"Antibacterial Toothpaste: Harmful, Helpful, or Harmless?"
Why do dogs lick their wounds?
In fact, they even lick our wounds, leading to a question posed
nearly a half century ago in the medical literature.
Might there be some kind of 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 from our diet.
How do we know we can get nitric oxide from licked human skin?
They had a bunch of volunteers lick their hands all over, front and back.
Today we have a better way to clean wounds called soap and water.
And we should never actually let our pets lick open wounds
as there are cases of serious infections reported.
The reason I bring it up is because 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,
and peripheral artery disease, and a number of inflammatory conditions.
If you remember, nitrates come from vegetables in our diets, 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
gets pumped by our body back into our saliva
to give our tongue bacteria a second chance.
So one way we can become nitric oxide production deficient
is to not eat enough vegetables in the first place,
so that 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.
If you remember me profiling this important study, perhaps
the largest public health initiative in the Western world
has focused on improvement of diet, particularly in those of high risk
of cardiovascular disease, our number one killer.
The most protective food for our heart may be green leafy vegetables
because, like beets, they have lots of nitrates.
And so if you eat 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 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. Concern has been raised about the antibacterial mouthwashes.
But what about the toothpaste? We didn't know until this study.
Here's the nitric oxide, nitrite and nitrate levels
after brushing with regular toothpaste. And here's after triclosan toothpaste.
No difference.
See, our good tongue bacteria live in the cracks on the surface of our tongue,
and if you just brush your teeth and not your tongue,
the chemical doesn't seem to get down there.
So is triclosan toothpaste safe?
Well, it won't make your heart miss a beet or beet juice.
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— no conflict of interest there—
concluded that triclosan was both safe and effective,
producing a significant reduction in gingivitis, plaque, and bleeding.
Though an independent review by the Cochrane group
suggests that the reduction, OK, may be statistically significant
but may not be beneficial enough to yield clinical significance.
And with regards to safety, the reason states are starting to ban
the stuff is because of data like this.
Despite the lack of efficacy, the stuff is so ubiquitous
that most of the U.S. population is exposed.
Because the rapid rise in obesity in the U.S. parallels the introduction
of the chemical, and because there are two potential mechanisms by which
it might alter human weight — 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 found an association
between triclosan levels and increase in body mass index.
They suggest further studies on how this chemical
could be altering human growth and wellbeing.