You must also visit your dentist every six months for a checkup and a cleaning, in order to remove any tartar that may accumulate-no matter which toothpaste you use.

Toothpastes contain abrasives (silicates, dicalcium phosphate, aluminum trihydrate, or calcium carbonate), a sudsing agent (often sodium lauryl sulfate) to carry away the debris from the teeth, flavoring and sweetening agents, moisturizers, binding, coloring, and water-plus additional agents for specific jobs, such as tartar control.

The most important ingredient a toothpaste can have is still fluoride, which prevents decay. Always buy a paste with the seal of the Canadian Dental Association (CDA), which means that it has been evaluated as safe and effective at preventing tooth decay.

Because so many brands are on the market, we list toothpastes below by category:

Anti-gingivitis toothpastes: Colgate's Total was approved recently by the FDA and given the ADA seal for its anti-gingivitis ability. It contains both fluoride and triclosan, a germ fighter already in some antibacterial soaps. According to controlled clinical trials, it can reduce gingivitis (bleeding gums, the first stage of periodontal disease) by one-third to one-half. The paste is formulated with a special polymer so that the triclosan sticks to the teeth for a significant period.

Other pastes make anti-gingivitis claims-without the CDA seal for those claims. Some of these contain stannous rather than sodium fluoride, but this is not as effective for cavity prevention and there's little or no evidence that it fights gingivitis. Viadent toothpaste, containing sanguinaria (a mild antiseptic), claims to reduce plaque if used in combination with its rinse, but there's no proof that it does more than the rinse alone.

Tartar-control toothpastes: Containing pyrophosphates or zinc salts, tartar-control pastes can reduce tartar accumulation on the teeth, but this is mostly a cosmetic benefit. They do not remove tartar or keep it from forming below the gum line, where it does its damage. Only regular cleanings by a dental hygienist or dentist can remove tartar. But tartar-control pastes cost no more than other kinds, and you may want to buy one, as long as it is fluoridated.

Baking soda toothpastes: These have a "natural" image, but no special cleaning or whitening abilities. Baking

soda loses its abrasive qualities when it's wet. There's no harm in using toothpastes with baking soda, or baking soda alone, so long as you brush thoroughly. Some baking soda products contain peroxide as an antibacterial agent, but this has not been shown to be more effective than plain brushing. Add a fluoride rinse to your routine if you use plain baking soda.

Mouthwash toothpastes: Listerine toothpaste contains the same ingredients as the mouthwash. Listerine is the only over the-counter mouthwash approved by the FDA and the ADA for reducing plaque. But there's no evidence that Listerine toothpaste is better than other pastes.

Whitening toothpastes: So-called tooth whiteners contain a variety of ingredients-titanium dioxide, aluminum oxide, papain, and/or peroxide. These agents may remove some of the thin protein layer on the tooth enamel that tends to get stained. (Peroxide as used in toothpastes is not strong enough to have any bleaching effect.) Some whiteners contain harsh abrasives that could damage soft tissues. But none of these pastes will whiten your teeth significantly, and most cost much more than regular pastes. Human teeth are seldom pearly white-if you have serious discoloration, see your dentist about bleaching.

Desensitizing toothpastes: These contain strontium chloride or potassium nitrate to block pain transmission and can help if your teeth are sensitive to cold or heat. But check with your dentist to make sure you have no underlying problem. Don't expect results right away-it may take two or three weeks for the desensitizing effect to begin. Choose a paste with fluoride.

Natural toothpastes: "Natural" ingredients in a toothpaste might make sense if you swallowed them, but little if any paste goes down the hatch while you brush. You may notice that "natural" toothpastes contain a lot of the same ingredients as "unnatural" ones, plus various herbs. There's no evidence these herbs are any help for dental hygiene. The real drawback to the "naturals" is that they seldom contain fluoride. And herbs, which may or may not be benign, are more likely to cause gum irritation and allergic reactions than a synthetic ingredient with a long track record of safety.

h have a much higher concentration of fluoride are now available with a prescription. Feel free to ask me for more information.

We welcome new patients!

www.drdavidross.net

Dr. Noel has left the practice. Patients who had been seeing him, will now be seen by the other dentists in the practice.

Dr Leclercq will be away from the office the weeks of January 12^th, February 9^th and March 15^th. She will be attending continuing education courses.

In an effort to keep the cost of dentistry down for our patients, we will no longer mail out monthly account statements. If necessary, we will contact you by phone or by email.

In the next issue of Tooth Talk, we will examine the ratings of the various electric toothbrushes and discuss our office sterilization procedures.

Also, the new Privacy Legislation takes effect in January. We have information we would like you to read when you come in for your next visit.