A new report in the British Dental Journal (BDJ) May 2019 has concluded there are a range of harmful attributes surrounding charcoal toothpaste use.
Used in Australia and around the world, manufacturers typically claim it whitens teeth and removes stains. However this report found some products were actually harmful to teeth. With the upcoming Australian Dental Association's (ADA) Dental Health Week approaching, the ADA wants to alert consumers to the risks associated with use of these products.
The BDJ report 'Charcoal-containing dentifrices' evaluated all the existing literature reviews from a database of 50 charcoal-based toothpastes and found:
*Based on a previous study of 118 articles, there was 'insufficient evidence to substantiate the cosmetic health benefits (antibacterial, antifungal or antiviral, reduced caries, tooth whitening, oral detoxification).
*It uncovered 'possible health risks' related to the possible inclusion of human carcinogenic polyaromatic carbons in charcoal and the use of bentonite clay in some charcoal-based toothpastes'.
*Only 8% of charcoal toothpastes contain fluoride, scientifically proven to prevent or slow the onset of dental caries.
* The report said that 'certain forms of charcoal used in oral hygiene products have been found to have relatively high abrasivity' and 'may result in the loss of tooth surface, in other words, tooth wear'. While low abrasivity is included in the claims of many of these products, 'these claims have not, to date, been independently verified.'
* Another conclusion is that 'one of the negative impacts of the use of charcoal-base dentifrices by patients with established periodontal disease' (gum disease affecting the supporting structures around the teeth including the gums and bones) 'may be the accumulation of particles deep in periodontal defects and pockets, causing grey/black discoloration of the periodontal tissues'. Further, that 'particles of charcoal may build up in deep fissures and surface defects of composite restorations (white fillings). If this occurs in the smile zone, then dental attractiveness may be adversely affected'.
Further, excessive brushing with these preparations 'may cause more harm than good, especially to tooth-coloured restorations with relatively low abrasion resistance.'
* The report referred to a previous study which found 'insufficient evidence to support the tooth whitening claims, let alone any associated bleaching effects of charcoal dentifrices'. It adds that 'activated charcoal does not change the colour of the teeth other than by abrasive action similar to that of a smoker's toothpaste and its use may pose some risk to the enamel and gingiva'.
* The BDJ report also looked at the 'worrying approach' to marketing of these products and concluded that there 'is a paucity of supporting scientific data' behind their promotion and that an 'evidence-based promotion' would be preferable.
ADA dentist spokesperson Dr Mikaela Chinotti said: "The ADA recommends against the use of charcoal-powder or charcoal-based toothpastes to clean and / or whiten the teeth.
"These products can be abrasive and damaging to the teeth and gums and many do not contain fluoride, a key ingredient in protecting and strengthening the teeth. These products use consumer-attractive terms such as herbal, eco-friendly, natural, organic and pure – however the health benefits of charcoal-based products remain unproven.
"Should patients wish to whiten their teeth, the ADA recommends they seek treatment by a registered dental practitioner who can advise on the best method and whether the treatment is right for them."
Key to the ADA's upcoming Dental Health Week from August 5 to 11, is the central message that achieving good oral health and preventing tooth decay come from four good habits.
"These include brushing twice daily with a fluoride containing toothpaste, flossing daily, eating a nutritious diet low in sugar and visiting the dentist regularly where you can discuss your oral health needs," said Dr Chinotti.
The theme of DHW is 'How's your oral health tracking?' and asks consumers and dentists to check how well they or their patients are following these fundamental principles of good oral health. "It's a gentle reminder that with repeated good practice, your oral health can be on track."
