Charcoal-Based Toothpastes
We may have thought we left the political drama back in 2020, but this week sure started 2021 off with a bang…
But as you read this article, the electoral college will have named Biden as the new President of the United States and hopefully, as the year goes on, we feel more united than divided. Both sides of the aisle need to gather up their pet of choice and head for the woods to rethink what is really important in America and for our children’s future. There you have it, I’ve thrown in my two cents on politics and I’m moving on!
Politics aside, this week I wanted to visit a hot dental topic…
Several patients have brought the topic up… and this month an article on the topic appeared in my Dental Abstract magazine (which presents articles from around the world). The hot topic? Charcoal dentifrices.
“How would I ever get onto this topic with a patient,” you ask. For one, New Year’s resolutions to have whiter teeth. But even monthly, this topic of whiter teeth comes up, usually when we’re nearing the end of a patient’s treatment and getting the braces off. Usually, somewhere in the discussion, bleaching comes up. I will address bleaching at another time (due to it being such a hot topic and I’ve been on the lookout for a well-designed paper that addresses all the pros and cons). Suffice it to say, the limitation to bleaching lies in the sensitivity - first of the gum tissue and second the teeth themselves to the bleaching chemicals, their pH, or a combination of factors. Due to this sensitivity limiting factor, some significantly sensitive individuals have broadened their search for a product to remove stains and, in turn, make their teeth appear whiter with an abrasive product rather than a chemical one.
Enter charcoal dentifrices (charcoal-based toothpastes)…
The article I found did a literature review of 118 articles and formed a database on 50 charcoal-based toothpastes. The authors, Greenwall and Cohen, found that these dentifrices were claimed to strengthen teeth (30%), have the ability to detoxify (44%), have anti-fungal properties (12%), and even have antibacterial or antiseptic properties (44%). 88% of the consumer-appealing verbiage of the advertisements included terms such as ecological, eco-friendly, organic, and pure. Thus, the charcoal dentifrices are marketed as an all-natural, holistic approach to teeth whitening.
Unfortunately, the literature review found there was insufficient evidence to support the claims that charcoal could whiten teeth and that charcoal itself has no bleaching ability. The absorptive capacity of charcoal may actually neutralize the fluoride ion present in the charcoal-based toothpaste, rendering it unable to strengthen the enamel. It was felt that individuals who change from a fluoride-based dentifrice to a charcoal-based one may be opening themselves up to a higher number of cavities in the future.
The abrasive index of charcoal-based pastes is based on the particle size, nature, and method of production and particle distribution of the contained charcoal. Those with higher abrasive indices when used with a high daily usage, can actually cause hypersensitivity due to enamel and gum loss. I found this to be quite an interesting finding, since the main reason for leaving conventional bleaching products was sensitivity!
Other negative outcomes were also a possibility. Those individuals with periodontal disease may develop a gray-black discoloration of their periodontal tissues due to accumulation of charcoal particles deep in their periodontal defects and pockets. In addition, charcoal-based dentifrices, according to the literature review, have no known antiseptic, anti-fungal, or antibacterial properties. Finally, those individuals (most of us) who have some type of restoration, crowns, veneers, and fillings, have micro-defects at their margins that can trap charcoal particles and begin to form a gray to black border around the restoration. Extra brushing and excessive pressure with a toothbrush may be necessary to remove these trapped particles. In turn, this can lead to tooth sensitivity and/or gum loss. And, in the worst scenario, a visit to the hygienist for a professional cleaning may be needed.
So there you have it - a relay of information I have read about charcoal dentifrices! I have never felt comfortable talking someone out of whitening their teeth (because I have always wanted whiter teeth myself). But I encourage you to do your research (or consult with your dentist) before selecting a product. I’m currently trying a couple of bleaching agents and will get back to my readers next month on what I have found.
In the meantime, have a Happy New Year Medina County!
- Dr. Pfister