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The aisles are full of a multitude of brands of toothpaste making promises for whitening, protection and cleaning. Determining which to buy can be confusing.

The purpose of brushing your teeth with toothpaste is to protect them, prevent cavities and gum disease and to keep your mouth clean and healthy. Ruchi Sahota, a consumer adviser for the American Dental Association and a family dentist in Fremont, California, says that whatever you buy should have the ADA Seal of Acceptance and contain fluoride, a naturally occurring mineral that helps prevent cavities by making the enamel or outer surface of your teeth more resistant to acid attacks that cause tooth decay.“ Studies show that the fluoride remineralizes tooth enamel in the early stages of cavity formation,” Sahota says.
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Andrew Schenkel, clinical professor and associate chair of the Department of Cariology and Comprehensive Care at New York University School of Dentistry, says that a dentist can evaluate your teeth to determine which toothpaste to use to make your teeth healthier.
“If your teeth are prone to high caries risk, that is, getting cavities, a high-fluoride prescription toothpaste might be recommended,” he says.
Toothpastes come in various forms, including gel, creamy paste or powder, and may have similar or different ingredients. While all toothpastes differ slightly, says Erinne Kennedy, director of predoctoral education at Kansas City University of Dental Medicine, all contain the same general components.
Kennedy says other beneficial ingredients you should look for include:
The ADA Seal of Acceptance is a widely recognized, important symbol of a dental product’s safety and effectiveness. The American Dental Association says that every product with the ADA seal has been scientifically evaluated by an independent body of scientific experts at the ADA Council on Scientific Affairs to be safe and effective. To earn the seal, companies are often asked to meet higher standards than what is required by law. Products that don’t meet these standards do not qualify for the seal.
Kennedy says there are multiple professional-grade toothpastes that might be a little more expensive than those you buy in a store, but they are highly effective. If your dentist recommends one of these, it’s worth paying the extra cost. If you have severe staining or sensitivity caused by oral disease, she adds, a toothpaste used to address whitening or sensitivity may not work for you. If you notice that your toothpaste isn’t working, you should make an appointment for a dental exam so any underlying concerns can be ruled out. “But in general, toothpastes deliver on their promises of helping to prevent disease and improve oral microbiome,” says Kennedy.
To get the most out of your toothpaste, Kennedy recommends not rinsing right after brushing. If you rinse after brushing, you rinse off the active ingredients, often before they can do the work they were designed to do. “After you brush, you can spit the extra toothpaste into the sink, but then leave the tiny bubbles that are present around your teeth to strengthen them and work to keep the bacteria in your mouth healthy,” she advises.
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Kennedy also says that if you have sensitive teeth, make sure the toothpaste has arginine bicarbonate in it. Arginine bicarbonate seals off the tubules in the second layer over your tooth that are often exposed when gum tissue recedes or when you have a chipped tooth. By sealing the tubules, your sensitivity is lessened. Additionally, if you’re worried about tooth stain or bad breath, look for a toothpaste with hydrogen peroxide, which will whiten your teeth from the inside out and alleviate bad bacteria in your mouth. Eliminating bad bacteria will freshen your breath over time. Bad breath can also be a sign of tooth decay and might warrant a trip to the dentist.
Ultimately, Sahota says, the best people to decide what toothpaste you should use are your dental team. “And to keep your teeth healthy, remember to brush twice a day with a fluoride toothpaste, floss or clean between your teeth at least once a day, brush in a circular motion at a 45-degree angle toward your gum and do not brush your gums,” she advises.
Tooth enamel is the hard, outer layer of a tooth. If a cavity is starting in your enamel, you should brush and clean between teeth to prevent it from moving to the dentin or middle layer of the tooth. Once a cavity moves into the dentin, it could move to the nerve of the tooth, requiring a root canal or procedure to remove inflamed or infected pulp from the inside of the tooth and to clean and disinfect the area.
Based in New York, Barbara Sadick is a freelance health journalist. Her work has appeared in The Wall Street Journal, U.S. News & World Report and The Washington Post, among other publications.
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