Yes they’re all so perfect,
So white and pearly.
Brush, gargle, rinse,
A couple breath mints,
My shiny teeth and me! -Chip Skylark & Timmy Turner
(Nickelodeon-My Shiny Teeth, LyricsMode)
Most people would probably agree that the first feature you notice about someone is their smile. Beyond the visual, we need healthy teeth to eat and, I’m no expert, but likely to talk effectively as well. Maybe that’s all up to the tongue. Regardless of which function we place the most weight on, we all hopefully strive to, at the very least, brush every morning and night, if not floss and rinse as well. The British are renowned for having lousy teeth thanks to characters like Austin Powers and the Simpsons, but this sentence was just an excuse to share that clip. The true objective here is to get you to reevaluate your oral care routine and see how much waste you’re currently producing.
Skip to the ‘…|The What’ section if you want to skip the in-depth analysis of oral care.
The Why Behind the What|…
According to the American Dental Association (ADA), we should be brushing twice per day and flossing once. Why? We subject ourselves to this rigamarole daily because more than we want nice white teeth, we don’t want tooth decay, gingivitis, tartar, and their other friends. In essence, we want our teeth to last as long as we do. According to the Mayo Clinic, the series of events looks like this: a film of plaque forms, which turns into tartar, which can eventually evolve into gingivitis and tooth loss if we neglect it long enough. The answer, just brush and floss regularly.
We underestimate the simple power of consistency.
Does anyone remember this hilarious GOT MILK? advertisement? Fluoride is to toothpaste as calcium is to milk, the perceived holy grail of that micronutrient’s source. Thanks to that commercial I know that milk has calcium, but I also thought I couldn’t obtain adequate amounts anywhere else. Silly, young Garrett. I would hope most people now know that isn’t true. The National Osteoporosis Foundation shows that collard greens, Ricotta cheese, yogurt, and sardines outrank milk in calcium content. Likewise, pretty much every carnivorous human thinks meat is the only way to ingest a complete protein profile – that means consuming the 9 essential amino acids our body can’t synthesize itself. I digress. The point is we don’t need store bought toothpaste to obtain fluoride. Our drinking water is dosed with it. “The American Dental Association unreservedly endorses fluoridation of community drinking water supplies as safe, effective and necessary in preventing tooth decay” (ADA Fluoridation Policy). While the appropriate quantity is up for debate, the presence-absence of it is not. Now, bear with me because this is a mouthful. The U.S. Department of Health and Human Services Federal Panel on Community Water Fluoridation released a paper titled U.S. Public Health Service Recommendation for Fluoride Concentration in Drinking Water for the Prevention of Dental Caries. Please read this compelling paragraph:
Fluoride in saliva and dental plaque works to prevent dental caries primarily through topical -remineralization of tooth surfaces.28,29 Consuming fluoridated water and beverages, and foods prepared or processed with fluoridated water, throughout the day maintains a low concentration of fluoride in saliva and plaque that enhances remineralization. Although other fluoride-containing products are available and contribute to the prevention and control of dental caries, community water fluoridation has been identified as the most cost-effective method of delivering fluoride to all members of the community regardless of age, educational attainment, or income level.9,30 Studies continue to find that community water fluoridation is cost saving (Gooch, 2015).
What did we glean? Well, the third sentence only states that water fluoridation is the most cost-effective delivery method. However, thanks to another paper published in the Journal of Dental Research, we can also say that it’s as effective at preventing dental caries:
One interesting find, however, was the consistency of the effect size for the various modes of fluoride delivery among adults, and their similarity to findings for children. Using findings from studies published after 1979, and assuming that the annual coronal caries increment among adults is 1 surface (Griffin et al., 2005), we found that exposure to any mode of fluoride reduced caries by about 25%. This value is similar to the prevented fraction for community water fluoridation. (Griffin et al., 2007)
This was a meta-data study, which means the researchers combined data from a host of other past studies to use as their data points. In this instance, they compared papers that covered community water fluoridation, self-applied fluoride – brushing your teeth, and a combination of self-applied and professionally applied. The one piece I would have liked to see is a comparison to community water fluoridation and self-applied. This is important for our purposes because I want to be confident that by explicitly cutting out fluoride application from my daily oral routine I am not jeopardizing the health of my teeth. I remain unfazed. If we’ve already determined that fluoride in our drinking water saturates out tongue and plaque enough to allow for constant remineralization than the topical application of fluoride through brushing should not have any significant added benefit. Does that make sense? Assuming your acting appropriately and drinking water throughout the day then ‘double dosing’ with fluoride enriched toothpaste is pointless. If this doesn’t seem clear please write to me and I can explain further.
Let’s put fluoride to bed. The CDC’s My Water’s Fluoride page tells you if your state participates in water fluoridation. *Sigh*. Mine does not…
However, according to the California Water Service website, “California’s fluoridated drinking water act, Assembly Bill 733, became law in 1995, requiring water systems with 10,000 or more service connections to fluoridate their water supply when funding becomes available.” I can rest easy.
If fluoride toothpaste is not the magic bullet than what is? Abrasion! The abrasive component is what allows us to scrape away plaque, tartar, and other films.
The Mohs Hardness Scale is a way of identifying minerals based on their relative resistance to scratching (National Park Service). As we all know, diamonds are a girl’s best friend and king of the Mohs Hardness Scale castle. On a 1-10 scale, diamonds are a 10, tooth enamel is a 5 and dentin is a 2.5. Dentin is the tooth root and although it looks like the enamel completely encapsulates it, dentin is what we’re worried about destroying with highly abrasive materials. This can happen is the gingiva surrounding your teeth recedes for whatever reason.
Working in conjunction with Mohs is the Relative Dentin Abrasivity (RDA) scale, which is a standardized scale developed by the ADA and others:
This scale assigns dentifrices an abrasivity value, relative to a standard reference abrasive that is arbitrarily given an RDA value of 100.19, 20 All dentifrices at or below 2.5 times the reference value, or 250 RDA, are considered safe and effective.21 In fact, clinical evidence supports that lifetime use of proper brushing technique with a toothbrush and toothpaste at an RDA of 250 or less produces limited wear to dentin and virtually no wear to enamel.22
According to Robert B. Shelton DDS MAGD, a Texan dentist, baking soda has a Mohs value of 2.5 and an RDA value of 7. This means that any material with an RDA greater than 7 has the potential to cut dentin. Do you want to know how many of the ~60 toothpaste entries on his website have an RDA less than or equal to 7? Just one. It’s baking soda.
So, baking soda can’t cut dentin and it certainly can’t harm enamel, the outer, pearly white portion we associate with the word ‘tooth/teeth’.
We’re almost finished, but we need to quickly address toothbrush bristles and floss. Bristles come in varying degrees of stiffness, which is important for the same reason as RDA values. They have the potential to erode delicate components of our teeth. Let’s look at three papers:
With respect to bristle stiffness there was no statistically significant difference in dentin loss within the EA group. In group A, a statistically significantly higher dentin loss was found for the soft in comparison to the hard bristles. No statistically significant differences were measured between soft/medium and medium/hard toothbrushes.
Dentin loss increased along with the RDA-value of the toothpaste slurries. The impact of the filament diameter on dentin loss was less evident compared to the RDA-value. However, toothbrushes with smaller filament stiffness caused higher dentin wear in all toothpaste slurry groups (RDA 20, 50 and 100) except for the paste-free control group (RDA 10).
Manual toothbrushes with hard bristles may better remove plaque, but may also cause more soft tissue trauma compared to brushes with softer bristles.
So, the bag is mixed. It sounds like, contrary to what seems logical, hard bristles are less harmful to dentin than soft ones. However, Weigand found that softer bristles didn’t actually cause higher dentin wear in slurries with an RDA of 10, 3 points higher than baking soda. Bizhang admits in the introduction that bristle stiffness, RDA, brushing force and other variables are all suggested co-factors in abrasion. My civilian opinion? From my do-diligence in reading these 3 papers, it appears that bristle stiffness if a toss up. Although, my dentists always recommends the soft variety.
Lastly, here is the ADA’s policy on flossing:
Interdental cleaning helps remove debris and interproximal dental plaque, the plaque that collects between two teeth; dental floss and other interdental cleaners help clean these hard-to-reach tooth surfaces and reduce the likelihood of gum disease and tooth decay. (Floss/Interdental Cleaners)
This is where I talk about the natural, zero-waste alternatives you should be using instead. I presented the excess of information above because I know people treat their health with paramount importance. Just like you, I wanted to be informed before I changed a long standing habit.
The ADA recommends replacing your toothbrush every 3-4 months and, according to the World Health Organization (WHO), the global population has an average life expectancy of 72 years. Acting conservatively, that’s 216 tossed toothbrushes over the course of our lifetime. We can round this to a clean 200 if we want to account for the first few years of life where we don’t really brush yet. If the world population was roughly 7.5 billion in 2016, the same time as WHO’s statistic, then that’s 1.5 trillion discarded plastic toothbrushes across that cohort of people. I hope I did the math right because that’s an absurd number.
Brush with Bamboo! This is a sustainably sourced bamboo toothbrush with compostable packaging. The bristles are 62% Castor Bean Oil and 38% nylon, which means they aren’t quite biodegradable, but they are recyclable. Bamboo grows faster than any other plant on Earth, so it regenerates remarkably fast. The handle can be composted after removing the bristles.
Brush with Bamboo: 4/$20 Colgate: 4/$8-16
Depending on how frequently you brush and obviously how much you dispense, toothpaste can last 3-6 months per 6 oz. tube. At roughly $6 per tube that comes to $12-24 a year. If you’re shopping for a family of 4 that begins to approach $100. Not to mention, tubes aren’t recyclable in any way, so they end up in the landfill along side your plastic toothbrush.
One reason I went into such detail about fluoride, RDA values and bristle stiffness is because this alternative to traditional toothpaste is a DIY.
2 Tablespoons Organic Coconut Oil
1 Tablespoon Baking Soda
15-25 Drops Organic Essential Oil
Coconut oil has a melting point of 76 Fahrenheit, so I recommend mixing the components when the oil is transitioning from one phase to another. After it’s prepared I simply store it in my refrigerator to keep it solid until it’s time to brush. Beyond that I just remove it about an hour before bed to let it soften before brushing. I tend to leave it out overnight because it’s still firm enough in the morning then I pop it back in the refrigerator while at work or away. The added benefit: all three ingredients are natural – and pronounceable. You can buy coconut oil and essential oils in glass jars that can later be recycled or repurposes. Baking soda is not as uncommon as you might think for bulk bins.
Based on the science I’ve presented above, I believe brushing this way is just as effective and healthy as ‘traditional’ methods. However, a few words of warning and intrigue: it will taste bad. Give it one week before calling it quits or at least try brushing this way a couple of times before adding a few more drops of essential oil. My only other concern is having the baking soda and coconut oil separating into immiscible layers. I travel for work every week, which means every week my toothpaste goes without refrigeration long enough for the coconut oil to truly melt. It appears the baking soda is falling out of ‘solution’ and settling on the bottom. I can always re-mix it and pop it in the cold, but I’ll have to see if there’s an alternative for coconut oil that has a more convenient melting point.
Baking soda can be purchased at BYO Long Beach for 30 cents/oz. and surely cheaper from WinCo. Essential oils and coconut oil are each only a few dollars per jar and can last for years if they aren’t stolen for cleaning or cooking purposes. Together these three simple ingredients can supply you with chemical free, natural, cheap, and sustainable toothpaste for $5 a year.
Purchase 100% mulberry silk floss coated in vegan Candelilla wax. They’re sold in cute, decorative glass containers and packaged in compostable cardboard and cellulose cellophane. Dental Lace produces said product for $9, which includes the glass container and two 33 yard spools of floss. Amazon sells a 10 pack of Colgate floss for $20. For the same distance of floss, Dental Lace costs $30 – refills of two more 33 yard spools cost $6.70.
WinCo Foods: Sells bulk items, like baking soda, up the wazoo. You’ll find zero-waste, fill-your-own-container options for hundreds of items, most of which you would never think of like blueberry muffin mix, soup bases, and candy.
BYO Long Beach: A quaint store situated next to Ballast Point Brewing Company. They sell all of the products mentioned: bamboo toothbrushes, organic essential oils, bulk baking soda, Dental Lace, and so many other hard to find zero-waste swaps for daily life. It’s largely because of them that I was able to make my transition into this lifestyle rather seamlessly.
Trash is for Tossers: Lauren Singer is a young women living in the the Big Apple following a zero-waste life. She founded Trash is for Tossers and is one of the leaders in her field. Her blog and website sell all of the commercial products mentioned along with much more.