity, but this really depends on the person using the toothpaste.

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On this page:

• How we choose what we test
• How we test electric toothbrushes
• Test criteria explained

We put rotary and lateral toothbrushes through a series of technical tests and an ease of use trial. This is how we do it.

How we choose what we test

With a range of products on the market, what makes us choose one electric toothbrush to test over another? 

As with most of our product testing, our aim is to test the most popular models on the market and what you’re most likely to see in the retailers.

We survey manufacturers to find out about their range of models, we check market sales information and we also check for any member requests to test specific models. From this information we put together a final list that goes to our buyers. 

They then head out to the retailers and buy each product, just as a regular consumer would. We do this so we can be sure the products are the same as any consumer would find them, and not ‘tweaked’ in any way for better performance.

We also aim to test a range of rotary and lateral brush heads to cover all personal brushing preferences. That way you can use our results to find a model that truly suits your needs.

How we test electric toothbrushes

Our test looks at the following criteria.

Feel (volunteer trialists)

A panel of volunteers are given rotary or lateral toothbrushes, depending on what they’re used to using at home. They use the brush for 30–60 seconds and answer the following questions:

• How does the toothbrush feel in hand? Consider weight, balance, vibration in hand etc.
• How well does the brush comfortably reach all necessary areas?
• How does the toothbrush feel against your teeth, gums and tongue while in use?

They also have the option to leave additional comments of note.

Ease of use (volunteer trialists)

We ask the trialists to rate how easy it is to remove and attach the heads, adjust modes and turn each brush on and off.

Ease of charging

We assess the charging method, clarity of charge notifications such as LED lights, and how easy it is to plug and unplug each toothbrush to charge.

Operating time in days

We fully charge each brush, then cycle through two minutes on, then two minutes off until either the battery runs flat or we reach 56 cycles. Two cycles represents one day of normal brushing, 56 cycles represents four weeks of normal brushing. So if a brush still has charge after our test, it has enough power to brush your teeth morning and night for four weeks straight without recharging.

Test criteria explained

The ÌÇÐÄVlog Expert Rating, our overall score that determines which products we recommend, is made up of:

• ease of use (volunteer trialists) 45%
• feel (volunteer trialists) 45%
• ease of charging (10%).

We recommend electric toothbrushes with a ÌÇÐÄVlog Expert Rating of 80% or more.

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