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Is Triclosan Antibacterial Toothpaste Safe?

Why do dogs lick their wounds? They even lick our wounds. This leads to a question posed in the medical literature nearly a half century ago: Might there be some healing property of dog saliva? Well, it appears that there are a number of immune defense mechanisms in saliva, one of which involves nitric oxide. Licking of human skin results in production of nitric oxide from salivary nitrite, which kills skin pathogens and comes from the nitrates we eat in our diet.

How do we know we can get nitric oxide from licked human skin? Researchers had a bunch of volunteers lick their hands all over, front and back. Today, we have a better way to clean wounds: soap and water. (And we should never let our pets lick open wounds because cases of serious infections have been reported).

The reason I bring it up is that this transformation of nitrates from our diet into nitrites in our mouth has important implications for our health. Insufficient nitric oxide production is recognized as the earliest event in the onset and progression of a number of chronic diseases, including high blood pressure, peripheral artery disease, and a number of inflammatory conditions.

Nitrates come from vegetables in our diets, such as beets and green leafy vegetables. Good bacteria on our tongue convert nitrates into nitrites which can circulate throughout the body to create nitric oxide, and any nitrates our tongue bacteria missed the first time around get pumped by our body back into our saliva to give our tongue bacteria a second chance. One way we can become nitric-oxide-production-deficient is by not eating enough vegetables in the first place. So, eating vegetables should be the first step. But, if our tongue bacteria die off, the cycle is broken no matter how many vegetables we eat.

That’s why we should not use antiseptic mouthwash. Previously, I profiled an important study in my video Don’t Use Antiseptic Mouthwash. The most protective food for our heart may be green leafy vegetables because, like beets, they have lots of nitrates. So, if you drink some beet juice, you can get a remarkable drop in blood pressure within just hours, but only if you swallow.

The nitric oxide pathway can be interrupted if you use an antibacterial mouthwash or by spitting and not swallowing beet juice because of the critical action of our tongue bacteria on the nitrates in our saliva. So, we have to eat our vegetables and keep our tongue bacteria happy––so, no antibacterial mouthwash. But what about antibacterial toothpaste?

There’s a toothpaste on the market that contains an antibacterial chemical called triclosan. In my video Antibacterial Toothpaste: Harmful, Helpful, or Harmless?, I present a study was done that showed there was no difference in the levels of nitric oxide, nitrite, and nitrate after brushing with regular toothpaste and triclosan toothpaste. Our good tongue bacteria live in the cracks on the surface of our tongue, so if you just brush your teeth and not your tongue, the chemical doesn’t seem to get down there. Does that mean triclosan toothpaste is safe?

The use of triclosan toothpaste may not be associated with any increase in serious adverse cardiac events. And though studies on rats suggest the chemical can affect thyroid function, the use of triclosan toothpaste does not seem to affect human thyroid function. A study funded by Colgate concluded that triclosan was both safe and effective, producing “a significant reduction in gingivitis, plaque, and bleeding.” However, an independent review by the Cochrane Group suggested the reduction may be statistically significant but may not be beneficial enough to yield clinical significance.

Regarding safety, states are starting to ban the stuff because of data showing that despite the lack of efficacy, triclosan is so ubiquitous that most of the U.S. population is exposed to it. “Because the rapid rise in obesity in the U.S. parallels the introduction of triclosan, and because triclosan has two potential mechanisms by which it might alter human weight”—that is, by mucking with our gut flora or our hormones––researchers at Stanford decided to assess the association between triclosan levels flowing through people’s bodies and how heavy they are. And, indeed, they found an association between triclosan levels and increase in body mass index, and suggested further studies on how this chemical could be altering human growth and well-being.

If we shouldn’t use antiseptic mouthwash, What’s the Best Mouthwash? (Spoiler alert: It’s green tea!)

I’ve created an extensive video library on the benefits of nitrate-containing vegetables for both athletic performance and cardiovascular benefits. Here are some of the latest:

For more on nontoxic ways to maintain oral health, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:


Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.

30 responses to “Is Triclosan Antibacterial Toothpaste Safe?

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  1. Laughing at the Green Tea as the best mouthwash.

    But only if we swallow the Green Tea?

    Inquiring minds want to know, does the Soy Milk in my Green Tea disrupt its value as a mouthwash?

    I have been perplexed about toothpaste, since I cleaned up my diet and tried to get rid of the chemicals in my house.

    Hoping your toothpaste video will give me some clues.

    I have been using a natural product, but is that enough?

    Some of the natural brands have “flouride free” and “flouride” versions and I stood in that section of the grocery store long enough to worry that my produce would get warm. Can’t remember what I bought. I know I have been using the “flouride free” version for the past few months, but I suddenly worried that it might not be enough.

    1. I make my own toothpaste with calcium/magnesium tablets (ground up), baking soda and coconut oil. Essential oils add flavor if needed.

      It’s wonderful. My toothbrush never gets gunky, I have zero gum disease, my breath is naturally fresh and it costs next to nothing when I get the tablets on sale.

      Nowadays, I can’t stand the chemical taste of any manufactured toothpaste. That really tells me something!

      1. I also make my own. Various combos of baking soda, erythrotol, cinnamon, cocoa powder (no sugar), matcha, dried mint leaves, and coconut oil.

    2. Hey Deb! I’m glad to see your dog is still doing well =D

      Dr. Greger wasn’t kidding about the green tea being an excellent mouthwash- he talks about it in the link provided. Basically the green tea is naturally inhibits cavity causing bacteria, and it doesn’t cause DNA damage like store-bought mouthwashes. It does have great internal effects if you swallow it afterwards too haha. If you use green tea as your mouthwash, preferably with a little bit of amla mixed into it, you can feel reasonably confident using non-fluoride toothpastes.

    1. An interesting study has been published in the last few days by a team of international researchers. However, it will infuriate keto diet advocates and low carb enthusiasts generally:

      “In this study, researchers exposed mice to 29 different diets varying from 8.3 percent to 80 percent fat, 10 percent to 80 percent carbohydrates, 5 percent to 30 percent protein, and 5 percent to 30 percent sucrose.
      The experiment, involving five groups of 100,000 mice, lasted for three months, equivalent to nine years of human life.
      They found that only increased dietary fat led to high energy intake and weight gains. Furthermore, food with high sugar content did not cause an increase in body weight, and low protein did not result in excessive energy intake, either.
      The research, led by the academy’s Institute of Genetics and Developmental Biology, was recently published in the international journal Cell Metabolism.”

      This isn’t altogether surprising. After all, before the Westernisation of diets in Asia, Africa and elsewhere, their populations ate diets in which the great majority of energy came from rice and other high carbohydrate foods. Yet, obesity and diabetes were apparently rare.

      In fact, even in the US before WW1, official food supply statistics show that Americans were obtaining more calories from carbs than they are today and fewer calories from fats. Both in absolute terms but especially in terms of the relative proportions of total calories in the diet coming carbohydrates and fat. Yet obesity and diabetes are much more common today in the US than they were at the beginning of the Twntieth Century.

      1. It’s kind of a shame they couldn’t do that study with people. I completely understand the monetary, logistical, and ethical reasons why that isn’t feasible but still…

  2. I wonder if cleaning my tongue with a scraper is doing more harm than good. Am I removing that good bacteria along with the plaque? My mouth feels cleaner after scraping and what I scrape off gets very hard if it sits for a day.

  3. Hello, there-

    Dental hygienist, here. The best toothpaste is no toothpaste. No need for triclosan, SLS nor synthetic sodium fluoride.

    Get a decent electric toothbrush, floss, proxabrushes (to disrupt plaque biofilm in between teeth) and/or Stimudents (to massage gum tissues in between teeth).

    Don’t listen to Colgate or Big Toothpaste. Thanks for reading.

    1. I brush with plain (warm) coconut oil. It offers a nice buffer between my gums and the toothbrush and it seems to dissolve plaque and make flossing more effective.

      1. Coconut oil is supposed to be anti-bacterial.

        I wonder if its effects on your natural oral/gum/dental bacteria are positive or negative? And if it is any different in this respect from any other antibacterial mouthwash.

        1. Hey Tom, iirc, Dr. Greger had a video with studies showing that oil pulling with coconut oil wasn’t more effective than just swishing with water. I wouldn’t be very confident in it’s ability to promote oral health personally

    2. Absolute agree with you, I use a combination of manual brush, toothpicks, flossers, dental floss and even gauze for deep cleaning. It’s hard work but pays off very well, my teeth and gums are perfect. Years ago I used toothpaste and my gums were always irritated with a burning sensation, but not anymore. Toothpaste is also messy and makes cleaning harder since you can´t see what you’re doing properly and it also kind of numbs your mouth. When it comes to flossing I use a magnifying compact mirror to avoid hurting the tissues

      1. I’ve seen patients get decent results with H20 piks. Their home care compliance is a hell of a lot better with a water pik because they won’t floss, use proxabrushes, etc. because of various reasons. I would rather have patients use something in between their teeth than nothing at all.

        Ooo! That would be a kick-ass study to crowdfund- people eating a WFPB diet while H20piking compared to those eating WFPB and flossing/proxabrushing.

    3. Howdy E! Thanks for your contribution, it’s nice to have voices from inside the field. What do you think about using baking soda in place of toothpaste? It was my understanding that the alkalinity and salt content were beneficial to preventing carrie (sp?) producing bacteria.

      1. Hi, Ryan!

        For myself, I use baking soda on my teeth when I notice more stain- once every three months or so. Sodium barcobonate is abrasive to enamel so using it sparingly, I believe, is best.

        In terms of OTC toothpaste, it would be awesome to crowdfund a study to compare the dental caries prevalence of those eating a typical, Western diet and using toothpaste compared to those eating a WFPB diet and not using any OTC toothpaste.

  4. I thought that triclosan was banned by the FDA. Hand sanitizers and antibacterial soaps being the culprit were removed from the store shelves. I never imagined it was also contained in toothpaste.

  5. What about the use of antiseptic mouthwash at night only? I have gum disease. I tried to stop using the mouthwash but my gums became worse and I had to start again. If I only use it at night, I wonder if my tongue will have time to re-establish the nitric oxide pathway before I eat the next morning?

  6. As the founding author of the blog Learning from Dogs, I would love to have your permission to republish this in full. If granted, properly credited and linked back to your own page.

    I look forward to hearing from you.

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