Friday, March 16, 2012


As I scrape rubbery solids from the nozzle of my Colgate toothpaste I remember that the meme of daily toothpaste use was one of the great achievements of early 20th century advertising.

That ought to make anyone nervous.

So what does that rubbery gunk to my gums [1]? Who tests toothpaste anyway?

Not the FDA ...

Toothpaste - American Dental Association - "

... the U.S. Food and Drug Administration insists that manufacturers of fluoride-containing toothpaste meet certain requirements for the product’s active ingredients, product indications, claims and other qualifications. However, the FDA does not test toothpastes to verify compliance. The ADA conducts extensive laboratory tests on toothpastes to determine whether they meet specific criteria for safety and effectiveness. The ADA determines the product’s fluoride content, how it is released and its effectiveness on tooth enamel...

"Certain requirements" and "specific criteria" are weasel words, but "does not test" is pretty clear.

So the ADA, which makes money from its "seal of approval" [2], is the only group that tests toothpaste, and they really only look at Fluoride content. The indexed literature doesn't seem any better, all I could find were poor quality studies of fluoride content.

Perhaps that's good enough. Maybe the ADA is more virtuous than, say, the AMA. Maybe we shouldn't pay too much attention to what we've learned about the marketing and utility of FDA tested medical products over the past sixty years. Maybe we should trust the libertarian world of toothpaste regulation and the goodness of manufacturers.

Or, more likely, most toothpaste, fluoride aside, is at best harmless. Probably quite a bit of it is mildly harmful; or good for whiteness but bad for plaque. If I were running the NIH, I'd fund some high quality randomized toothpaste trials.

For now I'm going to switch to a simpler brand with an easier to clean nozzle.

[1] Forget X, R and PG. We need a rating for posts that reveal too much of what lies ahead. There is no need for under 35 to know that for most of one's life gum-teeth borders are more important than teeth color.
[2] Has that seal ever been denied anyone willing to pay for it?

No comments: