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Without Fluoride, Toothpaste Would Just Freshen Breath

Toothpaste’s cavity-fighting ingredient.

Toothpaste has been around for centuries, but the defining event in its long and colorful history was the marriage of paste with fluoride, creating one of biggest success stories in all of health care.

"Toothpastes have evolved quite a bit through the years," says George Stookey, Ph.D., associate dean for research at the Indiana University School of Dentistry. "Mostly, toothpaste started out as a way to keep your breath fresh and your mouth relatively clean. It really was not considered therapeutic in the beginning."

Toothpaste goes back to the time of pharaohs. Through the centuries, the primary cleansing agents of toothpastes weren't pastes at all. They were combinations of herbs, roots, barks, leaves and aromatic substances.

That changed about the time of the Civil War with the creation of an airtight tube that could sustain a paste. But it wasn't until the 1940s and '50s, says Dr. Stookey, that dentists began to realize the effect toothpastes containing fluoride had on their patients. "For the first time, toothpaste was used as a vehicle to deliver true therapeutic benefits to the oral cavity."

Crest® toothpaste, featuring stannous fluoride, was the first product to receive the American Dental Association's Seal of Acceptance in 1961. It also was the first toothpaste to make a claim that is now taken for granted: "Fights cavities." Other brands quickly followed suit.

"Stannous fluoride was the first system; the gold standard for several decades," explains Dr. Stookey. "But one of the problems with stannous fluoride was its instability. Different companies had different formulations using different abrasive systems, but they all had problems with the shelf life of their products because of the instability of stannous fluoride."

By 1980, most manufacturers had switched their active ingredients to either sodium fluoride or monofluoride phosphate, also known as "MFP." Today, the most effective form of fluoride is believed to be sodium fluoride, and toothpastes that featured MFP previously have created toothpaste systems using sodium fluoride formulas. However, researchers continue to work with stannous fluoride and believe that highly stabilized formulas may be capable of reducing gingivitis.

"Fluoride had a significant change, but at first, we thought it was just for kids," says Dr. Stookey. "Up to then, we had the impression that tooth decay occurred only in kids, but if mom and dad wanted to use a toothpaste with fluoride, fine. That's all changed. Now we know that fluoride helps protect teeth from root caries, and that's significant because people are keeping their teeth longer. We know it's not just for kids."

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