I recently had a patient ask about the oral health benefits of using charcoal toothpaste. Are there any or is it just another fad?
Activated charcoal is a fine-grained black powder made from a variety of natural substances such as coal, slowly burned wood, coconut shells, olive pits, and peat. The powder activates when oxidized under extreme heat. Historically, charcoal has been used for water filtration and to remove toxins from the gut after an overdose of medication or drugs.
Today, the addition of charcoal to oral health care products is all the rage. There are charcoal-impregnated toothbrush bristles and dental floss and activated charcoal toothpastes, tooth powders, and mouthrinses. However, there is a lack of evidence supporting the oral health benefits of charcoal in dental products. In September 2017, the Journal of the American Dental Association published a literature review by Brooks et al1 on charcoal and charcoal-based dentifrices. The study looked at 118 potentially eligible articles and concluded that there was not enough clinical and laboratory data to demonstrate the efficacy of charcoal-based oral health products. The authors stated, “We as dental clinicians need to advise our patients to be cautious when using these types of products.”1
The use of charcoal in oral health products, particularly those made at home, may negatively impact dental health. In a study that looked at a variety of tooth powders traditionally used in India, researchers found that the use of a charcoal-based tooth powder caused permanent tooth discoloration and significant abrasion.2 A 1990 Malaysian study discovered that older adults who brushed their teeth with charcoal and table salt presented with significant abrasions on the labial surfaces of their teeth.3
With little evidence to evaluate, there is clearly a need for more scientific evaluation of the risks and benefits of charcoal-based oral health products.
As evidence-based decision making dictates, scientific evidence, clinician expertise, patient needs/wants, and patient circumstances should all be considered when recommending therapies and products. For patients at low risk of caries and periodontal diseases who continue to use a therapeutic toothpaste, the addition of a charcoal oral health product is unlikely to have any detrimental effect. However, research is lacking, and abrasion could be a concern.
This sort of question provides the perfect opportunity to ask patients what type of oral hygiene products they are using and educate them on the benefits of scientifically supported therapeutic modalities.
- Brooks JK, Bashirelahi N, Reynolds MA. Charcoal and charcoal-based dentifrices: a literature reviewJ J Am Dent Assoc. 2017;148:661–670.
- Singh RP, Sharma S, Logani A, Shah N, Singh S. Comparative evaluation of tooth substance loss and its correlation with the abrasivity and chemical composition of different dentifrices. Indian J Dent Res. 2016;27:630–636.
- Yaacob HB, Park AW. Dental abrasion pattern in a selected group of Malaysians. J Nihon Univ Sch Dent. 1990;32)175–180.
From Dimensions of Dental Hygiene. December 2019;17(11):48.