ORIGINAL CONTRIBUTIONS
Baking soda as an abrasive in
toothpastes
Mechanism of action and safety and effectiveness
considerations
Anderson T. Hara, DDS, MSD, PhD; Cecilia P. Turssi, DDS,
MSD, PhD
T
he success of an oral hygiene regimen depends
primarily on its ability to properly remove food
debris and biofilm formed on dental surfaces
without disrupting the physical and chemical
integrity of these surfaces. Many factors contribute to
achieving this goal, including brushing technique and
behavior, as well as specific toothpaste-related aspects.
Toothpastes function as vehicles for active ingredients
with therapeutic and cosmetic functions and inactive
ones such as detergents, humectants, and flavors.1,2
Among therapeutic agents, fluoride is probably the most
important, with strong evidence on dental caries and
dental erosion prevention; fluoride not only shifts the
mineral equilibrium between the tooth and the sur-
rounding environment toward the remineralization
phase but also makes the tooth more resistant to
demineralization. Other relevant constituents include
antimicrobials to inhibit biofilm growth, tartar control
compounds to inhibit calculus formation, and antisen-
sitivity agents. Abrasive components are fundamental to
removing dental surface stains, but they also improve
toothbrushing efficiency. Historically, abrasives in the
form of tooth powders or toothpastes have been used for
dental cleaning purposes since ancient times. As previ-
ously reported,1,3 ancient Egyptians scrubbed their teeth
with a mixture of ox hoof ashes, burned eggshells, and
pumice; later, their medical Ebers Papyrus reported a
toothpaste made of ground pebbles, honey, verdigris,
incense, and pulverized fruits. Ancient Greeks used a
Publication of this article was sponsored by Church & Dwight Co., Inc.
The articles in this issue have an accompanying online continuing
education activity available at http://www.ADA.org/bakingsoda.
Copyright ª 2017 American Dental Association. All rights reserved.
ABSTRACT
Background. Toothpastes can be formulated with
different abrasive systems, depending on their intended
clinical application. This formulation potentially affects
their effectiveness and safety and, therefore, requires
proper understanding. In this article, the authors focused
on abrasive aspects of toothpastes containing sodium bi-
carbonate (baking soda), which have gained considerable
attention because of their low abrasivity and good
compatibility, while providing clinical effectiveness
(further detailed in the other articles of this special issue).
The authors first appraised the role of toothpaste abrasivity
on tooth wear, exploring some underlying processes and
the existing methods to determine toothpaste abrasivity.
Types of Studies Reviewed. The authors reviewed
the available data on the abrasivity of toothpastes con-
taining baking soda and reported a summary of findings
highlighting the clinical implications.
Conclusions. On the basis of the collected evidence,
baking soda has an intrinsic low-abrasive nature because of
its comparatively lower hardness in relation to enamel and
dentin. Baking soda toothpastes also may contain other
ingredients, which can increase their stain removal effec-
tiveness and, consequently, abrasivity.
Practical Implications. Even those formulations have
abrasivity well within the safety limit regulatory agencies
have established and, therefore, can be considered safe.
Key Words. Baking soda; toothpaste; enamel; dentin.
JADA 2017:148(11 suppl):27S-33S
http://dx.doi.org/10.1016/j.adaj.2017.09.007
mixture of burned shells, coral, talc, salt, and honey, and
ancient Romans used a blend of crushed bones and
oyster shells plus powdered charcoal and bark. More
recently, in the 18th century, reports indicated that the
British included brick dust and crushed china in their
tooth powder.
JADA 148(11 suppl) http://jada.ada.org November 2017 27S
 ORIGINAL CONTRIBUTIONS
Over time, the selection and incorporation of abra-
sives in toothpastes have been optimized, and attention
has been given to some specific abrasive systems.
However, despite the considerable historical back-
ground, the large variety of toothpastes available with
different abrasive properties requires a proper under-
standing of their clinical applications, as well as of
potential effectiveness and safety concerns. In particular,
the use of sodium bicarbonate (baking soda) has
attracted attention because it has relatively low abra-
sivity. In this article, we review the effect of toothpaste
abrasivity on tooth wear, evidencing some mechanisms
of abrasive action; the existing evaluation methods used
to determine toothpaste abrasivity; and the literature on
the abrasive level of toothpastes containing baking soda,
highlighting some of the clinical implications.
DENTAL ABRASIVES AND TOOTHPASTE
FORMULATION
From a safety standpoint, toothpaste abrasives often are
investigated for the potential deleterious effects they
cause during toothbrushing. The ideal toothpaste should
have enough abrasiveness to remove surface stains
properly without damaging the tooth. Therefore, exces-
sively abrasive materials can abrade the tooth surface
away, resulting in undesirable tooth wear. Many factors
define the degree of abrasivity of a given compound,
including its hydration level; the size, hardness, shape,
and concentration of its particles; source; purity; and
how it has been treated physically and chemically.1
Some clinical factors modulate the effect of these abra-
sives on the tooth surface, such as toothbrush stiffness,
toothbrushing pressure and frequency,4 and enamel
and dentin mineralization level. Some of the dental
abrasives currently used include hydrated silica, hydrated
alumina, calcium carbonate, dicalcium phosphate dihy-
drate, calcium pyrophosphate, sodium metaphosphate,
perlite, nanohydroxyapatite, diamond powder, and
baking soda.2
Ideally, abrasives should not interact chemically with
the active ingredients in the toothpaste. For instance,
a calcium carbonate–based toothpaste should not be
formulated in conjunction with sodium fluoride because
chemical binding may occur between the 2 components
reducing the amount of available fluoride.2 In that case, a
more chemically stable fluoride compound such as so-
dium monofluorophosphate is preferable. From this
perspective, hydrated silica abrasive and baking soda
systems are advantageous because they are compatible
with most active ingredients.2,5,6
Because of the different properties of each of these
abrasives and the intended clinical application of the
toothpaste, the amount added in each formulation var-
ies.2 For instance, the most common abrasives, hydrated
silica and calcium carbonate, may be used in the range
of 8% to 20% weight per weight; alumina and perlite,
28S JADA 148(11 suppl) http://jada.ada.org November 2017
however, are added in lower concentrations of 1% to 2%
weight per weight, given their higher abrasivity in rela-
tion to enamel. In ideal circumstances, the toothpaste
formulation should be abrasive enough only to aid
properly in the removal of dental plaque and stains from
dental surfaces.7 This makes baking soda a particularly
interesting option because it long has been regarded as 1
of the least, if not the least, abrasive material, allowing it
to be added in much higher concentrations, often
exceeding 50% weight per weight.
TOOTH WEAR AND TOOTHPASTE ABRASIVITY
Wear can be defined as the progressive loss of material
because of relative motion between surfaces and con-
tacting substances. Four main types of wear are relevant
to dental surfaces; namely, abrasive, corrosive (caused by
chemical agents), fatigue, and adhesive wear.8
In abrasive wear, material is removed or displaced
from a surface by the action of hard particles either
moving between surfaces in relative movement or
embedded in 1 of the surfaces in relative movement.8-10
The latter arrangement describes 2-body abrasion,
exemplified by bruxism, also called dental attrition. The
former mechanism describes 3-body wear, when particles
are interposed between the surfaces. Examples are wear
resulting from toothbrushing and mastication. Corrosive
wear occurs in situations in which the environment
surrounding a sliding surface interacts chemically with it
and reaction products are worn off from the surface.8-10
In the oral cavity, corrosion best describes dental erosion
or erosive tooth wear, which results from the tooth’s
exposure to nonbacterial acids of intrinsic or extrinsic
origin. Fatigue wear occurs by means of intermittent
loading, resulting in repeated stressing and unstressing,
which in time may lead to the formation and eventual
break off of microcracks at or below the surface.8-10 Fa-
tigue has been the primary mechanism behind dental
abfraction lesions. Adhesive wear refers to the process in
which 2 surfaces contact each other under load, leading
to the local welding at the tips of the major asperities of
the surfaces.8,9 This type of wear has been related to
thread disengagement, screw loosening, and preload
reduction in dental implant systems.11
Dental abrasive wear is of particular importance
because it may result from toothbrushing, the main
intervention universally performed to remove dental
plaque and control caries and periodontal disease.4
Toothbrushing abrasion may be an issue for dentin
surfaces,12 more than for sound enamel,12-14 because the
latter is harder than almost all abrasives in toothpastes
ABBREVIATION KEY. ISO: International Organization for
Standardization. NA: Not available. RDA: Radioactive (or
relative) dentin abrasivity. REA: Radioactive (or relative)
enamel abrasivity.
 ORIGINAL CONTRIBUTIONS
(except the rarely used hydrated alumina, perlite, and
diamond powder).15 Simulation studies on lifetime
enamel toothbrushing wear showed it to be minimal or
clinically irrelevant, even if one considers enamel at its
thinnest anatomic area (near the cervical area).16,17
Conversely, dentin can wear approximately 10 times
more than enamel over a 10-year period.4 However, one
should bear in mind that toothbrushing wear on acid-
softened enamel can be 4-fold higher compared with that
on the sound surface.14 This holds true for eroded dentin
as well,18,19 which may show abrasion to be 4 to 5 times
higher than that observed in sound dentin, depending on
the toothbrush stiffness.19
Toothbrushing is considered a major contributor to
dental abrasion and involves both 2-body and 3-body
abrasive wear processes20 because of the frictional forces
caused by abrasive particles. In 2-body abrasion, abrasive
particles constitute an integral part of 1 surface that slides
against the other. This sliding takes place during tooth-
brushing because part of the abrasive particles of the
toothpaste are trapped under the toothbrush filament
tips and scratch the surface.20 In 3-body abrasion wear,
abrasive particles are interposed between 2 surfaces in
contact but are free to roll as well as to slide. Conse-
quently, abrasive particles in the toothpaste constitute
the third party interposed between the toothbrush and
the tooth surface.8 Three-body abrasion accounts for the
main abrasion process during toothbrushing.21
Evidence indicates that toothbrushing abrasion is
primarily a function of the abrasive level of the tooth-
paste.4 Essentially, the degree of abrasiveness of a given
compound depends on its hardness, shape, size, and
concentration.2 However, the dental wear magnitude
may vary according to the pressure, duration, and fre-
quency of brushing, as well as to the toothbrush bristle
stiffness and tip geometry of the filaments.
Despite the functional importance of abrasives, there
are few reports in which the investigators have compared
the various abrasives that may be contained in tooth-
pastes. In such studies, calcium carbonate has shown
lower abrasivity than has hydrated silica,22,23 whereas
baking soda has been classified as an agent of low
abrasivity.3,7 Because dentin is softer than enamel and
most toothpaste abrasives have hardness similar to or
greater than that of dentin,3,7,24 the dentin usually wears
in a higher proportion.
Limited knowledge exists with regard to the influence
of the abrasive particle size on tooth wear. Toothpastes
with larger particles cause higher abrasion rates than
those with small ones, on both sound25 and eroded
dentin26,27 although results from a 2016 article showed no
effect of the particle size on softened (demineralized)
enamel abrasive wear.18 Investigators have hypothesized
that there exists a threshold above which the wear rate
changes in different ways (that is, increases at lower
rates, becomes constant, or decreases), but it is likely that
wear also depends on the type of abrasive used in the
toothpaste formulation.
At least when hydrated silica is used, the content of
the abrasives plays a role in the tissue loss of softened
enamel.18 However, contrary to expectations, the amount
of hydrated silica added to a toothpaste has a nonlinear
association with abrasiveness.18 Absence or high con-
centrations of hydrated silica particles produced less
tissue loss than did formulations containing approxi-
mately 15% of such abrasives. These results may be
because in high concentration, abrasive particles tend to
agglomerate, preventing their rolling and therefore
causing less abrasion. Investigators have found such
nonproportional association between particle content
and abrasivity in a study with results showing that
increasing the level of particle concentration had only a
minor effect on the friction coefficient when brushing
was performed in the presence of diamond particles.20
Besides the abrasivity of a toothpaste, wear of dental
hard tissues may be influenced by the pressure,14 dura-
tion, and frequency of brushing,15 as well as toothbrush
characteristics.4 Laboratory simulations showed a trend
toward increasing dental wear with increased brushing
pressure.28 Increasing of filament loading likely increases
the load transmitted to the particles trapped between the
filament tips and dental surfaces.20 However, although
there is evidence that brushing load influences abrasion
of acid-softened enamel, investigators have speculated
that it might be of minor importance for sound enamel.14
Results of simulations in our laboratory (Sabrah and
colleagues, unpublished data, September 2013) have
shown that, depending on the toothpaste abrasivity,
tooth wear may be maintained or increased because of
brushing duration. When a low-abrasive toothpaste is
used, increasing brushing duration does not play a role in
the volume loss of teeth. In contrast, for high-abrasive
toothpaste, tooth wear increases exponentially with the
duration of brushing.
Although there are equivocal findings on how
toothbrush stiffness affects abrasion,27,29-32 its combina-
tion with toothpaste abrasivity seems to be important.12
In another laboratory simulation (Binsaleh and col-
leagues, unpublished data, November 2015), we observed
that toothbrush bristle stiffness seems irrelevant when
brushing with low-abrasive toothpaste. In addition, the
choice of a soft, medium, or hard toothbrush is of lesser
relevance to enamel than to dentin abrasion.12 However,
one should bear in mind that filament stiffness is likely to
follow toothpaste abrasivity in terms of relevance in the
abrasion process, even for dentin substrates.12 In-
vestigators have speculated that abrasion of dental hard
tissues may be minimized if filaments are round ended
and smooth.33,34 In a laboratory simulation, however,
flat-ended filaments entrain and trap fewer particles at
the filament tip region than do filaments with rounded
tips,35 which might imply increased wear with the latter.
JADA 148(11 suppl) http://jada.ada.org November 2017 29S
 ORIGINAL CONTRIBUTIONS

TABLE underestimated. Highly abrasive toothpastes can accel-

RDA* of different commercial erate the progression rate of dental abrasion,36 especially
in the cervical area, where dentin root surfaces may be
toothpastes, baking soda exposed owing to trauma or periodontal disease.
concentration, and stain removal. Therefore, there is great interest from clinicians and
TOOTHPASTE BAKING RDA IN VITRO especially oral care product manufacturers in testing the
SODA STAIN abrasive levels of toothpastes. Although clinical evalua-
(%) REMOVAL† tion of all the commercially available toothpastes is not
Pure Baking Soda (Arm & Hammer) 100 7‡ NA§ feasible, laboratory tests may provide a good indication
‡
PeroxiCare (Arm & Hammer) 50-65 35 NA of their abrasive potential in relation to enamel and
Optic White (Colgate) 0 46¶ NA dentin. A radiation-based method developed more than
Fresh Mint (Sensodyne) 0 52# NA 50 years ago37,38 and known as radioactive (or relative)
Advance White Extreme Whitening 50-65 53# 64 dentin abrasivity (RDA) and radioactive (or relative)
Stain Defense (Arm & Hammer)
enamel abrasivity (REA) remains the standard test
Paradontax (GlaxoSmithKline; 67 56# NA adopted by the International Organization for Stan-
sold in Europe)
Sensitive Whitening With Tartar 35-45 57# 38
dardization ([ISO] standard 11609).39
Control (Arm & Hammer) Briefly, this test measures the abrasivity level of
Dental Care Advance Cleaning 50-65 60# NA dentifrices (RDA-REA value) in relation to a standard
(Arm & Hammer) abrasive material, which is given an arbitrary value of 100
Advance White Brilliant Sparkle 15-20 84¶ NA for RDA or 10 for REA. To obtain comparable RDA-REA
(Arm & Hammer)
data from different dentifrices, this test relies on the use
Regular (Colgate) 0 98# NA of a specific reference material (a specially manufactured
Baking Soda & Peroxide (Crest) NA 101# NA lot of either calcium pyrophosphate or hydrated silica
Truly Radiant Rejuvenating NA 118¶ 116 materials) described in ISO 11609. The test simulates
(Arm & Hammer)
toothbrushing conditions by brushing dental specimens
Extra Whitening (Sensodyne) 0 120# NA
created from extracted human teeth (root dentin for
Truly Radiant Clean & Fresh 10-20 132# 140
(Arm & Hammer) RDA and enamel for REA), previously irradiated with a
Truly Radiant Bright & Strong 35-45 134# 100 neutron flux sufficient to produce approximately 1
(Arm & Hammer) millicurie of phosphorus 32 beta radiation, in an auto-
Baking Soda & Peroxide (Colgate) NA 161# NA mated toothbrushing machine. Slurries of test tooth-
Antiplaque & Whitening NA 164# NA pastes or dental abrasives are prepared to mimic their
(Tom’s of Maine) mixture ratio with saliva in the mouth and are used for
Total Advanced Whitening (Colgate) 0 181# NA the brushing procedure. Depending on the abrasivity
3D White Luxe Diamond Strong 0 205# NA of the test toothpaste, more or less irradiated dental
(Crest)
substrate is abraded away from the tooth and released
Max Fresh With Whitening (Colgate) 0 205# NA
into the test slurry. The radiation level of the slurry is
3D White (Crest) 0 233¶ NA
measured with a standard method such as a scintillation
Pro Health Advanced Whitening 0 245# NA
Power (Crest)
counter and is used to calculate the abrasivity of the
* RDA: Radioactive (or relative) dentin abrasivity.
toothpaste, in relation to the standard abrasive material,
† Ratio of enamel stain removal of the toothpaste in relation to calcium tested in the exact same conditions.
pyrophosphate standard material.48 Data provided by Church & The RDA-REA tests were developed with the aim of
Dwight Co., Inc.
‡ Source: Barnes.24 reducing and controlling for the variables and relevant
§ NA: Not available. behavioral, chemical, mechanical, and biological aspects,
¶ RDA test performed in an independent laboratory (study 14-267,
August 2014).
which invariably limits its clinical application.37 As an
# RDA test performed in an independent laboratory (study 17-205, example, brushing dental surfaces for 1,500 to 2,000
June 2017). strokes continuously, as recommended by the ISO
standard guideline to allow for proper sensitivity of the
test, has limited clinical application. Similarly, the lack of
TOOTHPASTE ABRASIVITY EVALUATION METHODS saliva in the testing system affects the characteristics of
From the clinical perspective, the importance of dental the slurry, most importantly its acidity and viscosity
wear diseases has increased considerably, especially with control40; in addition, the absence of acquired pellicle on
the increase in lifespan and tooth retention rates. Because dental surfaces may play an important role.41 However,
teeth are kept for longer in the mouth, they become more the use of pooled fresh human saliva in this type of
susceptible to the development of dental wear. The laboratory study is not practical, and the use of artificial
abrasive level of toothpastes can affect this process and, saliva without all the components of natural saliva would
despite the lack of clinical data in this area, should not be have a substantially reduced effect. To address these and

30S JADA 148(11 suppl) http://jada.ada.org November 2017

 ORIGINAL CONTRIBUTIONS

other clinical aspects,

we recommend more
elaborate in vitro
and in situ models.
Although there are
several limitations that
might affect clinical
abrasive wear, RDA
can be considered a
useful tool for deter-
mining the relative
abrasive level of denti-
frices and abrasive
powders.42
The ISO 11609 also
describes an alternative
Figure. Photos of toothbrushing wear on cervical area with toothpastes of different abrasivity levels. Lower
method for assessing abrasivity: PeroxiCare (Arm & Hammer; radioactive [or relative] dentin abrasivity [RDA]: 35; 50%-65% baking soda).
abrasivity, which mea- Medium abrasivity: Truly Radiant Clean & Fresh (Arm & Hammer; RDA: 132; 10%-20% baking soda). Higher abra-
sures toothbrushing and sivity: Pro Health Advanced Whitening Power (Crest; RDA: 245; no baking soda). *After horizontal toothbrushing
laboratory simulation of 35,000 double brushing strokes at 200-gram loading.
toothpaste abrasive ef-
fects directly on the
dental substrate by means of profilometry. It has the and 40 (4  the reference material) for the RDA and
advantage of not using irradiated specimens, therefore REA values, respectively. Therefore, for safety reasons,
not requiring access to a research reactor and regulatory investigators must consider these limits.39
clearance for isotope use. Results of studies in which the
investigators compared the profilometry- and radiation- CLINICAL IMPLICATIONS
based methods43,44 have shown that these methods have The data provided in the table24 show that toothpastes
potential as alternatives, although further verification seems containing baking soda, even when associated with
to be needed. Because of its historical seniority and the cleaning and whitening claims, showed RDA ranging
large body of research data, the RDA radiotracer method between 35 and 134 (for those for which data were avail-
should take precedence over the profilometry-based able), which is well within the safety limit of 250 proposed
method when a discrepancy between them arises.36,45-47 by the ISO. Such RDA values may be ascribed to the fact
Given the limitations imposed by the laboratory that baking soda is 1 of the softest abrasives present in the
nature of the RDA-REA tests, one should use caution most toothpastes.3 The intrinsic hardness of baking soda
when extrapolating these results to the clinical situation. is of the same magnitude as that of dentin and is less than
The oral care industry and some researchers arbitrarily that of enamel or of other commonly used dentifrice
have proposed a rank based on the toothpaste RDA abrasives, such as calcium carbonate, anhydrous dical-
values, suggesting that a high-abrasive toothpaste would cium phosphate, and calcium pyrophosphate.24 Although
be in the range of approximately 151 to 250, a moderate- studies still are needed, baking soda toothpastes may be
abrasive toothpaste would be in the range of 70 to 150, appropriate for patients at high risk of developing dental
and a low-abrasive toothpaste would be below 70.36 erosion because these toothpastes have lower abrasive
Although this classification seems reasonable from a levels and can minimize abrasive wear on softened or
purely abrasive property perspective, there are myriad eroded dental surfaces. The same applies for exposed root
clinical factors that directly or indirectly can affect the surfaces with dentin hypersensitivity symptoms. Baking
clinical dental abrasive wear caused by the toothpaste. soda is a low-abrasive substance and appropriate for
Additional modulating factors should be considered, dental resin composites and acrylic resin denture teeth
such as the behavioral (frequency, pressure, length, and because their hardness values are equivalent to or higher
so on), chemical and physical (fluoride, detergents, pH, than that of dentin.
temperature, and so on), mechanical (abrasive, tooth- Another beneficial characteristic of baking soda is
brush), and biological (type and condition of the sub- its high solubility, which also accounts for its low abra-
strate, saliva, and dental pellicle), as well as any particular sivity.3 Such a low-abrasive nature coupled with the high
interaction among them.46 Therefore, clinical validation solubility explain the low RDA values for the pure baking
still is needed. Nonetheless, it is important to pay soda (Table),24 which one mistakenly could assume to be
attention to the fact that the ISO guideline previously more abrasive than toothpastes containing this ingre-
mentioned sets the upper acceptable abrasivity limit of dient at lower concentrations (10%-20%, 35%-45%, or
the toothpaste to be 250 (2.5  the reference material) 50%-65%), despite an inverse relationship that seems to

JADA 148(11 suppl) http://jada.ada.org November 2017 31S

 ORIGINAL CONTRIBUTIONS
exist between baking soda content and toothpaste
abrasivity.3
However, baking soda toothpastes also may contain
other abrasives to improve dental cleaning and whitening
effectiveness, including hydrated silica, which invariably
increases their abrasivity level. In this respect, 5 of 11
(Table)24 formulations with no baking soda had RDA
values that hypothetically would characterize higher-
abrasive toothpastes (RDA, 181-245). In general, the
increase in abrasive level of toothpastes resulted in
improvement of stain removal effectiveness in a labora-
tory model (Table).24,48 However, not enough data were
available for better understanding of the effect of baking
soda content and concentration on the cleaning ability of
the toothpaste. The figure illustrates the lower abrasivity
of a high-content (50%-65%) baking soda toothpaste
(RDA, 35), after a laboratory toothbrushing simulation of
35,000 brushing strokes. No tooth wear was visible in the
brushed cervical area, similar to findings in the teeth
brushed with only water. In contrast, deep notched
lesions were visible in the cervical area of teeth brushed
with the higher abrasive toothpaste (RDA, 245), whereas
less pronounced lesions were visible with brushing with
the medium abrasive toothpaste (RDA, 132).
Besides its low-abrasive nature, baking soda has bio-
logical compatibility, acts as an acid-buffering agent, and
possesses antibacterial activity in high concentrations.24
Other advantageous features are that baking soda is
compatible with fluoride and is inexpensive.3 Two limi-
tations are that baking soda adds a salty taste to tooth-
paste and negatively affects foaming.2 To overcome the
salty taste, manufacturers have added varying levels of
baking soda, flavorings, and sweeteners.24 Baking soda
has a long history of safe use and is considered generally
recognized as safe by the US Food and Drug Adminis-
tration. The amounts of baking soda in toothpastes bear
no clinical concern related to toxicity.49
CONCLUSIONS
Baking soda is a safe toothpaste ingredient and has a low
abrasive potential in relation to dental surfaces. The
addition of other abrasives to toothpastes containing
baking soda, mostly hydrated silica, seems to improve
the toothpastes’ cleaning effectiveness and abrasive
levels. Nonetheless, even these more abrasive formula-
tions are well within the safety limit defined by regula-
tory agencies and, therefore, can be considered safe. n
Dr. Hara is an associate professor, Department of Cariology, Operative
Dentistry and Dental Public Health, Indiana University School of Dentistry,
415 Lansing St., Indianapolis, IN, e-mail ahara@iu.edu. Address corre-
spondence to Dr. Hara.
Dr. Turssi is an assistant professor, Division of Cariology and Restorative
Dentistry, São Leopoldo Mandic Institute and Dental Research Center,
Campinas, São Paulo, Brazil.
Disclosure. Drs. Hara and Turssi each received an honorarium from the
American Dental Association.
32S JADA 148(11 suppl) http://jada.ada.org November 2017
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