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Sweeteners in toothpaste pose health safety risk
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February 05 , 2018
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Prof Manjeet Aggarwal, Nidhi Kaushik and Prof R K Khandal
Food safety and health
Food safety has already become the sole criteria of food quality all over the world, thanks to the fact that these days, the global food trade is being driven more by the parameters of food safety than by the parameters of food quality.
As a result, a large number of capacity- and capability-building projects have been undertaken on a large scale, both by the importing as well as the exporting countries to meet the food safety standards, so that the consumers are able to get safe food.
While the importing countries, especially from the developed world, have been continuously upgrading the quality criteria by way of reducing the acceptable limits of residues, contaminants, adulterants etc., the exporting countries largely from developing world have been trying to meet the requirements of the importers.
Initially, there were a lot of hard feelings and the developing countries termed all this as indirect trade barrier. But that is no more the case.
Today, all such issues related to food safety and food quality are being, by and large, resolved by a system put in place for their amicable resolution.
With the WTO in place and the guidelines of Codex Alimentarius being accepted by signatory countries of WTO, the focus has shifted from top-down to bottom-up for quality now.
Issues of food safety are no longer being considered as the trade barrier. Consumers have also become so much aware that manufacturers are bound to remain on their toes.
As a result, residues, contaminants, adulterants, etc. are not checked and monitored just in foods, but also in several other products of human consumption.
It is now very clearthat the quality and safety of ingredients in all products meant for human consumption, includingfunctional foods and nutraceuticals, will also be checked for health safety.
Toothpaste is one such product that must be given a lot of attention as far as the rigorous studies of health safety of its ingredients is concerned.
Incidentally,there are certain health safety-related issues, mainly due to the incorporation of sweeteners to make toothpastes taste sweet.
Toothpaste is one product that is used by almost all throughout the globe and taken inside the mouth first thing in the morning every day by all strata of the society and by people of all age groups, includingchildren, to ensure oral care.
But yet, never ever, the health safety implications of using the toothpaste have ever been emphasised upon.
Here it may be noted that a quantity of anything put into the mouth, even if it is not swallowed,gets absorbed directly into blood and tissues through mucosal lining of the mouth and gums, which are highly vascular in nature.
Hence,a potential harmful ingredient in toothpastes coming into the blood stream in seconds and causing side effects associated with it cannot be overruled.
It appears that health safety of toothpastes has yet to draw due attention of regulators. This paper raisedsuch issues as why tooth pastes are always sweet in taste, and why sweeteners are added to toothpastes.
More specifically, why does the taste of a toothpaste become a unique selling point (USP), especially for pastes designed for children.
It is quite concerning to see the advertisements of toothpastes highlighting their taste to attract children so that they get tempted to use them.
Other issues that have been raised in the present paper are the presence of other ingredients and their safety to human health.
Recently, there have been concerns raised by the regulatory authorities in the United States, regarding the health safety of E171 (titanium dioxide), the most widely andcommonly-used ingredient the world over, by most of the manufacturers, as a whitening agent not only in toothpastes, but also in other food products.
What has been stated based on the outcome of the toxicity studies conducted on laboratory animals is quite disturbing for consumers as much as for the regulators.
It has been reported E171 (titanium dioxide), may be a potential health risk. There have been reports regarding allergies caused due to its topical applications.
Titanium dioxide dust when inhaled has been classified as the World Health Organisation (WHO) and the International Agency for Research on Cancer (IARC) Group 2B carcinogen, meaning it is possibly carcinogenic to humans.
Studies have further found titanium dioxide nanoparticles to cause inflammatory response and genetic damage in mice.
There is also some evidence that the rare yellow nail syndrome might be caused by titanium. E171 (titanium dioxide) is currently banned in Germany.
This ingredient (E171) also must be in use in India by the Indian manufacturers of toothpastes.
Therefore, this study must be taken note of by the regulators, and regulations need to be framed to regulate the use of such ingredients in toothpastes by the manufacturers.
The following claims have been by manufacturers vis-à-vis the need for toxicity data for presence of various ingredients:
E171
In India, manufacturers of toothpastes have been advertising making various claims, such as whitening of teeth, cavity protection, sensitivity relief, gingivitis prevention, tartar control, breath freshening, enamel protection, etc.
Incidentally, the ingredient E171 is known to make the teeth snow-white and shiny and it is also known to render other related benefits.
Thus, the usage of E171 is a matter of concern, and therefore, it becomes important to monitor its presence in toothpastes in India and also to check if there is any regulation existing to control the use of E171 in the toothpastes consumed by consumers in India.
Considering the reported data on the toxicity of E171, the need for a strict regulation on the use of such an ingredient in toothpastes by manufacturers need not be over-emphasised.
As a matter of fact, the manufacturers must be asked to provide the safety data about all the ingredients being used in toothpastes.
Further, each claim about the benefits rendered by the toothpaste must be duly substantiated by health safety data, besides their efficacy.
When the regulator is asking for strict guidelines about the claims made by manufacturers for a functional food, the same should be applicable to products like toothpastes as well, since almost every human uses them on a daily basis, and in many a cases, multiple times a day.
Salt, charcoal, various medicinal plants, etc.
Often manufacturers use gimmicks like the presence of salt, charcoal, various medicinal plants, etc. in toothpastes, while claiming the advantages of each of them. There must be strict regulations for such claims as well, so that the consumers are not misled.
Artificial sweeteners
One of the notable as also interesting observations regarding all the toothpastes available all over the world pertains to the fact that all of them are sweet in taste.
It is strange that no one has ever objected to this or raised any question on this. As a matter of fact, majority of the times, there has been a tendency to highlight the sweet and pleasant taste of toothpaste to attract consumers, mainly children, so that they are tempted to use such tasty toothpastes.
The parents or the guardians also have no objection to it, as they are able to make their wards brush their teeth happily.
Whether the sweet taste has any adverse impact on the health of children in their tender age was the question raisedin the paper.
Even for adults, why should toothpaste be sweet in taste? Should this not be considered as a food safety or health safety issue?
Toothpaste is supposed to kill the germs in the mouth and it is also supposed to protect the mouth odour at least for a period of 24 hours.
If all these are the functions expected from toothpaste, the sweeteners used to make the toothpaste sweet has no role, whatsoever, to play as far as killing germs is concerned. Then why should the use of artificial sweeteners be permitted?
There are various types of artificial sweeteners being used in the manufacture of toothpastes, the most commonly being saccharin.
We all may not be aware of the fact that saccharin can cause gut hormone secretions, alter metabolic functioning, thereby affecting the body weight, glucose and lipid levels, and cause other associated manifestations of toxicity. Imagine, a consumer ingesting saccharin everyday throughout life!
By a simple calculation, one can easily calculate the amount of saccharin one would end up absorbing over a period of life time.
If this daily consumption of saccharin is considered, it would be certain that one would find the situation as highly alarming.
It would certainly exceed the allowed limits of toxicity. Here, it must also be noted that saccharin is not considered a safe product for daily consumption.
Till the year 2000, saccharin was considered as unsafe. It was only after 2000 that the warning labels on saccharin-sweetened products were removed by the United States Food and Drug Administration (USFDA).
Recently, there were reports in the Indian media about the toxic effects of artificial sweeteners.
Considering all this, use of saccharin in toothpastes is certainly a cause of concern. It must be regulated more strictly.
In India, there has been a steep rise in number of diabetics. Whether such alarmingly high rate of cases of diabetics can be ascribed to the use of saccharine in toothpastes may be a matter of debate, but one cannot rule it out.
Today, India is being called the diabetic capital in the world. Whether the presence of sweeteners like saccharin in toothpastes is not responsible for the rising tendency of diabetics in consumers will have to be established.
Is it necessary for the toothpastes to be sweet?
Why can’t toothpaste be a tasteless product? Why can’t it be salty, sour, bitter, etc.?Will that not help reduce the incidence of diabetes in the country?
Traditionally, in India, thw rural population used datun of neem, babool, keeker, giloy, etc.All of them have a different level of bitterness in them.None of them are sweet in taste.
There are several other products in use, besides the datun. For instance, the use of a mixture of mustard oil and rock salt, charcoal ash, charcoal powder, etc. None of them are sweet in taste.
One of the commonly used products in certain regions of the country is the combination of jaggery and tobacco leaves (it is also called gudakhoo).
Even though this product is sweet in taste, the sweetener is jaggery, which is not known to have health safety risks, unlike saccharin.
Thus, till the other day, the majority of the population, for oral care, used products that were natural and had no artificial ingredients.
It is only in recent times (the last few decades) that this trend has changed. This certainly needs to be studied.
The aim of this paper is mainly to highlight a few fundamental and important issues of health safety due to the existing quality of toothpastes.
It is hoped that this will bring awareness and bring a change in perception of regulators about the use of various ingredients like E171, sweeteners, etc. in toothpaste.
[Aggarwal is head of the department, basic and applied sciences, and dean (research), National Institute of Food Technology and Entrepreneurship Management (NIFTEM); Kaushik is research fellow, NIFTEM, and Khandal is president, research and development (R&D), India Glycols, Noida, and former vice-chancellor, Dr A P J Abdul Kalam Technical University, Lucknow.]
  
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