HEALTH: Dentists recommend - yes, what now?

HEALTH: Dentists recommend - yes, what now?

In Switzerland, many toothpaste brands compete for customers. Dentists' advice can boost their sales. Which toothpaste is the right one also depends on age.

An autumn morning in a kindergarten class in Lucerne. The dentist explains to the children what they have to consider when brushing their teeth. She discovers discolouration in a child. She asks the mother present: "Is the child using Elmex toothpaste?" When the mother says yes, the doctor advises taking candida in the future.

Such statements from dentists are repeated again and again, even among adults. What's behind it? Can certain brands really be advised against? Or do dentists even allow themselves to be used by manufacturers? Questions to scientists, dentists, dental hygienists and those responsible for school dental care show that there are no official recommendations for individual brands. However, every dentist has their own experiences and so it can happen that they advise against certain toothpastes - and recommend others in turn.

Constant contact with dentists

There are numerous toothpaste brands in Switzerland, some of which belong to large international corporations. It goes without saying that they are courting dentists and dental hygienists. However, dentists emphasize that recommendations are always made independently. Free samples or other small gifts don't seem to play a role. The manufacturers themselves also see it this way: At the Migros subsidiary Mibelle, which manufactures the Candida toothpaste, it says: "We are in constant contact with dentistry professors and with numerous dentists in Switzerland." Mibelle also cooperates with universities, dental hygienists and school dental care. In this case, cooperation also means that product samples or brochures are distributed. "By working together, we want to incorporate the latest findings from dentistry into our products," says a Mibelle spokeswoman.

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Elmex manufacturer Gaba also makes no secret of its proximity to dentists. One maintains "intensive contacts with university institutes and practicing dentists." This ensures a lively exchange of knowledge between science and practice and guarantees the further development of the products according to the needs of dentists and patients. If dentists recommend Elmex, this will be done independently and "based on the recognized product quality and the customer benefit that can be proven over decades," says a spokeswoman.

Based in Therwil, Gaba has been part of the American Colgate-Palmolive Group since 2004. According to estimates by the Competition Commission, Gaba and Colgate control around half of the Swiss toothpaste market. When asked about the allegation that Elmex could cause discoloration, the Gaba spokeswoman says: "Elmex does not contain any ingredients that cause discoloration." The effectiveness of Elmex is proven by many scientific studies. In fact, according to experts, it can hardly be said that using products from well-known toothpaste brands causes discoloration. The development of discolouration depends on many factors such as the consumption of coffee, tea and red wine and of course smoking. In addition, external influences such as taking medication or pharmaceutical mouthwashes can also cause discolouration. Special toothpastes help against discolouration. One of them is called "Black Is White" and is made by the Kriens-based dental hygiene specialist Curaden. Special: This toothpaste is black; Activated carbon absorbs the particles that cause discoloration. However, this toothpaste is also more expensive than conventional ones.

Science itself does not recommend individual brands, according to the Center for Dentistry at the University of Zurich. The Swiss Dental Society and the Professional Association of Dental Hygienists in Switzerland also generally do not recommend any specific products. However, the associations emphasize product properties that are important for toothpaste. This includes above all the fluoride content (see box).

Ingredients more important than brand

For the Lucerne dentist Jürg Eppenberger, the fluoride content is one of two important criteria. "When choosing, you should also make sure that the toothpaste has a suitable, weak abrasive effect," says Eppenberger. Experts speak of the RDA value (Relative Dentine Abrasion), which is not usually declared on the paste. «The higher the RDA value, the more sanding takes place. So-called smoker's toothpaste with a high RDA value should never be used regularly to brush your teeth," advises Eppenberger. According to the Swiss Dental Society, care must be taken to ensure that the toothpaste has a medium abrasive value (RDA 40 to 80). If the value is too high, the tooth enamel can be damaged. According to experts, if you pay attention to the abrasive value and the fluoride content, the brand does not play a major role. There are still preferences: Eppenberger, for example, usually recommends toothpastes from Elmex or Colgate.

The main thing is fluoride, but not too much

The fluoride content is the most important criterion for toothpastes, say scientists and associations unanimously. Fluoride is involved in bone formation and bone growth; it not only hardens bones but also tooth enamel. A sufficient supply of fluoride to the body can also significantly reduce the occurrence of tooth decay.

According to the Zahnärzte-Gesellschaft, more than 90 percent of the toothpastes sold in Switzerland contain fluoride. Since the 1960s, caries in Swiss school children has fallen by 90 percent, partly thanks to the effects of fluoride. In adults with an increased risk of tooth decay, a fluoride gel should also be used once a week, advises the Dental Association. For children under the age of 6 there is usually no fluoride deficiency. For the little ones, we recommend children's toothpaste (from the first milk tooth) and later a low-fluoride toothpaste (at the latest from the age of 6).

However, there are also toothpaste manufacturers who deliberately avoid using fluoride. This includes Weleda from Arlesheim (Basel-Land). Fluoride can easily be overdosed, which can trigger negative effects such as increased bone fragility and dental fluorosis, says a Weleda spokesman. As an anthroposophically inspired company, Weleda also incorporates aspects of Rudolf Steiner's spiritual science into product development. Since fluoride is naturally contained in various foods such as fish, cereals, milk, nuts and water, the individually required dose of fluoride is often already reached through the food. However, the Lucerne dentist Jürg Eppenberger knows from his practice that Patients who use pastes without fluoride develop caries much more often and faster.

Maurizio Minetti

maurizio.minetti@luzernerzeitung.ch