Should We Fear Triclosan in our Toothpaste?
About the Doctor
JoAnn Gurenlian RDH, PhD, is a Professor and Graduate Program Director of the Department of Dental Hygiene at Idaho State. She is the President of the International Federation of Dental Hygienists and Past President of the American Dental Hygienists Association. Dr. Gurenlian maintains a column entitled, "Looking Ahead" in RDH magazine, and is the co-author of a textbook "Preventing Medical Emergencies." She has been active in dental hygiene for over 35 years as a leader, educator, clinician, administrator and researcher.
Over the past decade, concerns have been raised by the media about the use of triclosan in products such as soaps, deodorants, shaving cream, and toothpastes.
Articles and news programs have reported the dangers of triclosan leaving the public confused about the safety and efficacy of this ingredient.
Triclosan is a chemical added to Colgate Total toothpaste, designed to work with a copolymer to prevent gingivitis with effects lasting up to 12 hours. Dental science has demonstrated that it is effective as both an antibacterial and anti-inflammatory agent, and is effective in managing biofilm and gingivitis.
Unfortunately, there are naysayers who claim that triclosan is unsafe.
For example, as reported in examiner.com, an assistant professor in civil and environmental engineering at Virginia Polytechnic Institute stated that triclosan in toothpaste could react with chlorine in tap water to produce chloroform gas. This reaction may cause depression, liver problems, and cancer. A similar finding was reported in a study published on the Environmental Science & Technology research website As Soon As Publishable suggesting that triclosan may be ineffective and harmful.
A study conducted by researchers at the University of California, Davis, and the University of Colorado noted that triclosan hinders heart muscle cells and skeletal muscle fiber contractions at a cellular level, causes thyroid dysfunction, slows swimming in fish, reduces muscular strength in mice, and could cause disruption of reproductive hormone activity and cell signaling of the brain.
Given these health concerns and the purported association of triclosan with adverse effects, it is important to seek additional scientific information to determine if the evidence supports or refutes these issues. Fortunately, such science does exist.
First, Colgate had to submit a New Drug Application to the Food and Drug Administration (FDA) in 1997 to demonstrate that Colgate Total was both safe and effective. Approval for this product was received at that time and has been continuously monitored by the FDA. In a briefing conducted in December 2013, the FDA verified that Colgate Total is safe and effective.
In addition, Colgate Total is the most widely studied toothpaste in the world.
More than 80 published clinical trials involving more than 19,000 subjects have been conducted evaluating the safety and efficacy of this toothpaste with triclosan. The American Dental Association granted the Seal of Acceptance to Colgate Total after reviewing longitudinal studies that documented the safety of long-term use of this toothpaste. The criteria to receive this seal are substantive and rigorous.
More recently, the Cochrane Oral Health Group conducted an independent review of Colgate Total toothpaste. This international organization is designed to help individuals make well-informed decisions about health care by preparing, disseminating, and maintaining systematic reviews of the effects of health care interventions. Cochrane Reviews are globally recognized by health professionals as the authority for high-quality clinical decision making. As part of their independent review, The Cochrane Oral Health Group evaluated 30 studies from 1990 to 2012. These studies included 14,835 subjects randomized to receive either a triclosan/copolymer-containing fluoride toothpaste (Colgate Total) or a traditional fluoride toothpaste that did not contain the triclosan/copolymer. Results of this systematic review showed significant oral health benefits from using a triclosan/copolymer fluoride toothpaste. Findings showed a 22% reduction each in plaque and gingivitis, and a 48% reduction in bleeding.
There was no evidence of any harmful effects associated with the use of Colgate Total in studies up to three years in duration and no serious safety concerns.
Why should oral health care professionals feels comfortable, even enthusiastic, about recommending Colgate Total? What talking points can they use when discussing Colgate Total and triclosan with patients?
Dentists and dental hygienists should feel confident recommending Colgate Total toothpaste as the science supports its safety and effectiveness. For those patients who express concern about using a toothpaste containing triclosan, they can be assured that regular and continuous research has demonstrated that the formula in Colgate Total provides significant oral health benefits and has not shown any deleterious systemic health effects.