What Actually Matters When You're Choosing a Toothpaste

Dentists, frankly, don’t seem to know much about this either. We’ve had decades and still no real cure for cavities beyond “brush your teeth, and make sure it’s fluoride.” That’s it? There are tens of thousands of toothpaste products out there — some are clearly better than others, some are genuinely harmful — and yet nobody seems to actually check the research on what’s in them. And then there’s the classic move of Googling “best toothpaste” and finding lists like “this one whitens best,” “this one’s mint-flavored.” It’s treating people like they can’t think for themselves — and we go along with it, picking toothpaste by whether it’s mint or orange flavored.

That’s the rant. Here’s what I actually looked into, since I was going toothpaste shopping and wanted to figure out what really matters — not whitening or cosmetics, just genuine dental and gum health (teeth naturally return to their normal color over time if they’re healthy anyway). I looked into what an actually good toothpaste should contain, and I’m sharing it here — maybe even dentists will find this useful for their own patients.

What to look for:

• Some toothpastes wear down enamel. If the product lists an RDA (relative dentin abrasivity) value, make sure it’s under 200 (the FDA’s limit). There are published abrasiveness ratings by brand worth checking if you want to compare specific products.
• The fluoride source should ideally be stannous fluoride (tin-based) — it’s more effective than sodium fluoride at the same ppm level. It should be at minimum 1000ppm (1500ppm is even better) to actually work. Note: kids shouldn’t use this concentration since they tend to swallow toothpaste, and baby teeth matter less anyway — children’s toothpaste is typically capped around 500ppm. Don’t assume all toothpastes are equivalent and let kids use adult toothpaste. Some formulations go as high as 5000ppm, but as with anything, dosage matters — going too high may not be healthy long-term. The EU mandates minimum ppm levels (though Turkey isn’t in the EU) — look for a minimum of 0.41% w/w stannous fluoride or 0.21% w/w sodium fluoride.
• Gluconate/glucanate helps protect teeth.
• Arginine reportedly reduces tooth sensitivity — less important to me personally, but it also seems to help reduce cavities, which does matter.
• Triclosan — controversial. It’s an antibacterial agent, useful, but has potential neurotoxic effects, so it shouldn’t be used continuously long-term. Worth having on hand as an option for tougher periods if you can find a formula with it. I’ve read some manufacturers have removed it from their formulas.
• CPP-ACP (casein phosphopeptide–amorphous calcium phosphate) helps with remineralization — repairing early tooth damage before a cavity forms. If unavailable, CSPS (calcium sodium phosphosilicate) is a decent second choice.
• Nano-hydroxyapatite may also help (Japan has used this — though that reference is fairly old at this point).
• Instinctively, I’d also look for sodium bicarbonate — it can help raise pH, though it may have a mildly abrasive effect.
• Xylitol — I’m skeptical whether this is genuinely effective or just a marketing win, but it doesn’t seem to cause harm either way.

What to avoid:

• SLS (sodium lauryl sulfate) — a foaming/mild antibacterial agent, but it strips oils from your mouth in a way that can invite mouth ulcers. It also just has a bad reputation generally. If a brand won’t even bother formulating around it, that tells you something about how much care went into the product.
• Diethylene glycol — a carcinogenic sweetener some Chinese manufacturers have used. Avoid.
• PEG (polyethylene glycol) — generally fine, but can cause allergic reactions in some people.
• Menthol — binds to cold receptors on the tongue; probably harmless, but there’s no real reason for it beyond a fake sense of freshness that messes with your sense of taste.
• No fluoride at all — skip it. There’s no solid data showing fluoride-free “natural” toothpaste actually works.
• Charcoal — reportedly doesn’t help and can actually wear down enamel.
• The FDA specifically advises against toothpaste made in China.

I probably won’t find a toothpaste that checks every single box above, but I’ll try to get as close as I can.

A few practical notes on why toothpaste matters at all: there are a few specific bacteria species in our mouths that cause cavities by respiring without oxygen (which is part of why treatments like ozone therapy exist). It’s not as simple as “brush once and you’ve eliminated them all” — these bacteria protect themselves by forming plaque, hiding out in all the nooks and crannies of your mouth. Cutting sugar intake genuinely helps — countries with low sugar consumption in Africa report cavity rates as low as 2%. There’s no naturally alkaline food really — even milk is mildly acidic — so between that and typical sugary diets, it’s a losing battle unless you’re deliberate about it. Rinsing with a baking soda solution is a reasonably sound idea. There’s also research into using immunoglobulin Y targeted at these specific cavity-causing bacteria as a treatment approach.

Looking further ahead, if genetic engineering eventually lets us replace these harmful bacteria with less damaging ones, we might not need to fuss over toothpaste formulas at all in the future.

Update, the next day: I ended up buying toothpaste in person rather than online, since it’s surprisingly hard to find full ingredient lists for products sold online. Once I actually compared products in-store, I realized most toothpastes really are pretty similar — which explains why dentists tend to shrug and say “they’re all about the same.” A few notes from that shopping trip: most toothpastes — even the expensive, “luxury” ones — still contain SLS. Some skip SLS but also skip fluoride entirely. On the bright side, the humble, often looked-down-on Ipana toothpaste (the one everyone assumes is cheap and basic) actually holds up above average, with 1450ppm fluoride.

I didn’t even bother looking at products marketed as “whitening” — they’re likely either abrasive (which can actually make teeth look more yellow over time) or just temporarily tinting with white particles.

A few I’d call out as decent options I found:

• Love Beauty and Planet – Rosemary & Red Ginger (75ml): no SLS, 1450ppm fluoride (though sodium fluoride, not stannous)
• Oral-B Professional Gum & Enamel Repair Original (50ml): stannous fluoride, contains gluconate — downside is it does contain SLS
• Colgate Sensitive Pro-Relief Extra Strength (75ml): no SLS, contains 8% arginine and calcium carbonate, uses sodium monofluorophosphate (comparable to sodium fluoride) — this would be my top pick, except the box doesn’t actually state the fluoride concentration, which is frustrating. The Turkish market version doesn’t even list full ingredients, let alone fluoride ppm.

Foreign (Canadian/Australian) versions of some of these list 1450ppm on their packaging — if the Turkish version is identical, it’d likely be the best option on the market, but there’s no way to actually confirm that, since manufacturers aren’t always transparent.

Colgate Total Anti-Cavity initially caught my eye as promising, but I passed since it’s made in China, and the FDA doesn’t warn against that for no reason.

Notably, I ended up preferring the cheaper options across the board — I never found an expensive toothpaste that impressed me enough to justify the price difference.

Sources: Tooth decay treatment · Remineralisation of teeth · Dental restoration · Toothpaste, modern formulations · WebMD: weighing your toothpaste options · Cornucopia Institute toothpaste scorecard (a rating system I don’t fully agree with — I don’t think carrageenan content or “organic” status should weigh much in the decision — but useful for comparing formulations regardless).