Toothpaste, fluoride and vegan products

Introduction

Recently I was reading my girlfriend’s toothpaste (because I’m cool like that) and I noticed that it claimed to be vegan and fluoride free. Are there non-vegan toothpastes, I wondered. And what’s wrong with fluoride? Don’t you need it for strong teeth? My dentist told me so!

Image from wikipedia.org.
Image from wikipedia.org.

What’s wrong with toothpaste?

Since I’m not a medical scientist, the first question is perhaps one I’m a little more qualified to answer. I quickly checked the ingredients of my toothpaste and breathed a sigh of relief when I didn’t see any animal products that I recognised. But just in case, I looked up the issue online. Apparently glycerine, a common ingredient in toothpastes (and a component of my toothpaste, uh oh…) can be sourced from either animal or vegetable fats. It would seem that most toothpaste don’t specify where the glycerine came from! Products such as Colgate claim to be animal free and have a vegetarian product guide on their website. But that doesn’t necessarily mean it hasn’t involved animal testing, so if you want to be certain, keep an eye out for toothpaste with a ‘vegan’ label on it.

Fluoride

The fluoride part might be a little trickier for me to explain, but I will certainly try. On the outset it appears to be a hotly contested issue. I’m well aware that such issues are difficult to research for newcomers, for example it is easy enough for someone new to reading about global warming to see a few websites claiming that global warming is false and believe that. One needs to be careful when reading something from a particular group and consider whether they may have any vested interests in having you believe something (this could be conscious or unconscious bias). Even your search entries make a difference, for example searching ‘negative health effects of fluoride’ will, of course, yield vastly different results compared to searching ‘positive health effects of fluoride’. Having said that, let’s dive in.

Fluoride is often added to and found in toothpaste and drinking water. The hypothesis is that it prevents tooth decay and cavities, is safe, and saves money. We can break down our research into these 3 categories. Does it really prevent decay? Is it really safe? And does it really save money? If the answer to all three is unequivocally yes, then fluoride is good. If all three are no, it’s bad. If it’s a mix, we’re in a spot of bother. (A note on doing your own research – I highly recommend setting your decision making based on some key criteria prior to starting the research to help reduce bias)

According to a report from 2004 by the World Health Organisation (WHO), fluoride may be essential for humans, but it has not been demonstrated unequivocally, “and no data indicating the minimum nutritional requirement are available.” Low concentrations of fluoride in drinking water do appear to protect against dental cavities, particularly in children. The benefits increase with concentration of fluoride in drinking water up to about 2 mg per litre, and the minimum concentration required is around 0.5 mg/litre. For context, the Australian Drinking Water Guidelines recommend a maximum concentration of fluoride in drinking water of 1.5mg/L, which aligns with the WHO guidelines from 2008. However, the 2004 WHO report also states that fluoride may have negative effects on tooth enamel and lead to mild dental fluorosis with drinking water concentrations from 0.9-1.2 mg/L. It is curious to note that this level is lower than the WHO guidelines in 2008.

Recently, researchers have been proposing that the recommended fluoride concentration in water is reduced to err on the side of caution. The United States Department of Health and Human Services has suggested that the recommended level of fluoride per litre in public drinking water be reduced from the range of 0.7-1.2 parts per million (ppm) to a flat 0.7 ppm.

So is it worth avoiding fluoride? Most likely not. The risk of developing dental cavities remains over a lifetime, while the risk of developing dental fluorosis is primarily in younger individuals. The 2012 Fluoride Guidelines for Australia include the following key recommendations (quoted):

  • From the time that teeth first erupt (about six months of age) to the age of 17 months, children’s teeth should be cleaned by a responsible adult, but not with toothpaste
  • For children aged 18 months to five years (inclusive), the teeth should be cleaned twice a day with toothpaste containing 0.5–0.55mg/g of fluoride (500–550ppm). Toothpaste should always be used under supervision of a responsible adult, a small pea-sized amount should be applied to a child-sized soft toothbrush and children should spit out, not swallow, and not rinse. Young children should not be permitted to lick or eat toothpaste.
  • Fluoride supplements in the form of drops or tablets to be chewed and/or swallowed, should not be used

As an aside, decay in children’s baby teeth has been increasing in recent times and is possibly linked to the increased use of bottled water, which is often not fluoridated.

According to the American Dental Association (ADA), $1 invested in water fluoridation can save $38 in dental treatment costs. This sounds great – essentially it means that we’re saving $37 that could go back to the tax payer or towards other projects. It’s not that unreasonable, as anti-smoking campaigns yielded similar returns through reduced burden on the public health system. But first we need to be sceptical. Would the ADA have a reason for people to believe this statistic? Maybe.

This article does a bit of a dive into the cost benefit analysis for fluoride, (including a review of the original Journal of Public Health Dentistry paper from 2001 that makes this claim) and finds that the claim is mostly true, but perhaps slightly over exaggerated (the real benefit looks closer to 30:1 compared to 38:1). This does not appear to account for any potential negative effects associated with fluoride.

Verdict

If you’re old enough to read this, you should probably be using fluoride toothpaste and not avoiding fluoridated water. Fluoride is beneficial for reducing the risk of cavities, and the risk of developing dental fluorosis appears to be limited mainly to young children. It may depend on where you live, as different countries and even different regions within countries have varying fluoride concentrations in their water. Don’t take fluoride supplements if your water is sufficiently fluoridated. If you are at elevated risk of developing cavities, you may be advised by a medical professional to use a fluoride mouth-rinse in addition to toothpaste and water.

Conclusion

This also got me wondering what other products that I take for granted turn out to not be vegan. I did a bit of hunting and found a host of products that I never knew weren’t vegan, and which I use every day or support. Gulp! Other products include:

  • Plastic bags, which use animal fat
  • Car and bike tyres, which often use animal-based stearic acid
  • Fireworks, which use the same stearic acid (and also suck in terms of pollution)
  • Glue used for wood working and musical instruments, made from boiling animal tissue and bones
  • Biofuels, which can be made from beef (yeah, that’s a thing)
  • Fabric softener – certain brands contain dehydrogenated tallow dimethyl ammonium chloride which comes from cattle, sheep and horses
  • Shampoo and conditioner, which may animal products. Again, it’s tricky here as Panthenol, amino acids or vitamin B can be sourced either from plants or animals.
  • White and brown sugar – some brands use ash from animal bones to refine sugar
  • Bread, especially white bread, which often contains milk solids. Some breads contain egg.

The best way to be certain is to check for a vegan label or ask the manufacturer.

Most of the products in this article were taken from this list.

Do you have any unsuspecting everyday products to add to this list? Let us know by leaving a comment! If I’ve missed something in the fluoride write up or misrepresented some research, please comment below and I’ll be sure to fix it.

Disclaimer

This is not intended as medical advice. I research as thoroughly and carefully as I can, but I’m a geophysicist, not a medical scientist, doctor or dentist. I am just seeking to clear the air on a highly contested issue. If you are concerned about your fluoride intake, please seek professional medical advice. Pseudoscientific medicinal practitioners such as homoeopathists don’t count!