WHO emphasizes importance of fluoride in toothpastes

More than 50 fluoride toothpastes currently have ADA Seal

Dr. González-Cabezas

The World Health Organization's decision to add fluoride toothpaste to its list of essential medicines is shining a light on the benefits of toothpastes that have earned the ADA Seal of Acceptance.

WHO updated its Model List of Essential Medicines to include fluoride toothpaste, silver diamine fluoride and glass ionomer cement in fall 2021. In an editorial published in April by the British Dental Journal, Habib Benzian, D.D.S., Ph.D., research professor and co-director of the WHO Collaborating Center for Quality Improvement and Evidence-Based Dentistry at the New York University College of Dentistry, described how WHO's decision could lead countries to take steps to ensure fluoride toothpaste is available and regulated.

"Why do these changes matter for oral health? One may think that fluoride toothpaste is a ubiquitous commodity, yet for many it is unavailable, unaffordable or of dubious quality," Dr. Benzian said.

The ADA Seal, which celebrated its 90th anniversary in 2021, evaluates the safety and efficacy of dental products. More than 400 products currently have the Seal, including 57 fluoride toothpastes.

"The quality of fluoride toothpaste is instrumental for efficacy, as mentioned by WHO," said Carlos González-Cabezas, D.D.S., Ph.D., professor in the department of cariology, restorative sciences and endodontics at the University of Michigan School of Dentistry and member of the ADA Council on Scientific Affairs' Seal Subcommittee. "In the U.S., we are fortunate to have it regulated by the Food and Drug Administration. Additionally, we have the ADA Seal program that confirms the quality of the product and gives consumers reassurance that they are using a product of high quality."

A study published in 2021 by the British Dental Journal showed increasing use of nonfluoridated toothpaste, "which should be cause for public health concern," Dr. Benzian said.

Nonfluoridated toothpastes are available in the U.S., but all toothpastes that earn the ADA Seal must contain fluoride. The American Dental Association has long supported the use of fluoride as safe and effective in preventing tooth decay in both children and adults.

"The recent WHO decision to include fluoride toothpaste in the Model List of Essential Medicines is great news for the dental community and for dental health worldwide," Dr. González-Cabezas said. "In the U.S., the ADA has been a strong supporter of fluoride toothpaste for many decades as it is one of the best evidence-based caries prevention strategies available to the general public. In fact, many would argue this is the most important reason for the decline in caries prevalence in most developed countries, including the U.S., in the last 50 years."

For a list of fluoride toothpastes with the Seal, visit

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