Dental Care

Written By Dr. Jennifer Ebner

Hey, we all want to have a brighter smile. Except my patient, Mrs. X who accused me of trying to get her dates when I recommended bleaching her teeth before placing new crowns on her front teeth. I told her, “Mrs. X, NO, I'm thinking big picture here.” I tried, in vain, to convince her. Dark porcelain color is permanent. But I digress.

A quick, overly simplistic science lesson followed by a history lesson

Activated charcoal is highly porous. With its convoluted surface area, it is said that 1 teaspoon has the surface area of a football field. Like a tiny but super strength sponge, it can absorb a lot of chemicals and hold them (not going to get into Van Der Walls forces here). Activated charcoal can take the chlorine out of water, can interfere medication uptake (overdose) and is said to be able to take the stains and bacteria out of one’s mouth. In 1852, the crazy French pharmacist, Pierre Fleurus Touery ate 15 times the lethal dose of strychnine with activated charcoal in front of a pessimistic crowd of equally crazy scientists and walked away. There have been several accounts of not-no-lucky scientists trying to recreate the experiment. It seems the absorptive ability varies by how it's prepared.

But how does that work for teeth? Can brushing with black gritty toothpaste whiten one’s teeth and freshen one’s breath? Well, if we are to believe the talent on Instagram, then YES! However, to date there hasn’t been any scientific research that can prove this. I looked up and read the research cited by various articles online that promote the claims of activated charcoal. They appear to be from companies selling products made with activated charcoal. Let’s not be shy about mentioning that the Instagram talent has likely had their teeth bleached by their friendly dentist before promoting the charcoal whitening toothpaste featured on their page.

So what has legitimate research show, the kind that can be duplicated?

1) On the range of abrasiveness, activated charcoal is very high, as are mainstream whitening toothpastes. In fact, the abrasiveness is the likely cause of stain removal by toothpastes that contain activated charcoal, just as in "whitening" store bought brands. Using highly abrasive substances on your teeth is like using sandpaper on them. Yes, the stain will be scoured away, but so will enamel and later, dentin, the softer root part of the tooth. Overuse can damage enamel permanently and lead to darker teeth because the darker dentin shows through. It can also lead to sensitivity from enamel wear.

2) The little particles of activated charcoal can wedge in between teeth, and get underneath the gums causing irritation and inflammation.

3) The black particles can settle in between white fillings and the tooth leading to black lines on teeth with fillings. This is bothersome if it’s a filling on a visible area, like a front tooth.

4) Beyond the abrasive stain removal, the whitening effect is likely anecdotal and the effects superficial.

5) Activated charcoal increases the pH in the mouth after use. This is a good thing. Cavities are cause by acids secreted by bacteria in the mouth, weakening tooth structure. A higher pH buffers the saliva and reverses weakening caused by acid attack. On the other hand, baking soda also has a higher pH and buffers saliva if used in a toothpaste or as a rinse. The difference is baking soda costs about $0.50 a box at Safeway.

6) Activated charcoal attracts compounds that one eats or drinks that cause extrinsic stains (on the outside of the teeth) So, will brushing after drinking red wine or smoking decrease the staining effects? Maybe? Give it a try and get back to me.

7) Does activated charcoal toothpaste control halitosis (bad breath)? While I like the idea that noxious smell coming from my mouth after I eat garlic or drink coffee will be permanently removed until the next time I eat or drink, the charcoal is not held in the mouth for long. Any absorptive effects are lost as soon as one rinses. It doesn’t even get into the stomach where that garlic or coffee is fermenting in stomach acid. This is one that you’d have to try for yourself. No cheating and using flavored toothpaste that covers the smell with mint.

8) Most of the activated charcoal toothpastes have no or minimal fluoride added, leaving users at greater risk for tooth decay.

9) At $16 for 4-ounce tube of toothpaste on Amazon, one is better off buying a tube of professional tooth bleach from your dentist and putting it in custom trays. That will whiten your teeth.

I’ve included two of the resources I used to pontificate on this fascinating subject. I’m not recommending any course of action, except that professional teeth whitening should be supervised by a dentist.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4767212/

https://www.dentalhealth.org/News/health-charity-explores-the-facts-and-myths-of-charcoal-toothpaste

This blog is not meant to offer any advice, to diagnosis or suggest treatment recommendations for any condition, health related or otherwise. It is for entertainment purposes only.