You may or may not be surprised to find that in 2024, the value of the global toothpaste market sits at $US19.37 billion, with an expected $US10 billion growth by 2032.

It’s come a long, long way since the powdered ashes of Ancient Egypt; and even since its first commercial foray in the 1800s. With increasing awareness of the importance of maintaining good oral health comes the demand for high-quality products.

Toothpaste is one of the traditional preventatives that limit the opportunity for germs and bacteria to wreak havoc on teeth and gums, resulting in cavities, periodontal disease, and other mouth-related conditions that fuel this commercial enterprise. According to the global oral health report released by WHO in 2022, nearly 3.5 billion people suffer oral disease.

That’s almost half the world population. Certainly, that should be surprising.

Essentially, there are 19 brands producing approximately 160 varieties of toothpaste that can be found on supermarket and pharmacy shelves. The market has four segments: whitening, herbal, sensitive and others – which include the likes of those that target children and smokers.

Increasing consumer preferences for herbal, medicated, and cruelty-free choices in oral hygiene products has a number of brands focussing on the vegetarian and vegan prerequisites. Often, these are a combination of peppermint, chamomile cinnamon extracts, all known to enhance oral health. There is a lot of public concern too, about overexposure to fluoride; a strong motivator for some brands to offer both fluoride and fluoride-free varieties. Stabilised chlorine dioxide is used; it eliminates harmful bacteria and impedes plaque formation via its natural activation by the amino acids in saliva.

So to the question of whether there is any difference between toothpastes, yes there is; along with a crop of decadent products carving its share.

At $US100 a tube, Theodent 300 arrives in a creamy, marbled box with gilded flourishes that matches the tube inside it, and is the most expensive toothpaste in the world. It is a marketable mix of opulence, mystery and – with its square nozzle delivering a delicate ribbon of paste to you brush – magic.

Also, it has the magnetism of chocolate. With a hint of mint.

What makes it so costly, is that it’s non-toxic and fluoride-free: instead, containing a compound the company has named ‘Rennou’ – a safe to swallow active ingredient, and in clinical-strength, in comparison to its other, less expensive offerings.

An extract of cocoa, it is claimed to remineralise tooth enamel better than fluoride.

Fluoride is the gold standard in the prevention of caries, and remains controversial in terms of health impacts. Stannous fluoride too, has long been established as an anti-cavity agent; with the added benefit of antimicrobial properties and a challenging history that began in the 1950s.

It earned the American Dental Association’s (ADA) Seal of Acceptance in 1964 but due to chemical stability issues, stannous fluoride was replaced in the ’70s with sodium fluoride and sodium monofluorophosphate. Reformulated versions of stannous fluoride toothpastes were introduced in 1997; however, dental staining remained an issue for a small proportion of consumers.

Over the last decade technological advances have finally resolved this, making it possible for dentists to now recommend oral health products containing stannous fluoride to their patients at risk of both cavities and periodontal diseases.

While in general, fluoride provides great benefit on the smooth, thicker-enamelled tooth surfaces like the crown, research suggests stannous fluoride better protects the thinner, more vulnerable area of the tooth root against the incidence of cavities. It also assists dental tissue becoming more resistant to bacterial acids, and the mouth maintaining a neutral pH.

The reason it’s not in all toothpastes, is that it’s more expensive than sodium fluoride: which for many people, is all that’s needed – except if you juxtapose that to the WHO statistic on the poor state of oral health worldwide. Maybe it’s not true: maybe that’s just lip service from the highly profitable.

Research shows that products containing stannous fluoride offer improved protection for tooth and gum health; you just have to be prepared to pay for it.

In Australia, Aesop Dentifrice Toothpaste continues its vegan, fluoride-free, cruelty-free takeover of the bathroom that it began in 2017. At around $AU20 a tube, it uses sea buckthorn to relieve gum inflammation, and wasabi extract and cardamom to freshen breath.

There are broad strokes that now please the depth and breadth of consumer aesthetics. From showcase packaging, to flavours such as orange-ginger-clove and mint-coriander-cucumber; making apple-and-cinnamon seem rather pedestrian. Açai, dragon fruit, and hemp are also part of the expanding demands being met by a multi-billion dollar market.

For those seeking fluoride alternatives, many dentists suggest splitting the difference and alternating; the belief being that fluoride is very important in nurturing and maintaining good oral health.

Ultimately, the best toothpaste is the one you’ll actually use. Ingredients count – but what matters more is brushing technique, and the time spent doing it.

That’s priceless.

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