Toothpaste, which can be either a paste or a gel, is used to clean the teeth. It is used with a toothbrush and is mildly abrasive, making it effective in sloughing dental plaque and food debris from the teeth while gently polishing the enamel. Its use in an effective oral hygiene routine can reduce bad breath and prevent tooth decay and gum disease. Most commercial toothpastes contain fluoride, which helps the enamel of the teeth remineralize and which is the primary active ingredient that helps prevent disease; for this reason, it is not recommended that people, especially children, swallow excessive amounts of toothpaste. Some toothpastes also include antibacterial agents, which may help to reduce plaque and reverse the earliest stages of gum disease, and more recently, xylitol has become a more common ingredient. Toothpastes are also usually flavored, with the most common flavors in the United States being peppermint, spearmint, and wintergreen, though unflavored toothpastes do exist, and consumers in other countries prefer different flavors, like anise.
Tooth-cleaning concoctions have been in use since 5000 BCE, when the ancient Egyptians made a powdered blend of myrrh, burned and powdered eggshells and ox hooves, and pumice. In the 9th century, the first recorded toothpaste was made, though it is not known what it was made from. In the 19th century, toothpastes and tooth powders came into wide general use. Tooth powders were often made of pulverized chalk, brick, or charcoal. Baking soda-based tooth powders were commonly used in the U.S. until relatively recently and are still used in other countries.
Modern toothpaste recipes historically varied in their appeal, using ingredients like burned bread, resin, and burned alum. By 1900, however, the most common base for toothpastes was a combination of hydrogen peroxide and baking soda. The first toothpaste containing disinfectants was introduced in 1908, and fluoride was first added to toothpastes in the 1890s. It wasn’t until the 1950s that fluoride toothpastes were approved by the American Dental Association, with Procter & Gamble’s Crest toothpaste being the first clinically proven fluoridated toothpaste, and by the 1960s, the ADA was fully endorsing fluoridated toothpaste to reduce tooth decay.
The toothpaste tube was first manufactured in New London, CT, in 1880 and was based on the design of paint tubes. These first toothpaste tubes were made of lead. Although this soon fell out of favor, there are other safety risks associated with commercial toothpaste, including fluoride toxicity at high doses and possibly allergic or adverse reactions to some active ingredients in toothpaste. People who wish to avoid these possible reactions may choose a natural or herbal toothpaste, many of which do not contain fluoride, triclosan, or sodium lauryl sulfate. These natural products instead use essential oils and botanical and herbal products, along with baking soda and sometimes charcoal, to clean the teeth. There is insufficient evidence to support whether these herbal and natural toothpastes are as effective as fluoridated toothpastes in fighting tooth decay and gum disease, though fluoridated municipal water supplies often expose the teeth to sufficient amounts of fluoride in the absence of fluoridated toothpastes.