Toothpaste Ingredients: Long-term Effects on Oral Health

Regarding toothpaste ingredients?

Hello, Director Zeng.
I have seen some information suggesting that chlorhexidine can kill both good and bad bacteria, and long-term use may lead to an imbalance of bacterial species, worsening periodontal conditions.
I would like to ask you:
1.
Based on this principle, is it also inadvisable to use toothpaste containing IPMP (isopropyl methylphenol) for an extended period?
2.
If one wishes to help suppress periodontal disease, are there any recommended toothpaste ingredients suitable for long-term use? Is propolis an option?
Thank you for your clarification, and I wish you good health, peace, and happiness!

Mr. Huang, 30~39 year old female. Ask Date: 2024/07/22

Dr. Zeng Guanghui reply Dentistry

Hello Mr.
Huang,
1.
Some mouthwashes may contain chemical agents that can kill bacteria.
Short-term use can help reduce oral bacteria, but long-term use may also affect the normal flora of the mouth.
IPMP is a plant extract that contains antibacterial and antioxidant properties.
Currently, there are no definitive research reports confirming whether long-term use of dental products containing this ingredient will impact the normal oral flora.
2.
There are no specific contraindications for the long-term use of toothpaste containing beneficial bacteria.
However, the key is to thoroughly clean the tooth surfaces and interproximal areas to remove dental plaque and calculus in order to improve periodontal health.
Dr.
Tseng Guang-Hui, Department of Dentistry, Nantou Hospital

Reply Date: 2024/07/22

More Info

Dear Patient,
Thank you for your thoughtful questions regarding the long-term effects of toothpaste ingredients on oral health. Your concerns about the balance of oral microbiota and the potential impacts of certain ingredients are valid and important for maintaining optimal oral health.

To address your first question regarding chlorhexidine, it is indeed a powerful antiseptic that can kill a wide range of bacteria, both harmful and beneficial. While it is effective in managing periodontal disease and reducing plaque, long-term use can lead to an imbalance in the oral microbiome. This imbalance may potentially exacerbate periodontal conditions over time, as the beneficial bacteria that help maintain oral health are also eliminated. Therefore, chlorhexidine is typically recommended for short-term use, especially in cases of acute periodontal disease or after dental procedures, rather than as a long-term solution.

Regarding your question about toothpaste containing isopropyl methylphenol (IPMP), similar principles apply. IPMP is an antimicrobial agent that can effectively reduce plaque and gingivitis. However, like chlorhexidine, its long-term use may also disrupt the natural balance of oral bacteria. While it can be beneficial in the short term, relying on it indefinitely may not be advisable.
For long-term oral health, it is essential to choose toothpaste that promotes a healthy balance of oral bacteria while still providing protection against cavities and gum disease. Here are some recommendations for ingredients that can be beneficial for long-term use:
1. Fluoride: This is a well-known ingredient that helps to remineralize enamel and prevent cavities. It is safe for long-term use and is recommended by dental professionals.

2. Xylitol: This natural sugar alcohol can help reduce cavity-causing bacteria and promote a healthier oral environment. It can also stimulate saliva production, which is beneficial for oral health.

3. Probiotics: Some toothpaste formulations now include probiotics, which can help maintain a healthy balance of oral bacteria. These beneficial bacteria can inhibit the growth of harmful bacteria associated with gum disease.

4. Honey or Propolis: Propolis, a resin-like material made by bees, has antimicrobial properties and may help in managing oral health. Some studies suggest that it can be effective against bacteria that cause periodontal disease. However, more research is needed to fully understand its long-term effects.

5. Essential Oils: Certain essential oils, such as tea tree oil and eucalyptus oil, have antimicrobial properties and can be beneficial in maintaining oral health. However, they should be used in moderation and as part of a balanced oral hygiene routine.

In conclusion, while certain antimicrobial agents can be effective in managing oral health issues, their long-term use should be approached with caution due to the potential for disrupting the oral microbiome. It is advisable to consult with your dentist about the best toothpaste options for your specific needs, especially if you have a history of periodontal disease or other oral health concerns. Regular dental check-ups and a comprehensive oral hygiene routine, including brushing, flossing, and possibly using a mouthwash with beneficial ingredients, are crucial for maintaining optimal oral health.

Thank you for your questions, and I wish you continued health and happiness!
Best regards,
Doctor Q&A Teams
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