The habit of brushing teeth every morning and evening is essential for maintaining good dental and oral health. As such, toothpaste is an essential daily oral care product for both children and adults. Apart from basic cleaning function, many toothpastes flaunt other properties, such as desensitising, whitening, prevention of dental calculus, etc. In the Consumer Council’s test on 30 models of toothpaste for common use and for children, 3 out of the 13 models of children’s toothpaste were found with a pH level that was too low, failing to comply with the Mainland standard and might lead to damage of the tooth enamel; whereas the fluoride contents of 2 children’s toothpaste models claiming to contain fluoride were too low and might not be able to strengthen the teeth. Besides, 16 models were detected with allergenic fragrance, of which 4 had a detected amount that exceeded the upper limit that required labelling set by the European Union (EU) regulation, yet did not display the name of the allergens in the list of ingredients. Furthermore, 90% (27 models) were detected with trace amounts of heavy metals (arsenic and/or lead) and while the levels did not exceed the relevant standards, consumers should be mindful of the risks of ingesting these substances over a prolonged period. The Council stresses that as toothpaste is an important daily oral care product, traders have the responsibility to ensure the products are able to provide adequate protection for the teeth, and to clearly list out the ingredients, and prevent any allergenic substances or heavy metals, so as to safeguard the health of consumers.
Between March to May this year, the Council sourced 30 models of toothpaste from the market., including 17 models for common use and 13 for children, of which 16 models were labelled with the suitable age on the packaging. The retail price ranged from $10 to $100. The test was conducted in accordance with the Mainland standard and EU regulation relating to cosmetics, with test items covering the heavy metal content, pH value, fluoride content, microbiological content, as well as the allergenic fragrances and harmful substances.
Toothpaste with Substandard pH Value and/or Fluoride Content Might Weaken Protection for Teeth
It is essential for children to nurture the good habit of cleaning their teeth and oral cavity from a young age, in order to ensure the healthy growth of their teeth during the developmental stage (6 months to 6 years old). However, if the toothpaste’s ingredients do not comply with the standards, it could affect dental and oral health despite good oral care habits. When purchasing toothpaste, consumers should be mindful of the product’s pH value. Prolonged contact with too acidic (pH value too low) or too alkaline (pH value too high) oral care products might be detrimental to dental and oral health.
The pH values of the 13 children’s toothpaste models ranged from 3.8 to 8.2, amongst which the pH values of 3 models were relatively low and failed to comply with the Mainland standard, which required the pH value of toothpaste to be not lower than 5.5 or higher than 10.5. The Council reminds consumers that when the pH value in the oral cavity drops to below 5.5, the tooth enamel might be dissolved. Brushing the teeth with toothpaste that is too acidic, added to the friction of the toothbrush, might weaken the surface of the teeth and could even lead to abrasion. Therefore, consumers are advised to avoid using toothpaste that is too acidic. The Council has referred the relevant test results to the Customs & Excise Department for following up. As for the 17 toothpaste models for common use, the pH value ranged from 6.4 to 9.5, all in compliance with the Mainland standard.
Furthermore, many toothpastes are marketed as containing fluoride to strengthen the teeth against damage by acidic substances, as well as to inhibit the formation of plaque. Regular intake of an appropriate amount of fluoride could strengthen the tooth enamel of young children, make their teeth stronger, and prevent tooth decay. Amongst the tested models, 6 toothpastes for children and 6 toothpastes for adults were labelled as containing fluoride and/or displayed its fluoride content on its product packaging.
Amongst the 6 models of children’s toothpaste claiming to contain fluoride, the test results revealed that the actual fluoride concentrations ranged from 0.042% to 0.061%, of which 2 models did not comply with the Mainland standard’s requirement of 0.05% to 0.11% for fluoride, possibly unable to provide sufficient protection to children’s teeth. Out of the 17 common use toothpaste models, 9 were detected with fluoride at levels that were generally higher than that of the children’s toothpaste models, all complying with the Mainland standard. However, 3 models did not declare that it contained fluoride and/or its fluoride content on the packaging.
Over Half the Models Detected with Allergenic Substances
Moreover, eugenol is added into many oral care products as a flavouring, whereas limonene is a common fragrance for fruity flavoured toothpastes. However, some individuals could have severe allergic reactions to these 2 allergenic fragrances. Overseas study reports revealed that the severe allergic reactions to these chemicals could lead to contact dermatitis and even mouth ulcers. In view of this, the EU Cosmetic Directive requires that all rinse-off cosmetic products with an allergenic fragrance concentration of higher than 0.010% must declare it in the list of ingredients.
16 of the tested models were detected with the allergenic fragrances eugenol and/or limonene respectively, including 12 common use toothpastes and 4 children’s toothpastes. 6 models were detected with eugenol at concentrations ranging from 0.002% to 0.013%, of which 1 children’s toothpaste model contained 0.013% eugenol, which exceeded the upper limit that required labelling for this substance as set out by the EU’s Cosmetic Directive, yet this product did not declare eugenol in its list of ingredients as required. Additionally, 12 models were detected with limonene at concentrations ranging from 0.001% to 0.10%, amongst which 2 children’s toothpaste models and 3 common use toothpaste models had detected limonene concentrations that exceeded the upper limit for mandatory labelling set by the EU directive. 3 of these models did not display limonene in their lists of ingredients, including the highest-priced adult toothpaste model. The Council urges relevant traders to list out the products’ allergenic substances, and recommends consumers with history of allergic reactions to carefully read the list of ingredients when choosing oral care products.
Heavy Metals Could Accumulate in the Human Body
Beware of Ingesting by Mistake
Referencing the Mainland standard, the current test reviewed the contents of the heavy metals arsenic and lead in the toothpaste models. Arsenic was detected in 7 models at levels ranging from 0.088mg/kg to 0.29mg/kg, lower than the 2mg/kg upper limit set by the Mainland standard. 26 models were detected with lead at levels ranging from 0.052mg/kg to 0.80mg/kg, which was also lower than the Mainland standard’s upper limit of 10mg/kg.
Consumers should bear in mind that, despite detected heavy metal levels of all models being compliant with the Mainland standard, as heavy metals could accumulate inside the human body, they could pose greater health risks. If inorganic arsenic is ingested over a prolonged period, it might cause peripheral vascular disease, cardiovascular diseases or high blood pressure. As for lead, it could accumulate once it enters the body. As chronic exposure to lead could impair children’s cognitive development and affect the systolic blood pressure of adults, the intake of any lead-containing substances should be minimised as much as possible. The Council is concerned that out of the 13 models of children’s toothpaste tested, 12 were detected with trace amounts of heavy metals, including some models which were labelled as suitable for babies and young children under the age of 3. As babies and young children are yet to grasp how to completely spit out the toothpaste and foam when rinsing their mouth, parents should provide guidance by their side, so as to minimise the intake of heavy metals due to swallowing the toothpaste.
Though the test also found microbiological contaminations in 2 models of children’s toothpaste, the colony-forming units were lower than the maximum limit set by the Mainland standard. All models were not detected with prohibited substances set by the EU directive, performing satisfactorily in this test item. However, out of the 30 models, only 23 were labelled with detailed information of the ingredients in Chinese and English on the tube or outer packaging. Consumers might not be able to fully grasp the product information. Another 2 models were not labelled with the expiry date, which was unideal in terms of product labelling information.
To maintain healthy teeth, apart from selecting a suitable toothpaste, it is also important to practice regular oral care appropriately. Consumers may refer to the tips below:
- Brush your teeth at least twice daily, while also bearing in mind that brushing the teeth too frequently might abrade the tooth enamel and irritate the gums, increasing the chance of infection and inflammation;
- Use a toothbrush with soft bristles to lower the impact of brushing the teeth too hard, which might damage the tooth enamel and irritate the gums;
- The toothbrush should be placed at a 45-degree angle with the teeth and moved in circular motions along the gums. Dental floss or interdental brushes could be used for cleaning the area between the gums and teeth, helping to remove plaque and reduce the formation of dental calculus;
- Parents should wipe the oral cavity of babies regularly each evening from their birth, as this could help babies learn and get accustomed to brushing their teeth more easily as they grow up;
- After children develop their first tooth, parents should brush their teeth when they wake up each morning and before bed each evening. For children under the age of 3, parents could smear a small amount of regular adult toothpaste containing fluoride on the toothbrush, while children aged 3 to 6 should use a pea-sized portion of toothpaste.
Download the article (Chinese only): https://ccchoice.org/552toothpaste
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