Sugar-Free Toothpaste: A Better Choice for Your Oral Care?

Is there sugar in my toothpaste? This is a question many of us have never thought to ask. But in a world where sugar is added to practically everything, it may just be the right question.

What is sugar-free toothpaste?

While toothpaste definitely has a sweet flavor, it is not the traditional table sugar you are tasting. Almost all toothpastes commercially available today are technically sugar-free.

The American Dental Association does not approve sugar in its traditional form because sugar increases the risk of cavities. Brushing two or three times a day with a traditional sugar-containing toothpaste would not benefit the teeth. Therefore, most traditional toothpaste uses some form of non-nutritive artificial sweeteners to give it that sweet taste and mask the other ingredients. The most commonly used one is sodium saccharin.

However, people are shifting their focus to products with natural ingredients, and sugar-free alternatives are becoming more popular. No-sugar toothpaste has no traditional sugars or artificial sweeteners, using naturally derived sweeteners for flavor purposes instead.

Ingredients in no-sugar toothpaste

Most toothpaste contains a long list of ingredients. Each one is designed to help prevent cavities, reduce plaque production, strengthen enamel, and support overall oral health.

No-sugar toothpastes typically exclude many of the common additives. While sugar-free toothpaste can contain some of the same ingredients as traditional toothpaste, most sugar substitutes are derived from natural sources. After reviewing many of the natural sweetener toothpaste available, here are some of the most common ingredients found in commercial no-sugar toothpaste.

Including no-sugar toothpaste alternatives in the oral hygiene routine may help support overall oral health. However, it is important to always consult your dental professional to make sure your toothpaste is right for your individual needs.

Benefits of no-sugar toothpaste

There are many reasons people choose to ditch traditional toothpaste and seek a no-sugar alternative, general health maintenance being one of them. Here are some other reasons people switch to sugar-free toothpaste.

Lowers the incidence of ulcers

Sodium lauryl sulfate (SLS) is one of the most common substances used in traditional toothpaste. Studies show SLS may potentially cause an increase in the number of ulcers in people who experience recurrent aphthous stomatitis (RAS), complicate oral wound healing, and cause irritation or pain in the oral cavity in some people.

Research also suggests switching to a SLS-free toothpaste may help prevent and lessen the severity of ulcers in people with RAS. While more research is needed to see whether people with RAS would benefit from SLS-free toothpaste, most natural and sugar-free toothpaste does not use this compound as an ingredient. Still, some may include it, so be sure to read the label before selecting a sugar-free option.

Lowers the risk of certain health issues

Sodium saccharin is a non-nutritive sweetener most commonly found in traditional toothpaste, as well as many other foods, drinks, and lip balms. Saccharin is non-cariogenic, meaning it does not encourage cavities. Sodium saccharin is commonly known as the sweetener Sweet N’ Low. Some people may be sensitive to saccharin, especially those who with sulfonamide allergies.

Some studies also show consuming saccharin may increase the risk of developing obesity, insulin resistance, and coronary artery disease in some people, however, the scientific research on these conditions in terms of sweetener use is still ongoing. The intake of such sweeteners from toothpaste is low, especially when it should not be swallowed, thus, it is unlikely that such sweeteners may contribute to the increased risk of developing these conditions.

Common ingredients in regular toothpaste like SLS, triclosan, and titanium dioxide have also been associated with potential health concerns in some people, like gastrointestinal irritation and even endocrine disruption. While usually, such substance inclusion in toothpaste is regulated to meet the health safety levels, due to limited long-term effects, choosing a toothpaste without these ingredients may be preferable by some people.

Most ingredients show adequate safety

In a review of common ingredients in natural toothpastes released in 2022, most of the ingredients used in natural toothpastes are shown to be safe. According to the review, these ingredients have fewer side effects and less risk of being toxic than the ones used in traditional toothpaste. This study also includes the natural sweeteners commonly used in sugar-free toothpaste. However, more research is needed to determine all the potential benefits natural toothpaste provides for oral health.

What sweeteners are used in sugar-free toothpaste?

Sweeteners are added to toothpaste to improve the taste while masking the potential flavors of other ingredients. The ADA requires any sweeteners in toothpaste to be non-cariogenic, meaning they do not cause cavities in teeth. Let's take a look at what sweeteners are used in sugar-free toothpaste.

Xylitol

Xylitol is a sugar alcohol that naturally occurs in some fruits and vegetables. Studies show it may help reduce the risk of cavities by inhibiting Streptococcus mutans — cavity-causing bacteria — and increasing saliva production. It is commonly used in products other than toothpaste, like mouthwash, gum, and candy because it has the equivalent sweetness of table sugar. Unlike regular sugar, xylitol has a relatively low glycemic index, which makes it very popular for diabetics as well.

However, some people may experience gastrointestinal disturbances with xylitol. Recent studies are also raising questions about the consumption of xylitol causing cardiovascular issues. Therefore, more research is needed to determine how xylitol should be used and its safety in all products, not just toothpaste.

Sorbitol

This sugar alcohol has been shown to prevent demineralization and lower the formation of dental cavities by decreasing acid production and reducing cavity-forming bacteria. According to a three-year study, patients who used a xylitol-sorbitol mixture toothpaste showed fewer cavities as compared to those who used sorbitol-only toothpaste. Besides its sweetness, sorbitol is also often used in toothpaste as a humectant to prevent the paste from drying out and hardening in the tube as it is exposed to air.

Erythritol

Erythritol is another sugar alcohol that is stable in acidic and alkaline environments, tastes sweet like table sugar, is non-cariogenic, and has a low glycemic index. Also, a number of studies on the toxicology and safety of erythritol show a complete lack of adverse effects associated with its consumption. Some evidence suggests erythritol may be better than sorbitol and xylitol at maintaining and supporting oral health. It is often used as a sweetener in other products like gum, processed foods, beverages, and condiments.

Tips for choosing the right toothpaste

With so many ingredients and so many intended purposes, such as cavity protection, sensitivity relief, plaque prevention, gingivitis fighting, or whitening, picking one suitable for individual needs may be challenging. Unfortunately, there is not one toothpaste that can fit every person's needs. This is why, while much of it comes down to personal preference, here are a few things to consider when searching for the toothpaste that best fits you.

Choose a toothpaste with cavity protection

Fluoride is the most common ingredient used to prevent tooth decay in toothpaste. In 2021, the World Health Organization (WHO) added fluoride toothpaste to its Model List of Essential Medicines, along with other fluoridated products. Fluoride is a mineral that naturally occurs in plants, soil, and even some water supplies. Many studies show that fluoride may help strengthen the enamel of your teeth and prevent cavities. Fluoride was first added to toothpaste in 1956. Now, fluoride is commonly found in most major toothpaste brands.

There are other cavity-preventing ingredients that are becoming more readily available. This includes toothpaste with:

• Xylitol. This naturally occurring sugar alcohol is commonly used as a sweetener in various products, including toothpaste, mouthwash, and sugar-free gum. In a review of literature, it is suggested xylitol can be effective in cavity prevention. It is often used in combination with fluoride. However, more in-depth studies are needed.
• Hydroxyapatite. When studied in children, hydroxyapatite toothpaste performed comparable to fluoride toothpaste, remineralizing initial caries and preventing demineralization. Hydroxyapatite toothpaste may be an alternative for those who may not be able to use fluoride.
• Arginine. There are many suggested benefits to arginine in toothpaste, like disrupting biofilm, buffering the pH of the oral cavity, increasing remineralization, and decreasing enamel demineralization. However, most research involves the combined effects of arginine with fluoride. So, more research is needed to completely understand the full benefits of arginine alone.
• Theobromine. A recent study compared the results of using a theobromine toothpaste and common fluoride toothpaste in children. Both showed promise in the ability to remineralize tooth enamel, but the theobromine toothpaste increased the pH of the saliva and lowered the number of harmful bacteria in the mouth to prevent tooth decay. It is also beneficial for sensitive teeth. Theobromine is often combined with fluoride as well for added benefits.

Although these ingredients may be comparable to fluoride, more research is needed to assess if they should replace the use of fluoride. Currently, the ADA recommends brushing for two minutes twice a day with fluoride toothpaste to help protect your teeth from cavities. So, be sure to check with your dental provider before switching to a fluoride-free toothpaste.

Look for the ADA seal

The ADA seal means the product was tested and approved for things like toxicity, effectiveness, quality, and safety. Potential product benefits must have scientific research to support the statements made about the product. However, the ADA seal is not required for oral care products. Many products without the seal can provide effective benefits. This seal simply offers some assurance about the product you are buying.

Consider your specific needs

Many of the ingredients in toothpaste can alleviate common tooth issues. Some active ingredients help with whitening, sensitivity, dry mouth, and others. The first step in choosing the right toothpaste is to determine what your needs are. Carefully consider your oral conditions and desired results, then choose a product that addresses those needs. And since there are so many toothpastes available, it may be necessary to consult your dental provider for specific suggestions. They may make the process of picking suitable toothpaste easier and less stressful than choosing alone.

Final thoughts

Toothpaste is an important part of our oral hygiene care routine. Toothpaste helps freshen breath and, most importantly, prevent common dental issues and promote gum health. Brushing your teeth two times a day with the right toothpaste can make all the difference. So, the ingredients in your toothpaste matter. A good hygiene routine, regular dental check-ups, and the right toothpaste ingredients will help keep your smile healthy and happy for a lifetime.

We would love to hear from you. Please share your questions or experiences with sugar-free or natural toothpaste below.