Recent media reports are citing a new study that links the antibacterial agent triclosan with osteoporosis. CNN related the scientists’ theory that triclosan’s effect on the thyroid gland results in an increased incidence of bone fractures in the elderly. Toothpaste is generally listed in every news report regarding this study as a household item featuring triclosan, but the fact is, there are presently no toothpastes in the over-the-counter market featuring triclosan. We hate to say it, but this is “fake news” when it comes to toothpaste.
Why Was Triclosan in Toothpaste?
Although it kills bacteria, triclosan is technically considered a biocide, not an antibiotic. This makes it similar to disinfectants, since its primary purpose is to prevent bacterial infection. As defined by the European Union, antibiotics are chemicals that “eradicate bacterial infections in humans and animals.” So by definition, a biocide stops bacteria before they cause harm, and antibiotics stop bacteria after they have started to cause harm.
Under that definition, it can still be difficult to define triclosan’s purpose in dentistry. Although some people used triclosan toothpastes as a gum disease preventative, others used them as a form of gum disease treatment. In effect, triclosan served as both a biocide and an antibiotic in dental practice. Perhaps it’s easiest to say that triclosan was used in toothpaste due to its antimicrobial properties. And studies did show that triclosan toothpastes were effective in reducing the side effects of gum disease.
Not in Retail Toothpaste Anymore
For some time, Colgate Total was the only toothpaste featuring triclosan. After the U.S. Food and Drug Administration forbid the use of triclosan in hand soaps in 2016 due to a lack of evidence regarding its effectiveness, Colgate vigorously defended the safety and efficacy of triclosan in dental products, based on many credible scientific studies “amassed over 25 years.” In 2019, however, Colgate removed triclosan from its toothpastes that featured it and now they use only stannous fluoride as the active ingredient for advanced gum disease and tooth decay prevention. (Stannous fluoride is considered more effective than its common counterpart, sodium fluoride.) This should have little effect on the value of Colgate Total for preventing gum disease. For example, one study indicates that triclosan and stannous fluoride have relatively the same effect on gum health.
The Sacramento Dentistry Group did not generally recommend the use of triclosan in toothpaste, primarily to reduce the incidence of bacterial resistance. Although we typically talk of resistance as applying to antibiotics, bacteria can also genetically adapt to successfully survive the application of biocides like triclosan, and there was evidence to indicate that this had indeed happened with certain bacteria and triclosan. Therefore, Colgate’s step to eliminate the use of triclosan in its own toothpastes is a positive development, one that took place well in advance of the reports warning about a connection between this biocide and osteoporosis.