Which toothpaste is best for gum disease prevention? Stannous or Sodium Fluoride?

The quick answer: A stannous fluoride toothpaste, in addition to fighting cavities,  will have some effect versus the early stage of gum disease, and will delay the recurrence of gum disease after treatment by a dental professional. It has no effect versus advanced gum disease. The negative: Long term use of stannous fluoride is likely to stain your teeth irreversibly. Sodium fluoride will fight cavities only – it has no effect on gum disease bacteria – and will not stain your teeth.
Remember: All over-the-counter products are “band-aids” for tooth decay and gum disease. Just brushing with a certain toothpaste is not a substitute for regular care by a dentist. Neglect leads to a high probability of significant tooth loss in your lifetime.


The Long Answer:

First Stage of Gum Disease:  Mouth bacteria infects the gums only, especially the hard to clean areas between the teeth. Called gingivitis.  The antimicrobial effect of stannous fluoride  is effective at delaying the onset of gingivitis, but unfortunately it will happen eventually, typically by age 50-60, even if you have regular dental cleanings.  A stannous fluoride toothpaste is also effective at delaying the recurrence of gingivitis after treatment of gum disease by a dental professional.
Second Stage: Mouth bacteria spreads from the gums into the surrounding bone, causing the bone to resorb.  Called periodontitis. Think of periodontitis as mouth bacteria “eating away” the bone supporting your teeth.   Stannous fluoride, a two minute surface antimicrobial,  has no effect on periodontitis bacteria which are multiplying deep below the gum surface 24 hours a day.

Common national brands of stannous fluoride toothpaste are Parodontax, Colgate Total SF, and Crest Pro Health. To avoid confusion, just look at the active ingredients on the  back of the tube – there will only be one listed – and remember:
Stannous Fluoride: Will fight cavities and the first stage of gum disease, but may stain my teeth.
Sodium Fluoride, equivalent in action to sodium monofluorophosphate: Will fight cavities only, with no staining.

Regular dental cleanings are an absolute must, as they remove the tartar, or hard deposit, on the teeth, which is impossible for the patient to remove themselves. Without regular cleanings, tartar buildup will cause the majority of patients to develop gingivitis in 1-2 years and periodontitis in 3-4, even if their home care is excellent. Once periodontitis destroys 75-80% of supporting bone (typically 8-20 years), teeth loosen and fall out. This is why most of the world ends up in dentures by age 50-65. While modern dentistry can easily stop gum disease, virtually immediately, there is currently no way to restore lost bone. Once “eaten away” by disease, the bone is lost forever.

Contact us  at (617) 924-7301 or [email protected] with any questions on this article,  and see our website at GreaterBostonDentist.com. Greater Boston Dental is a group practice of four dentists and four hygienists in Watertown, MA,  designed to serve all your dental needs in one easy to navigate location. Please call us with any dental needs – we would love to give you reasonable, conservative, cost effective advice as your new trusted dental office.