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Spokane, Washington  Est. May 19, 1883
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Ask Dr. K: Choose toothpaste with fluoride

Anthony L. Komaroff Universal Uclick

DEAR DOCTOR K: I’m confused by the many types of toothpaste on pharmacy shelves. What should I look for in a toothpaste?

DEAR READER: To prevent cavities and tooth decay, you need to brush away plaque – that sticky, bacteria-laden material that builds up on teeth. It’s best to brush at least twice daily, once after you eat breakfast, and then again before you go to sleep.

And toothpaste definitely helps, in several ways. It removes stains and leaves your mouth fresher. Here are some ingredients you may see highlighted on labels:

• Fluoride. Choose a toothpaste that contains fluoride, which helps prevent tooth decay.

• Triclosan. This ingredient helps fight the gum disease known as gingivitis. It also helps reduce plaque, inflammation and bleeding of the gums.

• Anti-sensitivity ingredients. Some toothpastes are designed to reduce sensitivity of teeth to heat and cold.

• Abrasives. When choosing a toothpaste, consider its level of abrasiveness. A little bit of roughness helps remove plaque and stains, but too much can strip away tooth enamel. Using a toothpaste that’s too abrasive can lead to permanent tooth damage, particularly around the gum line. The American Dental Association issues its Seal of Acceptance only for toothpastes that are mild to moderately abrasive.

• Whiteners. Toothpaste makers have bombarded the marketplace with products that claim to whiten teeth. All whitening toothpastes contain mild abrasives that help remove surface stains. Whitening toothpastes that display the ADA Seal of Acceptance also have chemical or polishing agents that boost their stain-removal power.

Finally, don’t forget to floss regularly. No matter how thoroughly you brush your teeth, it’s impossible to reach the plaque and food debris that lodge under the gum line between your teeth. Your teeth and gums will thank you.

Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.
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