Elmex Sensitive Professional Toothpaste Review

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Elmex Sensitive Professional toothpaste

Elmex is a very old brand by GABA International AG (Switzerland). Gaba International AG is owned by Golgate-Palmolive of the United States. They brought out Elmex Sensitive Professional toothpaste which has added benefits to their Elmex Sensitive toothpaste.

I am always sceptical about new oral health care products and I make my judgement by testing the product myself and asking experiences of my patients. Lets find out what my professional opinion is about Elmex Sensitive Professional toothpaste. There will be an ingredient list at the end of this post.

The Selling Speech

The manufacturer promises scientifically proven immediate and long-lasting pain relief for sensitive teeth. It is quite bold promise, but the older Elmex toothpaste versions have always been relatively good toothpastes because they contain organic fluoride called amine fluoride. Amine fluoride has been considered to be superior to more commonly used inorganic fluorides in toothpastes – sodium fluoride and sodium monofluorophosphate. But having said that, it’s good to bear in mind that the type of fluoride makes very little or no difference to a relatively healthy mouth.

The suprising fact with the Elmex Sensitive Professional toothpaste is that it does not contain amine fluoride. It contains sodium monofluorophosphate 1450ppm which is the recommended level of fluoride for adults. Any less would be ineffective. I am not sure why they don’t use amine fluoride with this toothpaste. But I try not to get stuck to this detail because there is something else in this toothpaste that will make it a super star of the toothpastes.

That is Pro-Argin technology.

Pro-Argin Technology

Pro-Argin technology system contains arginine and calcium carbonate. Arginine is an amino acid naturally found in saliva.

Once the arginine and calcium carbonate bind to the surface of the tooth, they will start to attract calcium. Calcium is the mineral we loose from the surface of the tooth (demineralisation) when we eat something with carbohydrates or drink something with carbohydrates or drinks that are acidic. The saliva normally tries to fix the surface of the tooth by returning the calcium and neutralising the acids (remineralisation). But often our life style habits are too much for the saliva to handle and not enough calcium is returned to the surface of the tooth.

This will result in cavities, hypersensitivity and/or erosion. The hypersensitivity happens because the tiny channels (tubules) leading from the surface of the tooth to the nerve of the tooth, loose their mineral cap. Open tubules cause the nerve to react to the temperature changes and pressure. It reacts by pain. So using a toothpaste that comes to saliva’s aid in remineralisation process, is definitely a good thing. Together with saliva the Pro-Argin toothpaste can block the tubules again with a mineral cap.

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Pro-Argin technology in toothpastes blocks the open tubules and therefore reduces sensitivity.

The Design

Well, the design has not changed really and there is no need to. It is a trusted brand with quality toothpastes so no need for any hocus pocus to make it more appealing.

I love the environmental advice on the packaging. When people get these hints on the products they use regularly it will raise awareness. Maybe the environmentally-friendly habits will find their way into peoples everyday life. Let’s save the world by little deeds!

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The Testing

Over the years of being a dental professional I have noticed that people struggle sometimes when they run into toothpastes that have the same design for opening the tube as Elmex Sensitive Professional.

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How to open that tiny little lid that looks like a sprocket? The answer is in the cap.

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Just turn the cap upside down and it will fit on top of the tiny lid. By twisting the cap the tiny lid will come off effortlessly.

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The consistency of the toothpaste is more a gel than a paste which is perfect if you are using Philips Sonicare toothbrush. It’s not too runny which I appreciate (no toothpaste marks on the sink) but will very quickly transform into liquid when brushing.

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The closer look shows that it is rather smooth in texture. So to my mind this means two things. It’s not too abrasive and also it most likely does not contain microbeads. The RDA level which tells you how abrasive the toothpaste is, should be under 100 for safe use of toothpaste. Elmex Sensitive Professional toothpaste has RDA level of 65. Perfect!

To know if a toothpaste contains microbeads, the polyethylene is the ingredient to look for. No-one should buy a toothpaste that contains microbeads as those tiny little beads will pollute our oceans. Elmex Sensitive Professional toothpaste does not have polyethylene in the ingredient list (see at the end of this post).

The toothpaste stays on top of the toothbrush bristles without dripping but it slowly disperses between the bristles if you have time to wait for this. I emphasise that you don’t need to wait – I just wanted to see what happens.

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I brush my teeth for two minutes and I get slight burning feeling in my mouth. It’s not unpleasant though and most of the non-professionals would say that the feeling is fresh, not burning. I’m just very sensitive.

The representative of Elmex Sensitive Professional toothpaste advised to spit the toothpaste out after brushing but not to rinse. So I follow this advice. The teeth feel very clean despite the low RDA level. That always makes me satisfied with the toothpaste.

I carried on using the whole tube of toothpaste twice a day and I must simply say Wow! I have been suffering hypersensitivity for example if I eat ice cream. The hypersensitivity does not happen while I eat it but as soon as I have stopped I get this excruciating pain, nerve pain that lingers way too long. There’s been no way to relieve it other than by avoiding the ice cream.

But after using one tube of Elmex Sensitive Professional, the hypersensitivity is gone! So I guess the Pro-Argin technology really works.

There is also an advice on the tube to rub the toothpaste over the most sensitive areas with a finger. The rubbing should continue for 1 minute. The toothpaste can be left in place without rinsing. Remember that this advice is only applicable from the age 12.

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Would I Recommend

I would definitely recommend this toothpaste to anyone suffering from sensitive teeth or dental erosion. Or anyone who wants to prevent these two things. I have not had this good results with sensitive teeth than with Elmex Sensitive Professional. Also the Pro-Argin technology has tendency to resist acids from a diet that contain food of low pH which is why it helps to prevent dental erosion.

I’m just wondering why manufacturers want to add soap (sodium lauryl sulfate) to their toothpastes as for some individuals it can work as an irritant. Sodium lauryl sulfate is the foaming agent in the toothpaste. It may cause dry mouth and aphthous ulcers. Mind you, nothing is scientifically proven but it is widely recommended amongst dental professional that people suffering from aphthous ulcers should change their toothpaste to non-foaming toothpaste.

Always remember to check from the ingredients if a toothpaste contains soap. There are other ingredients that may produce foam so not all the foaming toothpastes contain soap.

This toothpaste can be used for children as well (if they accept the taste), but remember to use only pea-size amount for children under 6 years and to very young children who cannot spit out yet, use only smear of toothpaste.

The Ingredients

  1. Calcium Carbonate – a mild abrasive. Combined with arginine the alkaline conditions are created to the surface of the tooth which will encourage phosphate ions and calcium to deposit on to the dentin
  2. Aqua – a main carrier for all ingredients. Helps dissolve other soluble ingredients. Helps the mechanical process of cleaning teeth in mouthwashes
  3. Sorbitol – a sweetener, humectant and texturising agent
  4. Arginine – an amino acid, the good in the toothpaste
  5. Sodium Lauryl Sulfate – a soap and therefore the foaming agent. Can work as an irritant
  6. Sodium monofluorophosphate – the good in the toothpaste
  7. Aroma – a chemical compound which adds odours to dental products. The specific aroma is not specified by the manufacturer
  8. Cellulose gum – a thickening agent
  9. Sodium bicarbonate aka baking soda – a mild abrasive as an ingredient of a toothpaste. Do not use your own baking soda to brush your teeth as it will be very abrasive.
  10. Tetrasodium Pyrophosphate – an agent to remove calcium from saliva. Used normally in tartar control toothpastes but with Elmex Sensitive Professional toothpaste I believe it is used for attracting the calcium from the saliva to the surface of the teeth
  11. Titanium Dioxide – a colorant and thickening agent
  12. Benzyl Alcohol – a solvent and preservative. In rare cases, this ingredient can cause contact allergy.
  13. Sodium Saccharin – an artificial sweetener
  14. Xantham Gum – a thickening agent
  15. Limonene – a natural solvent that cleans. Also it flavours the product.

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Dental Erosion and Tea

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Dental Erosion Risk Factors in Bullet Points

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Eating fruits and berries frequently will put you at risk of dental erosion.

There has been so much discussion about dental erosion recently that I wanted to gather all the latest information in one post. I have been in dental profession for over 20 years and even I still learn new things about dental erosion. So read this post to see if you knew these things as well.

I will update this post every time I learn something new that will cause dental erosion. I would be grateful if you could collaborate by commenting this post in case I have missed some risk factors.

The Risk Factors

  • diet that does not contain dairy products
  • vegetarian diet even if dairy products are used
  • consumption of acidic beverages, especially when consumed between the meals (including all juices, sugar-free drinks, sparkling water, any drink with flavouring, alcohol and bubbles. As an example the pH of Coca-Cola is 2,5 = highly acidic)
  • vitamin supplements in a form of a drink (including fizzy tablets)
  • use of sport drinks
  • dehydration
  • dehydration + sport drinks = increased risk
  • drinking tea apart from green tea and black tea
  • consumption of erosive foods, increased risk if consuming erosive foods/drinks over 3 times per day (e.g. fruits, berries, vinegar, pickled food, herbal tea, cola, sparkling water, juice, flavoured water)
  • eating sour candy
  • frequent consumption of alcohol
  • use of smokeless tobacco
  • frequent use of salad dressings
  • gastro-esophagel reflux disease (GERD)
  • gastro-esophagel reflux disease combined with a use of a mouth guard (read this to find out how to protect your teeth if you use mouth guard)
  • eating disorder (anorexia, bulimia)
  • frequent vomiting (e.g. when pregnant)
  • eating fruits between the meals (when fruits are eaten as a part of a meal = no risk)
  • eating indian food frequently (indian spices, especially panipuri masala, are acidic)
  • swishing acidic drink in mouth before swallowing
  • sipping an acidic drink (e.g. herbal tea, cola, sparkling water, juice, flavoured water) over a long period of time
  • brushing teeth after eating
  • brushing teeth after drinking acidic drinks like wine, juice, sparkling water
  • dry mouth (saliva protects the teeth, neutralises the acids)
  • drinking herbal tea very hot (high temperature increases the erosive potential of a drink)
  • consumption of pickled foods
  • medication that dry the mouth as a side-effect (e.g. antihistamines, antidepressants)
  • use of oral moisturizers with pH below 6.7 (see a table pH levels of commonly used oral moisturizers and dry mouth treatment products here)
  • acidic mouthwashes e.g. Listerine Total Care rinse pH = 3.57
  • anti-tartar toothpastes that has chelating agents – chelators bind or trap other chemicals such as calcium = they effectively remove calcium also from teeth.
  • use of non-fluoride toothpaste
  • liquid breakfast (including smoothies). There’s no saliva in mouth in the morning = nothing to neutralise acids. Chewable breakfast would make the saliva flow again after sleeping.
  • certain illnesses that affect the saliva flow (e.g. Sjögren’s syndrome)
  • drinking fruit juices instead of eating the real fruit – fruit juice has been proven to cause erosion 10 times more than the same fruit chewed.
  • chewing gum with liquid center including sugar-free chewing gums (also xylitol). The liquid inside the chewing gum is acidic.
  • sugar-free candy, especially fruit-flavoured ones (they contain high levels of food acid, particularly citric and phosphoric acid)
  • dry mouth + sugar-free fruit-flavoured candy to stimulate saliva flow = increased risk of erosion
  • asthma medication, especially if brushing after corticosteroids (e.g. Flixotide evohaler)

Edit 27.1.2019

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How Diet Affects Your Teeth

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But I brush my teeth twice a day and floss them daily!”

I get cavities very easily. It runs in the family… We have weak teeth.”

Sound familiar? This is something I often hear when I tell patients they have a new cavity or early signs of them. Because my way of thinking is generally based on no-nonsense, I will not speak nonsense to my patients and therefore will correct any nonsense coming from their mouth. What I will say immediately to the person thinking bad teeth are hereditary is that there is no such thing as hereditary bad teeth. What can be hereditary is

  • diet and lifestyle habits (sort of… at least until you get to decide yourself what to eat and drink and how often)
  • bacteria (but not exactly hereditary, the baby is born without bacteria in mouth and bacteria will be transferred into baby’s mouth normally from the parents)
  • genetic susceptibility to periodontitis (but this does not mean you are doomed to have periodontitis)
  • position and the shape of the teeth

But it is only the diet and lifestyle habits that can be easily changed by person himself to such that is more tooth-friendly. So what is tooth-friendly and what’s not? I will tell you but I cannot do that before I tell you little bit about bacteria first.

Bacteria – the Beloved Enemy

There are bacteria in everyone’s mouth and so there should be. The bacteria keep the soft tissues healthy. Every day the bacteria try to find hiding and breeding places from our teeth forming this sticky glue around them. Bacteria and this glue we call plaque.

We can live in peace with the bacteria if we remove it regularly from the surfaces of our teeth. It is beneficial also to remove it from the surface of the tongue. Brushing twice a day with an electric toothbrush and cleaning between the teeth once a day (the best tool for you to use between the teeth should be checked at the dentist – preferably by the dental hygienist) will prevent the bacteria causing problems like cavities and gum disease.

But if the bacteria can stay in place for longer period of time, there will be consequences. Let’s first think about how it will affect the gums around the teeth.

Healthy gums will start to get inflammation after three days of bacteria presence (there is some individual variation to this) because the bacteria will produce toxins amongst other things. For example if you do not clean between the teeth for four days, the chances are high for you to notice bleeding from the gums when you finally decide to clean them. The bleeding is always a sign of an inflammation in the gum (gingivitis) caused by prolonged bacteria presence. It is never a sign of you doing something wrong with the tool you use. So consider the bleeding as a reminder for you to clean between the teeth more regularly as gingivitis can lead to more severe and irreversible type of gum disease (periodontitis).

The bacteria also produce acids from the carbohydrates in your diet. This is called the acid attack. The acids will affect the teeth.

The acids that the bacteria produce from the carbohydrates will make the pH of the mouth drop below 5,5 and this will remove minerals like calcium from the surface of the teeth. It is called demineralisation. The saliva neutralises these acids bacteria produce and also it is the saliva that will try to restore the lost minerals from the enamel but it is slightly slow process and normally after 30-45 minutes of finishing you dinner/snack the job is done and the pH has risen above 5,5. This is called remineralisation.

The teeth can take only certain amount of demineralisation per day without getting cavities. Too much demineralisation combined with inadequate oral hygiene habits will most certainly lead to decaying. Sometimes very fast decaying.

Not Necessarily What You Eat, but How You Eat It!

So now you know that the demineralisation will begin when you offer carbohydrates to the bacteria in your mouth. There are carbohydrates in pretty much everything we eat. The juices, milk, fruits & veg, bread, cereals, honey, pasta, rice – they all have it. Sweets definitely have it. Even just one tiny grape will begin the demineralisation which will last the next 30-45 minutes before the saliva has neutralised the acids.

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Teeth can take up to 5-6 of these acid attacks per day without getting decay. So if your eating habits include more than 5-6 meals/snacks/drinks with carbohydrates, you have a higher risk of getting decay. How fast the decaying is depends on your oral hygiene habits (plus some other factors like buffer capacity of the saliva but these details will only confuse you so let’s stick to the basics).

The worst you can do to your teeth is to snack every half an hour because this means the pH level that dropped when you began your session of snacking will never raise above the safe level of 5,5. So in the worst case scenario you might take e.g. cookie/fruit every half an hour from midday till you leave work around five to get you through the day. This means that you had a massive 5-hour-long acid attack in your mouth. If this happens often, it will definitely lead to decaying.

Sugar-Free Does Not Always Mean Tooth-Friendly

Soft drinks contain massive amounts of sugar. A 16 oz bottle of coke can have 13 sugar cubes (4g cubes). This is one reason some people switch to sugar-free soft drinks. Often people do not realise that the drinks that are better for the waist-line are still as harmful to teeth as regular soft drinks. The reason for this is the pH of the drink.

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The lower the pH the more harmful it is to teeth. The low pH does not cause decay as such but it causes dental erosion which is as damaging as decaying is. Erosion on teeth means the surface of the tooth is loosing minerals as a result of an acidic drink making the enamel thinner. Here is the most important sentence to memorise:

The enamel does not grow back!

So it is very important to prevent any loss of tooth structure before you are in trouble with sensitive teeth, colour change of the teeth to yellow (thinning enamel allows the yellow dentin under it to show through), decaying (thin enamel decays quicker) and possibly imbalanced bite due to the loss of tooth structure. These problems caused by enamel erosion are very difficult and expensive to treat.

Do not think these things are not happening in your mouth. They are. I see it every day with more and more patients. Remember that the acidic drinks are not recommended to be consumed daily and when you do, consume them with a meal and drink tap water after you have finished eating and drinking. This will neutralise some of the acids.

Here are a couple of examples of the drink’s pH value:

  • cola drinks from 2,32 (Pepsi Max 2.74)
  • lemon juice 2,25
  • 7up 3,24
  • Ocean Spray Cranberry 2,56
  • strawberry Dasani 3
  • pure water 6-8
  • Red Bull 3,3
  • Full Throttle 1,45

Remember that the plain sparkling water’s pH is around 5. But if you add flavour to it with your soda maker the pH will drop close to 3 or even below it. So it is always better to choose the plain sparkling water than the flavoured one but it is worth noting that there is still a debate amongst us dental professionals whether the plain sparkling water is harmful to the enamel.

If you want to find out more about the pH value of the drinks, click here. And here is an article worth reading: The Washington Post: Why flavoured waters are bad for you teeth.

Vegan Diet and Erosion

Vegan diet in a nutshell means that the diet is devoid of all animal products, including meat, eggs and dairy. The vegans who base their diet on fruits and vegetables are at higher risk of developing dental erosion. The culprit for this is the acidity of the diet and lack of calcium in diet.

Patient Case

50-year-old lady came in to see me for the first time. She had been on a vegan diet for almost all her life. She started the day with a lukewarm water with a splash of lemon followed by a smoothie after which she brushed her teeth with a non-fluoride toothpaste. During the day she followed her vegan diet, drank herbal teas between the meals. In the evening she brushed her teeth again with a non-fluoride toothpaste.

The clinical findings:
The enamel of every single teeth was riddled with severe erosion. The fillings she had were protruding from the tooth as the tooth structure itself had dissolved around them. She had suffered from sensitive teeth and could not eat or drink anything too cold. The enamel of her front teeth were so thin that the colour of the teeth was yellow from the dentin showing through. The front teeth looked like the gremlin’s teeth due to chipping of the thinned enamel. She would need extensive rehabilitation of the occlusion and the aesthetics with crowns and fillings. Needless to say that the treatment would cost a small fortune.

What was the downfall of her teeth? Well, many factors contributed to this severe dental erosion:

  1. The combination of acidic diet and lack of calcium-containing products in the diet. It is advisable to combine acidic food with a dairy product. For example by adding natural yoghurt to your smoothie.
  2. The breakfast should include something you chew. Your saliva flow has dramatically decreased over night and it is chewing that will make the saliva flow again. If you drink something acidic when the mouth is dry (in this patient’s case lemon water and non-dairy smoothie) there is no saliva to protect the teeth. It is the saliva that neutralises acids and restores the minerals back to the enamel.
  3. Non-Fluoride toothpaste. Fluoride will work like calcium on the enamel. It will form even a stronger layer on the surface of the tooth than calcium and other minerals found on enamel. So when using only non-fluoride toothpaste, you are relying on your saliva to do the remineralisation. But like with this patient it simply was not enough to protect the teeth.
  4. Unawareness. Not knowing how our diet affects your teeth is the downfall of many. This patient had acidic vegan diet plus drinks that are highly acidic like water with lemon and the herbal teas.

Other Harmful Diets

There are new fashionable diets popping up all the time and I might not know all of them. But to name a few:

  • Juicing – everything is in a form of a juice. The problem with teeth: no chewing means no saliva to protect your teeth! No dairy-products.
  • Smoothie diet. The problem with teeth: no chewing or no dairy-products.
  • Alkaline diet. No this is a bugger considering teeth. They have their own pH chart for the foods that can mislead people into thinking that some foods are absolutely safe to eat as often as desired. Their pH chart tells what the pH of certain food is when you digest it. Let’s take lemon as an example. In alkaline diet’s pH chart lemon has pH of 10, but when the lemon is entering the mouth, the pH level is 2.0 which is highly acidic and harmful to teeth if teeth are exposed to it often.

How to Protect Your Teeth from Your Diet?

  • If you decide to follow certain trendy diet, find out first how it will affect your teeth. Do not turn to Google if you are not able to tell the difference between fake health news and real, scientifically proven advice. Ask your dentist or hygienist instead.
    These fake health news -sites are very convincing. Even I almost started to believe in the nonsense they were writing when researching for this post. So be alert, trust the dental professionals who have many years of education that is based on science.
  • Think about your current diet. Does it include lots of acidic drinks or foods. You can find out the pH level of many foods and drinks from the internet.
  • Finish your dinner or snack to a slice of cheese. Chew it well. This will neutralise the acids and restore the calcium to the enamel (cheese is rich in calcium).
  • Finish your dinner or snack to a Xylitol. This will neutralise the acids after dinner. Two pastilles sweetened 100% by xylitol five times a day will also decrease a chance of decay. Want to find out more about xylitol, click here.
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  • Use products like GC MI Paste Plus or GC Tooth Mousse to restore the lost calcium in your enamel. The GC Tooth Mousse can be used many times a day as it does not contain fluoride. The best time to use it is just before bedtime by applying pea-size-amount with e.g. cotton stick all over the teeth and leaving it overnight.
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  • Use fluoride toothpaste twice a day and do not rinse your mouth after brushing. Just spit out.
  • Avoid fizzy drinks and juices. Only drink them at mealtimes and try to avoid daily consumption.
  • Avoid snacking. But if you do snack, remember that natural nuts are tooth-friendly snack.
  • Avoid alcohol or drink in moderation. Alcohol is always a risk to your teeth, mouth and general health. It is an acidic drink and the bacteria in your mouth will metabolise the alcohol into acetaldehyde which is carcinogenic in humans.
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