NB This text first appeared in Ethical Consumer 86, December 2003/January 2004

Ninety-six percent of people use toothpaste,1 but how many stop to consider the moral implications of their choice?.

Labelling

Animal parts, egg shells, incense and myrrh have all been used in toothpaste since its conception in China and India in 300-500BC.(4) Since companies are not required by law to list all ingredients, current labelling practice means that it's difficult to find out whether toothpaste ingredients have improved much since then. For example, Aquafresh, Colgate, Clinomyn, Euthymol, Mentadent P, Pearl Drops, Theramed and Ultrabrite brands vaguely list 'aroma' as an ingredient. In addition, the artificial sweetener saccharin (E954) is used in the majority of mainstream brands, but it is not labelled as an active ingredient.(5) The US-based Center for Science in the Public Interest (CSPI) reported that "the only committee of non-governmental scientists... to review the data on saccharin concluded... that saccharin still should be considered a cancer-causing chemical. However, panels of government scientists ignored that Board's views and voted in split decisions that saccharin did not pose a cancer threat."(10) The Women's Environmental Network is also concerned about the health effects of some ingredients and about labelling. Campaigners want to see clearer labelling in plain language rather than the current wording that seems "designed to bamboozle the consumer."(6) Parabens are used as a preservative in common brands such as Clinomyn, Theramed and Ultabrite. They are even used in alternative brand Sarakan, but not in Bioforce, Green People, Jason Natural, Kingfisher, Tom's of Maine or Weleda.(5) Parabens are oestrogen mimics, which can penetrate the skin and have been linked to breast and testicular cancer and sperm count reduction.(7) They can be labelled as alkyl parahydroxy benzoates; butyl, methyl, ethyl or propylisobutyl parabens.(6) Sodium Lauryl Sulphate (SLS) is a detergent used to create foaming action in most toothpaste. It is not labelled as an active ingredient and no information on concentration is provided on labelling. SLS has been linked to skin irritation,(8) and has also been described as a gastro-intestinal or liver toxicant(9) and as having a degenerative effect on cell membranes.(8) Furthermore, certain Colgate and Crest products claim to provide overnight protection, and therefore may increase exposure to ingredients such as SLS and parabens. Bioforce, Green People, Jason, Sarakan and Weleda brands do not contain SLS. Triclosan (Microban)(2) is a microbiocide and is increasingly used to help prevent gum disease in toothpastes, including Aquafresh, Colgate, Crest, Mentadent P and Sensodyne. It is labelled as an active ingredient, and concentration information is provided in all cases except Crest. Triclosan has been detected in human breastmilk and in fish,(11) and it may upset the functioning of normal bacteria that keep the body healthy.(6) Also, a Danish report found that wastewater effluents discharged into rivers contained the chemical,(11) and a US study found that it eliminated one or two species of algae from the stream community.(12)

Fluoride

The BDA claims that three years' use of fluoride toothpaste decreases tooth decay by thirty percent.(22) They recommend 500ppmF (parts per million fluoride) for children under seven.(22) Mainstream brands contain at least twice this amount. As children are prone to eat toothpaste, parents should supervise brushing. In the USA, fluoridated toothpaste must carry a 'poison warning'.(30) Bioforce, Green People, Jason, Sarakan and Weleda market fluoride-free toothpaste, and Kingfisher and Tom's of Maine provide both options. Fluoridation of water is much more controversial.(28) Evidence that water fluoridation is good for teeth is weak and it has been stopped by every other country in Europe. In 2000, a UK government-commissioned report, the York Review, found that, despite its practice for fifty years, there was "no reliable, good quality evidence in the fluoridation literature worldwide" about the effectiveness of water fluoridation in reducing decay.(29) Despite this, so-called dental and health chiefs have continued to misrepresent the case for fluoridation, as the York Review scientists complained to the government.(29) They also concluded that more research was needed on the negative effects. More information about this debate can be found by contacting the Safe Water Information Service (see Links below).

Whitening toothpaste
Toothpastes claiming to whiten teeth account for one sixth of sales.(1) The British Dental Association (BDA) has expressed concern that the smokers' whitening toothpastes Clinomyn and Pearl Drops are too abrasive.(1) Macleans Whitening is the only such toothpaste currently BDA-approved.(5) However, companies have to pay to carry the logos of the BDA or the British Dental Health Foundation (BDHF).(13) Moreover, many whitening toothpastes, including Macleans, contain titanium dioxide. This is a suspected carcinogen and can be absorbed by the skin,(7) and, when the effluent containing it is discharged from manufacturers, it acidifies rivers and seas.(14)

Packaging
The average person in the UK throws out their body weight in rubbish every three months.(15) Toothpaste is packaged in plastic tubes or pump-action containers, with extra cardboard packaging that is rarely labelled as recycled. Even the alternative brands, Bioforce and Sarakan, don't use recycled cardboard, and though Jason Natural Products does, its boxes are wrapped in unnecessary cellophane. Kingfisher claims to be a better environmental option because its tubes are made from biodegradable cellulose. Tom's of Maine and Green People's aluminium tubes state that they can be recycled alongside aluminium cans.

Alternatives

You could join the four percent of the adult population not using toothpaste.(1) Brush your teeth with bicarbonate of soda and add peppermint oil for a more familiar flavour.(16)

Best Buys as of December 2003
As our ratings are constantly updated, it is possible that these companies will not always come out top on the Ethiscore table.
Best Buys for this report are Green People (01444 401444), Jason Natural Products (UK distribution 01714 355911), Kingfisher (01603 630484), Sarakan (01420 544424), Tom's of Maine (020 798 52944) and Weleda (0115 944 8200).

References
References: 1 Mintel Oral Hygiene report 4/02 2 Chiapaslink, the International Co-operative Biodiversity Groups (ICBG) Email Bulletin, 8/01 3 Factory Watch website, viewed on 1/6/01 4 The History of Toothpaste www.sadanet.co.za/dhw/history/toothpaste 28/10/03 5 ECRA shop search 16/9/03 6 'Take a toxic tour of your bathroom' Diane Taylor, Guardian Unlimited, 25/2/03 7 Ethical Consumer issue 83 9/03 8 'Sodium Lauryl Sulfate in Shampoos -The Real Story,' David Steadman viewed 5/11/03 9 Ethical Consumer issue 69 2/01 10 'Repeal of Saccharin Warning Label Criticized,' Michael F.Jacobson, Center for Science in the Public Interest 2/1/01 11 'New Warning on Triclosan Threat,' Friends of the Earth Press Release 23/9/03 12 'Algae laid low by soap and toothpaste,' Hannah Hoag 28/3/03 13 Ethical Consumer issue 69 02/01 14 'H is for Ecohome,' Anna Kruger, Gaia Books, 1991 15 'Waste,' Friends of the Earth 7/02 www.foe.co.uk/campaigns/waste/issues/what_a_mess/index.html 16 Home Ecology, Karen Christensen, Arlington Books, 1989 17 www.stopanimaltests.com2 viewed on 3/6/03 18 Telephone conversation with a representative of BUAV 7/7/03 19 Multinational Monitor 5/03 20 Ecologist 4/03/03 21 Ethical Consumer 8/01 22 Mintel report Oral Hygiene report 4/02 22 BUAV campaigns report, Autumn 2002 23 Uncaged Newsletter 9/02 24 www.ecolinks.net viewed 25/2/03 25 PETA Animal Times, Winter 1999 26 www.ecolinks.net viewed on 25/2/03 27 Conversation with a representative of Animal Aid 11/9/0328 See for instance, pharmacist and Liverpool councillor, Paul Clein's piece in The Pharmaceutical Journal, (vol 271, p234), 23/8/29 Letter to Hazel Blears, Health minister, from York Review scientists, 11/12/02 30 www.fluoridealert.org/news/1611.html2, viewed 14/8/03