The Healthy Skeptic: Keeping the cavities away with fluoride-free toothpaste

By: Chris Woolston

Theodent says its compound Rennou is more effective than the mineral in strengthening tooth enamel. One study backs that claim, but it has yet to be published.

Fluoride is a natural mineral with an unnatural ability to stir controversy. On the Internet, the cavity fighter is often portrayed as a grave threat to health. Various sites call it “a deadly poison” and “an invisible killer” — the sort of thing you’d want to avoid if you had any choice.

“...the only major toothpaste innovation in over a century...”

Most toothpastes contain fluoride, but people who prefer to brush without the additive have plenty of options. Tom’s of Maine, a health and beauty company based in Kennebunk, sells several varieties of fluoride-free pastes. (The company also makes many with fluoride, so shoppers should read the labels.) Anti-Plaque and Whitening, the company’s most popular fluoride-free paste, contains red seaweed along with more typical toothpaste ingredients such as xylitol (a sweetener), hydrated silica (an abrasive) and sodium lauryl sulfate (a foaming agent). A 5.5-ounce tube, available at many grocery and health food stores, costs about $5.

New to the game is Theodent, a toothpaste containing an extract of cocoa. (The packaging looks like a chocolate bar, but don’t count on the paste to satisfy your sweet tooth; it looks and tastes just like regular toothpaste.) The cocoa extract is the key to the paste’s active ingredient, a compound the company calls Rennou. Other ingredients include xylitol, glycerin and xanthan gum.

Theodent comes in two varieties, Theodent Classic and Theodent 300, an extra-strength version with higher levels of Rennou. A 3.4-ounce tube, available at many Whole Foods Markets, costs about $10.

The Claims

The Tom’s of Maine website makes no claims that its fluoride-free pastes are any safer or more effectivethan their fluoride pastes. The site simply notes that “some people do not want fluoride in theirtoothpaste. We respect our customers’ diverse needs and interests.”

Pam Scheeler, stewardship manager for Tom’s of Maine, says that the fluoride-free pastes offered by the company will clean teeth just as thoroughly as regular pastes but that they won’t offer the same level of cavity protection. She acknowledges that many of the company’s customers are afraid of fluoride, “whether that fear is founded or not.”

The Theodent website calls the product “the only major toothpaste innovation in over a century” and says the active ingredient, Rennou, is “a non-toxic and revolutionary alternative to fluoride.”

Arman Sadeghpour, president and chief executive of New Orleans-based Theodent, says his research as a doctoral student at Tulane University showed that Rennou was even more effective than fluoride for improving the hardness of tooth enamel. According to Sadeghpour, Rennou strengthens teeth by encouraging the growth of natural crystals in the enamel. “It works better than fluoride and has none of the toxicity,” he says. “It’s a no-brainer.”

The Bottom Line

Brushing with a fluoride-free paste is certainly better than not brushing at all, says Dr. Edmond Hewlett, associate professor of dentistry at the UCLA School of Dentistry and a consumer advisor spokesman for theAmerican Dental Assn. If nothing else, he says, the pastes will help clear the mouth of food particles and plaque, a big step toward good oral hygiene.

Still, he says, there’s a reason why only fluoride toothpastes carry the ADA seal of approval. As he explains, fluoride protects teeth by filling in tiny gaps in the ename surrounding each tooth. The extra fortification protects teeth from acid, the root cause of tooth decay and cavities. “Fluoride has saved millions and millions of teeth from decay,” he says.

Besides, Hewlett says, there’s no need for most people to avoid fluoride in their pastes. (The ADA says parents should talk with their dentist before giving a fluoride paste to children 2 and younger.) According to Hewlett, the amount of fluoride found in pastes is completely safe for brushing. “There’s an overwhelming amount of misinformation about fluoride on the Internet. This is not something that people need to worry about.”

Hypothetically, the ADA could some day endorse a fluoridefree paste if it contained a compound that was just as effective as fluoride, Hewlett says. But it’s too soon to say whether Theodent and its active ingredient Rennou would fit the bill.

For one thing, the studies involving Rennou have yet to be published. TheU.S. Food and Drug Administrationhas ruled that all the ingredients in Theodent are “generally recognized as safe,” but the agency has not tested the claims that Rennou strengthens enamel.

But there is already some room for optimism.

Dr. Bennet Amaechi, associate professor of comprehensive dentistry at the University of Texas Health Science Center in San Antonio, recently conducted a small study of Rennou on human teeth in an artificial mouth. (Theodent helped pay for the study, but Amaechi says he has no ongoing financial ties to the company.) In tests, Rennou proved to harden enamel better than similar concentrations of fluoride, Amaechi says. The results will be published this year in a scientific journal, he adds.

“It’s something that I can confidently recommend in place of fluoride,” he says. However, Amaechi stresses that fluoride toothpastes aren’t dangerous. “Some people still don’t like to use fluoride. If they have concerns, there’s another choice.”

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