Toothpastes Facts Controversies and Concerns · Interesting Facts/Controversies The toothpaste tube...

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Toothpastes Definition tooth·paste /ˈto͞oTHˌpāst/ Noun a thick, soft, moist substance used on a toothbrush for cleaning the teeth. Synonyms dentifrice Regulation (in Australia) considered by the Therapeutics Goods Administration (TGA) as a cosmetic 2005 discussion paper released to reconsider this classification (yet still not acted on) Therapeutic Goods Administration (TGA) The Therapeutic Goods Administration (TGA) is part of the Australian Government Department of Health and Ageing, and is responsible for regulating therapeutic goods including medicines, medical devices, blood and blood products. This includes goods that we rely on every day, such as sunscreens, through to goods used to treat serious conditions, for example prescription medicines, vaccines, blood products and implants. Ingredients Principle Contents 1. Water (20-42%) 2. Abrasives 3. Fluoride 4. Detergents. 2. Abrasives (50%) insoluble particles to assist in plaque removal - act as “polish” to remove extrinsic stains from teeth by mild abrasion of the enamel surface - no proven dental health benefit (in the removal of plaque and/or tartar) Examples: - aluminum hydroxide (Al(OH)3) - calcium carbonate (CaCO3) - various calcium hydrogen phosphates - various silicas and zeolites (microporous, aluminosilicate minerals) - hydroxyapatite (Ca5(PO4)3OH). - powdered white mica (silicate (phyllosilicate) miner 3. Fluorides most critical/essential ingredient (indeed only ingredient that really matters) anti-cariogenic limits/inhibits caries formation and development strengthens tooth surface against caries Form/Source sodium fluoride (NaF) - most common source of fluoride

Transcript of Toothpastes Facts Controversies and Concerns · Interesting Facts/Controversies The toothpaste tube...

Page 1: Toothpastes Facts Controversies and Concerns · Interesting Facts/Controversies The toothpaste tube was not invented, but reuse of the previously invented Paint Tube that had revolutionalized

Toothpastes Definition tooth·paste /ˈto ͞oTHˌpāst/ Noun a thick, soft, moist substance used on a toothbrush for cleaning the teeth. Synonyms dentifrice Regulation (in Australia) • considered by the Therapeutics Goods Administration (TGA) as a cosmetic • 2005 discussion paper released to reconsider this classification (yet still not

acted on) Therapeutic Goods Administration (TGA) The Therapeutic Goods Administration (TGA) is part of the Australian Government Department of Health and Ageing, and is responsible for regulating therapeutic goods including medicines, medical devices, blood and blood products. This includes goods that we rely on every day, such as sunscreens, through to goods used to treat serious conditions, for example prescription medicines, vaccines, blood products and implants. Ingredients Principle Contents 1. Water (20-42%) 2. Abrasives 3. Fluoride 4. Detergents. 2. Abrasives (50%) • insoluble particles to assist in plaque removal

- act as “polish” to remove extrinsic stains from teeth by mild abrasion of the enamel surface

- no proven dental health benefit (in the removal of plaque and/or tartar) Examples: - aluminum hydroxide (Al(OH)3) - calcium carbonate (CaCO3) - various calcium hydrogen phosphates - various silicas and zeolites (microporous, aluminosilicate minerals) - hydroxyapatite (Ca5(PO4)3OH). - powdered white mica (silicate (phyllosilicate) miner 3. Fluorides • most critical/essential ingredient (indeed only ingredient that really matters) • anti-cariogenic • limits/inhibits caries formation and development • strengthens tooth surface against caries Form/Source • sodium fluoride (NaF) - most common source of fluoride

Page 2: Toothpastes Facts Controversies and Concerns · Interesting Facts/Controversies The toothpaste tube was not invented, but reuse of the previously invented Paint Tube that had revolutionalized

• stannous fluoride (SnF2) - SnF2 is more effective than NaF in reducing the incidence of dental caries &

controlling gingivitis • olaflur (an organic salt of fluoride) • sodium monofluorophosphate (Na2PO3F) Strength • Australia: 1000 - 1100 parts per million fluoride. • Europe (E.g.: UK; Greece), the fluoride content is often higher - NaF 0.312% w/w

(1,450 ppm fluoride) 4. Surfactants • many toothpastes contain sodium lauryl sulfate (SLS)(and/or related surfactants

(detergents)) • acts as a foaming agent - enables uniform distribution of toothpaste - improving its cleansing power (SLS is found in many other personal care products such as shampoo) 5. Antibacterial Agents • Zinc Chloride (ZnCl) • Triclosan - a phenol (or phenolics) polychloro phenoxy phenol - antibacterial and antifungal agent. 6. Flavouring Agents • intended to encourage use of the toothpaste • “masking” agent for halitosis • 3 most common flavorants are peppermint, spearmint, and wintergreen. - flavours are provided by the respective oils, e.g. peppermint oil • Unusual Flavours: peppermint-anise oil is popular in the Mediterranean region.. • Exotic flavours: anise, apricot, bubblegum, cinnamon, fennel, lavender, neem,

ginger, vanilla, lemon, orange, and pine. • More unusual flavours: e.g. peanut butter, iced tea, and even whisky. • Unflavoured Fluoride-Containing Toothpastes - recommended for patients with chronic ulcerating conditions of the oral cavity who find the flavouring agents astringent or intolerably uncomfortable 7. Miscellaneous Components (Excipients) • Stabilisier/Moisture Preserving Agents: agents are added to suppress the

tendency of toothpaste to dry into a powder. - various sugar alcohols, such as glycerol, sorbitol, or xylitol, or related derivatives, such as 1,2-propylene glycol and polyethyleneglycol.

• Strontium chloride or potassium nitrate is included in some toothpastes to reduce

sensitivity. • Sodium polyphosphate is added to minimize the formation of tartar. • Whitening Toothpastes: contain polishing abrasives such as silica or calcium

carbonate that reduce or remove surface stains - also tripolyphosphate or carbamide peroxide, which aid in dissolving or breaking down surface stains.

Page 3: Toothpastes Facts Controversies and Concerns · Interesting Facts/Controversies The toothpaste tube was not invented, but reuse of the previously invented Paint Tube that had revolutionalized

• While all toothpastes remove surface stains from teeth, teeth whitening toothpastes are said to be more abrasive, and there is a risk of increased tooth surface wear with prolonged use

History • The Greeks, and then the Romans, used toothpaste recipes containing abrasives

such as crushed bones and oyster shells.[21] • In the 9th century, the Persian musician and fashion designer Ziryab invented a

type of toothpaste, which he popularized throughout Islamic Spain. - unknown is whether these early toothpastes were used alone, were to be rubbed onto the teeth with rags, or were to be used with early toothbrushes, such as neem-tree twigs and miswak. Tooth Powders • tooth powders for use with toothbrushes came into general use in the 19th century

in Britain - most were homemade, with chalk, pulverized brick, or salt as ingredients. 1892 Toothpaste Tube In 1892, Doctor Washington Sheffield, an American Dentist of New London manufactured toothpaste into a collapsible tube, Dr. Sheffield's Creme Dentifrice. He had the idea after his son travelled to Paris and saw painters using paint from tubes. In York in 1896, Colgate & Company Dental Cream was packaged in collapsible tubes imitating Sheffield. The original collapsible toothpaste tubes were made of lead. Fluoride was first added to toothpastes in the 1890s. "Tanagra", containing calcium fluoride as the active ingredient, was sold by Karl F. Toellner Company, of Bremen, Germany, based upon the early work of chemist Albert Deninger. Fluoride toothpastes developed in the 1950s received the American Dental Association's approval. In 1955, Procter & Gamble's Crest launched its first clinically proven fluoride-containing toothpaste. Interesting Facts/Controversies The toothpaste tube was not invented, but reuse of the previously invented Paint Tube that had revolutionalized painting and allowed for the development of the Impressionist Movement in Paris, France.

Dr. Sheffield’s Creme Dentifrice, The American Magazine, ca. 1908 http://connecticuthistory.org/aristocratic-dental-cream-gets-squeezed/#sthash.HEi0Vfao.dpuf

Page 4: Toothpastes Facts Controversies and Concerns · Interesting Facts/Controversies The toothpaste tube was not invented, but reuse of the previously invented Paint Tube that had revolutionalized

The paint tube was invented in 1841, superseding pig bladders and glass syringes[4] as the primary tool of paint transport. Artists, or their assistants, previously ground each pigment by hand, carefully mixing the binding oil in the proper proportions. Paints could now be produced in bulk and sold in tin tubes with a cap. The cap could be screwed back on and the paints preserved for future use, providing flexibility and efficiency to painting outdoors. The manufactured paints had a balanced consistency that the artist could thin with oil, turpentine, or other mediums. The artist Pierre-Auguste Renoir said, “Without tubes of paint, there would have been no Impressionism.” For the Impressionists, tubed paints offered an easily accessible variety of colors for their plein air palettes, motivating them to make spontaneous color choices. With greater quantities of preserved paint, they were able to apply paint more thickly.

The Darkie Toothpaste Controversy

Darlie (Chinese: 黑人; literally "black person"), formerly known as Darkie, is a toothpaste brand of Hawley & Hazel Chemical Company. First manufactured in Shanghai in 1933 and later based in Hong Kong and Taiwan, Hawley & Hazel was acquired in 1985 by the US corporation Colgate-Palmolive, although the product is not marketed by Colgate-Palmolive.[1] Darky, or darkie, is a term used primarily in the United States and Britain to refer to black people, and is now generally considered a racial slur. The package featured an image of a wide-eyed, smiling dark-skinned black male wearing a top hat, monocle and bow-tie, very similar to the Golliwogg in England. In 1985, after Colgate-Palmolive acquired Hawley & Hazel, the English name of the toothpaste was changed to "Darlie", and the image on the packaging was altered to show a racially ambiguous face in a top hat. The Chinese name of the brand, "黑人牙膏" (in English, "Black Person Toothpaste"), remains the same, and a Chinese-language advertising campaign reassured customers that "Black Person Toothpaste is still Black Person Toothpaste".[2] The toothpaste remains popular in some Asian countries such as The People's Republic of China, Malaysia, and Thailand.

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SLS and Oral Aphthous Ulceration SLS is a surfactant found in most toothpastes. In high concentrations it can be an irritant to skin, so it was concluded it may have a role in recurrent aphthous ulceration (RAU). RAU is an immune-mediated condition which results in the development of painful criops of three-dour ulcers that last 2-3 weeks before healing, unlike common, traumatic induced ulcers. Two studies demonstrated conflicting results regarding the role of SLS in aphthae, with one demonstrating no role, and later one 2012 showing it increased the apin and discomfort associated with the ulcers, but did not actually increase the number, frequency and/or duration of the ulcers. (Healy CM, Paterson M, Joyston-Bechal S, Williams DM, Thornhill MH. The effect of a sodium lauryl sulfate-free dentifrice on patients with recurrent oral ulceration. Oral Diseases 1999; 5: 39–43.) The Triclosan Controversy Triclosan an antibacterial/antifungal phenololic agent is found in many toothpastes as it has a proven role in lessening oral bacterial plaque-associated gingivitis. However, concerns have been raised as triclosan’s role in bacterial resistance to antibiotics and antibacterial agents and disinfectants, but no conclusive porrof regarding these concerns has yet been found. Bedoux G. Roig B. Thomas O. Dupont V. Le Bot B. Occurrence and toxicity of antimicrobial triclosan and by-products in the environment. Environmental Science & Pollution Research. 19(4):1044-65, 2012 May. CONCLUSION: Furthermore, the excessive use of TCS is suspected to increase the risk of emergence of TCS-resistant bacteria and the selection of resistant strains. Kookana RS. Ying GG. Waller NJ. Triclosan: its occurrence, fate and effects in the Australian environment. Water Science & Technology. 63(4):598-604, 2011. “…studies on the effect of TCS on soil microbiological processes showed that triclosan can disrupt the nitrogen cyclein sensitive soils at concentrations >=5 mg/kg. In view of the recent risk assessment by the Australian regulatory agency NICNAS, there is an urgent need to assess exposure to TCS and its effect on ecosystem health.” Rodricks JV. Swenberg JA. Borzelleca JF. Maronpot RR. Shipp AM. Triclosan: a critical review of the experimental data and development of margins of safety for consumer products. Critical Reviews in Toxicology. 40(5):422-84, 2010 May. “…Based on these results, exposure to triclosan in consumer products is not expected to cause adverse health effects in children or adults who use these products as intended.” The Diethylene Glycol Controversy Diethylene glycol (DEG) is an organic compound with the formula (HOCH2CH2)2O. It is a colorless, practically odorless, poisonous, and hygroscopic liquid with a sweetish taste useded commonly as a coolant in radiators. It is miscible in water, alcohol, ether, acetone, and ethylene glycol.[1] DEG is a widely used solvent.[2] It can be a contaminant in consumer products; this has resulted in numerous epidemics of poisoning since the early 20th century. On June 1, 2007, the FDA warned consumers to avoid toothpaste from China, although there was no information if these toothpastes had already entered the US, and started testing any imported Chinese toothpaste.[50][51] Days later, Colgate-Palmolive found counterfeit toothpaste with its name, which was contaminated with DEG and found at dollar-type discount stores in New York, New Jersey, Pennsylvania and Maryland. Australian Perspective The World Today - TGA considers regulating toothpaste [This is the print version of story http://www.abc.net.au/worldtoday/content/2007/s1937822.htm] The World Today - Wednesday, 30 May, 2007 12:33:00

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Reporter: Tanya Nolan ELEANOR HALL: “….Some retailers in northern New South Wales and an online supplier have sold the toothpaste, which contains a chemical linked to the deaths of 300 people in Panama. But in Australia toothpaste is not usually monitored by either Australia's Therapeutic Goods Administration, or the Quarantine Inspection Service. As Tanya Nolan reports, though, the Therapeutic Goods Administration is now considering regulating the toxic chemical. TANYA NOLAN: “…The article told of 300 people in Panama who consumed a cough syrup produced by the same Chinese manufacturer that makes the Excel toothpaste the manager stocked on his supermarket shelves. A closer look revealed the industrial chemical di-ethylene-glycol, typically used as a solvent and a coolant, was responsible for the deaths. It was then discovered that that same chemical, albeit at much lower levels, was contained in the toothpaste. It was at this point Australia's regulatory loophole became apparent. A call to the Therapeutic Goods Administration revealed that because toothpaste isn't considered a food or a drug, there are no checks done on its ingredients. ….” Listing of Therapeutic Toothpastes (F of 5000 ppm) on the PBS For patients at increased risk of dental caries, high potency fluoride toothpastes demonstrably reduce the risk and extent of dental decay. Patients at increased risk include any patient with decreased saliva production, such as after intensive radiotherapy treatment for cancers in the head and neck region, patients on multiple medications which are anti-saliva producing. Such toothpastes are expensive and their listing on the PBS would seen their cost subsidised for the general public.