Best Toothpaste 2023

How to choose a toothpaste specific to your needs — 7 points to consider

With the hundreds of toothpaste options available, how can you pick the best toothpaste? You may be tempted to stick with the same toothpaste brand, but you could try to pick the best toothpaste for you.

The best toothpaste can be very personal, and there are a number of things to consider. I would take it on a step by step basis, thinking about the following questions:

1. Is there fluoride in the toothpaste?

• There are three types of fluoride approved for use by the US Food and Drug Administration (FDA). Toothpastes containing fluoride are actually considered to be over-the-counter drugs or medicines so are regulated by the FDA.
• Fluoride is the single most important ingredient for protecting the teeth from cavities.
• Fluoride free toothpastes are available, but do not receive the American Dental Association (ADA) Seal of Acceptance.
• If you have a high risk of tooth decay, your dentist may do you a prescription for a special high fluoride toothpaste.

2. Are there specific ingredients you want to avoid?

• This could be for medical reasons, such as an allergy or sensitivity.
• This could be for a number of reasons, such as wanting to avoid ingredients that are harsh on the environment. For example, opting for an SLS free toothpaste.
• If there’s a particular ingredient you want to know about, see our guide to toothpaste ingredients

3. Do you have any specific problems that you need help with?

• Toothpaste can have ingredients added that can help protect your teeth against more than just cavities.
• Gum disease can be improved with specific toothpastes (in addition to following the cleaning regime recommended by your dentist or hygienist).
• If you suffer from tooth sensitivity, you may want to choose a toothpaste containing ingredients to help reduce the discomfort you feel.
• If you have a dry mouth, you may want to avoid ingredients that make this worse, or choose a toothpaste that can help you.
• Some people suffer from tartar build up, and despite good cleaning at home and regular professional cleans, they still get a build up. Some ingredients can help protect against this.

4. Do you want a whitening toothpaste?

• Whilst toothpastes are unlikely to be whitening in themselves, they have an important role in removing and preventing staining of teeth, making them appear whiter.
• Baking soda is a common ingredient used to help remove stains, and there are specific baking soda toothpastes available.
• Smokers suffer from staining and they may benefit from whitening toothpaste.
• Charcoal toothpastes are branded to help whiten your teeth, and there are more and more products available with charcoal as an ingredient. However, there is a lack of evidence around the effectiveness of charcoal and you need to be careful when using it as it can be more abrasive.

5. What flavour do you want?

• The most common flavour for toothpaste is mint.
• There are alternatives available, from unflavoured natural toothpastes to bubble gum flavoured toothpaste.
• Non-mint toothpastes differ only in their taste, and aren’t only for kids!

6. Consider the environment

• Toothpastes come with chemicals, some of which can be avoided by option for a natural toothpaste.
• As an over-the-counter drug, toothpastes will require testing before going to market. You can choose vegan toothpastes and avoid products tested on animals.
• Plastic free alternatives to toothpaste are available to reduce your impact on the environment.
• You can choose toothpastes with sustainable packaging, and recycle packaging through schemes such as Terracycle.

7. Be aware about tooth wear

• Toothpastes contain abrasives to help with their cleaning action.
• Abrasives can cause damage to the tooth surface, removing the enamel layer over time.
• Toothpaste RDA values should be below 250 to receive ADA Seal of Acceptance.

What about fluoride free?

As a dentist I am familiar with the arguments for and against fluoride. But I work with evidence.

At present the overwhelming evidence supports the use of fluoride in toothpaste, and in particular I would like to draw your attention to the following pages to help inform you about fluoride:

• The American Dental Association (ADA) Fluoridation Facts resource.
• The Centres for Disease Control and Prevention (CDC) Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States.
• The Cochrane Library systematic review Fluoride toothpastes of different concentrations for preventing dental caries

Because of this I am unable to recommend any product that does not contain fluoride as the best overall toothpaste. However, there are developments in the use of calcium phosphates for re-mineralisation, and you can find out more about this in our article about toothpaste ingredients. In some cases, fluoride free toothpastes may contain calcium phosphates which can provide some protection.

I respect that some people will choose a toothpaste without fluoride, and for those people, you can find out which toothpastes are fluoride free in our post on fluoride vs fluoride free toothpaste.