CSO Letter – why Theodent’s Toothpastes are so Revolutionary and Unique
Dietary habits of various foods and drinks in our daily lives significantly impact our health. The mouth (oral cavity) is the beginning of the digestive tract, and its health represents the health of the entire person.
In today’s society, daily consumption of large quantities of soft drinks, fruit juices, and wine causes erosion (washing away of tooth mineral due to acid exposure – also known as “cavities”). Most of these drinks are acidic. This enamel erosion is one of the reasons for increased tooth sensitivity.
In normal mouths, the exchange between tooth surface and saliva, which contain calcium and phosphate, provides the tooth surface with building blocks for enamel remineralization. Teeth are formed from calcium phosphate in the form of hydroxylapatite (HAP) mineral.
Erosion of enamel surfaces becomes a pathological situation when the repair process cannot keep up with the rate of erosion. This eventually leads to thinning of enamel surfaces and cavity formation. You can think of this as a delicate balancing act.
Correlations have been reported between chewing and daily life activities and the nutritional status of the elderly (Neurosci Biobehav Rev. 2011; 35: p. 483). For example, chewing gum is associated with increased alertness and more positive mood (Nutr Neurosci. 2010; 13: p. 7). Chewing can also stimulate memory (Neurosci Lett. 2008; 436: p. 189), suggesting that proper chewing can become an important contributor to mental alertness. Recently, it was reported (Wall Street J, 8/12/2014, D1) that increased chewing during meals leads to reduced calorie consumption, which could control weight over time.
Gum disease may be associated with the development of myocardial infarction (J Int Acad Periodontol. 2011; 13: p. 40), respiratory disease (J Periodontol. 2011; 82: p. 1155), coronary heart disease, chronic kidney disease (Curr Opin Nephrol Hypertens. 2010; 19: p. 519), several forms of cancer (J Evid Based Dent Pract. 2010; 10: p. 223), and the clinical onset and progression of Alzheimer’s disease (Alzheimers Dement. 2008; 4: p.242). Some oral symptoms may predict mortality from pneumonia and cardiovascular diseases (J Dent Res. 2008; 87: p. 485).
These examples show how healthy oral condition and/or function is crucial for maintaining our general health. The purpose of Theodent, the revolutionary toothpaste, is to play an important role in promoting “Healthy teeth” and general health.
Studies on Xanthines
Almost 30 years ago, we discovered that caffeine consumption causes increased dissolution of enamel surfaces. Later, it was found that this was due to the formation of reduced enamel crystal size due to caffeine exposure (Arch Oral Biol 1993; 38: p. 441). Caffeine belongs to a group of naturally occurring compounds known as xanthines.
These phenomena are explained with a simple example. If we pour a gallon of water into two glasses and one container has one pound of solid ice, while the other container has crushed ice. The container with crushed ice will melt faster due to its smaller size (larger surface area).
Dental caries and cavity formation are partly due to acid produced by bacteria in the mouth dissolving the hard surface (enamel) of teeth. Therefore, it’s reasonable to assume that smaller crystal size will increase caries in teeth exposed to caffeine compared to unexposed teeth. This hypothesis proved to be true (Arch Oral Biol 1993; 38; p. 919). Children’s teeth of pregnant or nursing women who drink a lot of coffee (coffee contains caffeine) could be unintentionally affected, i.e., offspring’s teeth could become susceptible to future dental caries.
While studying caffeine’s effects on enamel, an accidental discovery was made. We assumed all xanthines would have the same effect on enamel as caffeine, but this proved to be a false assumption. Another member of the xanthine family, theobromine, had the opposite property of caffeine; meaning theobromine increases crystal size. Large crystallite size is associated with resistance to dissolution and dental caries (JADA 1975; 91: p. 594). Thus, in the ice example above, crystals larger than the block of ice have less surface area and will therefore dissolve or melt more slowly than crushed ice.
Theobromine is the only known substance that increases the size of hydroxylapatite crystals on tooth surfaces. This may explain why cocoa feeding prevents dental caries (Arch Oral Biol 1966; 11: p. 149). It has also been shown that theobromine is 71 times more effective at remineralization than fluoride (Caries Res 2013; 47: p. 399).
Theobromine is the main ingredient in cocoa. Our proprietary ingredient, “Rennou TM ” is the culmination of years of intensive study and was developed based on this discovery.
Effects of Fluoride
Fluoride-based toothpastes have been the standard for many years. In the presence of fluoride, fluoro-hydroxyapatite crystals form. Partially fluorinated crystallites have lower solubility in acid produced by bacteria in the mouth than non-fluorinated HAP and thus protect against caries. Another role of fluoride is promoting tooth remineralization in early stages of decay (Brit Dent J 2013; 214: p. 161). These are the mechanisms of fluoride protection against dental caries.
The first fluoridated toothpastes were introduced in 1955 (Scientific American 2008; p. 74). Although fluoride is considered the gold standard in oral care, toothpastes containing fluoride have a warning “Keep out of reach of children under 6 years of age. If more than used for brushing is accidentally swallowed, get medical help or contact a poison control center right away.” A poison control centers report showed 21,513 calls in 2011 regarding fluoridated toothpaste ingestion (Clinical Toxicol 2012; 50: p. 911).
Given this warning, one wonders what harmful, cumulative effects there might be on the general health of adult and elderly populations who may be exposed to or swallow even very small amounts of fluoride daily throughout life? Excessive fluoride ingestion has been linked to increased risk of permanent staining of developing teeth, and approximately ninety percent of toothpastes in the USA are fluoridated (Environ Health Perspect 2005; 113: p. 111). Additionally, increased risk of bone fracture from excessive fluoride has been reported (Pediatrics 1986; 77: p. 876) and possible increased incidence of osteosarcoma (Cancer Causes and Control, 2006; 17: p. 421).
Dentists in the USA see young children with as many as 10 cavities. The American Dental Association (ADA) recommends using only a pea-sized amount of fluoride toothpaste for brushing, starting at age 2. (JADA 2014; 145(2): p.190). Unfortunately, it has been shown that 1-3 year olds swallow 30-75% of toothpaste (BMC Oral Health 2006; 6(Suppl 1):S9 p.1). It’s difficult to teach a two-year-old to spit out toothpaste, especially if it tastes excellent.
Tooth discoloration is just one aspect of fluoride concerns. A recent report from China showed a connection between fluoride intake and significantly lower IQ scores for children (Fluoride 2003; 36: p. 84). A Harvard University review suggested further in-depth studies on this aspect of fluoride (Lancet 2006; 368: p. 2167). On the other hand, a more recent report from New Zealand challenges the finding of a link between fluoride exposure and IQ (Am J Public Health 2014; e1-e5. doi:10.2105/AJPH.2013.301857).
Fluoride appears to readily accumulate in the human pineal gland (a small gland representing the brain), and a positive correlation has been demonstrated between fluoride and calcium content in this gland (Caries Res 2001; 35: p. 125). The pineal gland produces melatonin, a hormone associated with determining sleep rhythms and duration. The rate of calcification has been linked to decreased melatonin secretion (Neuropsychopharm 1999; 21: p. 765). Thus, this could cause disruption of circadian rhythms and sleep patterns (Psychiatry Res 1998; 82: p. 187).
A possible connection between fluoride intake and thyroid disease has been reported (Fluoride 2005; 38: p. 98). There are many arguments for and against the benefits of fluoride in fighting caries. Given the evidence presented above about possible harmful effects, it’s understandable that strong opposition has developed to daily use of fluoride in consumer products.
One of the obvious advantages of Theodent toothpastes is that they are safe to swallow. This non-toxic formula is an advantage for concerned parents. Theodent Kids toothpaste has the FDA’s highest food additive designation, which is GRAS (Generally Regarded As Safe) status.
Theodent’s Effect on Sensitivity
As mentioned above, erosion of tooth surfaces can result from consumption of various soft drinks, fruit juices, and wine. Sensitivity from this source is one of the problems frequently encountered by dentists. It’s estimated that 15-57% of adults suffer from sensitivity (J Clin Dent 2009; 20: p. 1), and the incidence appears to be increasing (US Pharm 2011; 36: p. 12).
Theodent sponsored a clinical study with 80 individuals (Clin Oral Invest 2014; DOI 10.1007/s00784-014-1226-1). The electron microscope images below show the results. The first image shows an eroded tooth surface before brushing. Note the small tube openings that are exposed in the mouth. It has been found that the more exposed the tubes are, the more pain a person will feel with cold or hot drinks. One way to treat sensitivity is to plug (close) these tubules. Results after one week of brushing with a regular commercially available fluoride toothpaste (twice daily, morning and evening) are shown in the middle image. Tubule occlusion is very small and most remain open, indicating the toothpaste is not effective at reducing sensitivity. The third image shows the results after using Theodent in the same manner as the fluoride toothpaste. Here all tubes are completely plugged. Those interested in more details can read the original article (Clin Oral Invest 2014; DOI 10. 1007/s00784-014-1226-1).
Whether Theodent is more effective than fluoride-containing toothpastes in preventing dental caries is currently planned for future studies.
Theodent’s Mission
In science, absolute truth is difficult to reach. The introduction of Theodent became controversial as soon as the new technology was presented. However, we have every reason to believe our results and expectations will stand up to any challenges in the future.
Theodent’s philosophy is to produce premium products that will lead to consumer satisfaction and good oral health. By maintaining healthy oral function, this will eventually lead to a healthy lifestyle that can be maintained in future years. Considering the potential harmful effects described by many scientists for fluoride, why take the risk?
We don’t advertise our products, but people tell others when they’re satisfied with them. That’s how a revolution in oral care began in New Orleans.
Chief Science Officer, Theodent LLC