This question is, by far, the one I am most often asked by patients.
The short answer is: it depends! A toothpaste should provide cavity protection with fluoride, leave your mouth and teeth feeling clean, not irritate your gums or make your teeth sensitive.
In general, I steer patients away from toothpastes that claim to do everything. You’ve seen them – Whitening! Tartar control! Cavity protection! Antimicrobial! The more bullet points on the front of the box, the more likely the toothpaste is to have larger, abrasive particles that can cause mild to severe sensitivity, or wreak havoc on the gum tissue.
Just a plain, good toothpaste: For a basic toothpaste, I recommend plain Crest or Colgate in the anti-cavity paste form. Crest and Colgate each have their distinctive taste from their individual formulations, and generally people prefer one over the other – so pick what you like!
For sensitive teeth: For patients who have mild to moderate sensitivity that seems to be around all the time, Sensodyne is a great choice. It takes a few weeks to build up the insulating layer on the dentin or root surfaces of the tooth, so be patient and let it work. There are several flavors to choose from, and they all work equally well. Some years ago, Sensodyne reformulated their flavor and it’s much improved from the days of your grandmother’s toothpaste!
For patients with moderate to severe sensitivity – the kind where you can’t even think about eating ice cream – we have prescription toothpaste options with higher concentrations of fluoride, calcium and phosphate that are very effective. Ask us!
For whiter teeth: Toothpastes are not going to lighten your teeth to a noticeable extent. Most studies that claim to have clinically significant results use the toothpaste in conjunction with a mouthrinse that stains plaque. The effectiveness is more a measure of plaque removal than whitening. These toothpastes don’t actually whiten the enamel of the teeth. For lighter teeth, the best option is in-office whitening followed by take-home trays with a carbamide peroxide gel that best fits your particular situation. Opalescence toothpaste does a great job after bleaching of keeping your teeth their whitest – we stock it in the office along with a range of refill gels for your bleaching trays.
To reduce gum sensitivity or canker sores: Some patients using abrasive toothpastes experience sloughing of the skin inside the mouth that can be mild to severe. For other people, chronic canker sores can be a problem. Switching to a mild toothpaste like plain Crest or Colgate may help, but there can also be sensitivity to the foaming agent in toothpastes – SLS or Sodium Lauryl Sulfate. Tom’s of Maine makes a great option. It is the only toothpaste without fluoride that I recommend and it is only a good choice for patients with very low rates of cavities.
Just for something different: Sometimes toothpastes from around the world make for a nice change of pace. I don’t recommend making these your regular toothpaste (no fluoride!) But whether it’s the pretty packaging like Marvis or an exotic flavor like Neem & Pomegranate, they can mix up your oral hygiene routine for short term use.