Updated 25 August 2014

Popular toothpaste in trouble over cancer links

One of South Africa's best-selling toothpastes, Colgate Total, has come under scrutiny for containing a chemical with links to cancer.

Triclosan, one of the active ingredients in Colgate Total, has been under contention for over a decade, with many multinational companies removing it from their products outright.

Uncertain status

However, the chemical is still used in Colgate Total in many countries due to its effective anti-bacterial properties. An independent review by the Cochrane Oral Health Group showed that the Triclosan formula "delivered a 22% reduction in plaque and gingivitis, a 41% reduction in plaque severity, and a 48% reduction in gum bleeding."

As a result of its efficacy, Colgate Total is the only toothpaste endorsed by both the Federal Drug Administration and the American Dental Association. However, recent research has thrust this status into uncertainty. 

According to the FDA's website "several scientific studies have come out since the last time FDA reviewed this ingredient that merit further review". Triclosan has officially been under review since December 2013.

Read: How safe is your toothpaste?

The studies in question link Triclosan to, amongst other things, endocrine disruption. It has been associated with impaired functioning of the thyroid gland and a lack of testosterone in males. The results of this disruption include infertility, learning difficulties and behavioural issues.

Classified a poison

There are also links between Triclosan and cancer. A 2008 study in Environmental Health Perspective suggested that Triclosan, even in very low doses, can mimic oestrogen and increase the likelihood of breast tumours developing.

Despite not being banned, Triclosan use is heavily regulated. In Europe it is illegal for it to be used in any product that may come into contact with food, this ban does not extend to toothpaste.

In most countries the Triclosan threshold is 0.3% and any product that contains more than this is classified a poison. Colgate Total contains 0.3% Triclosan.

Triclosan originally came into use as a pesticide, being approved for this use in 1969. A large-scale 2008 study by the CDC found that notable levels of Triclosan were found in the urine of 75% of American's tested.

Read: Anti-bacterial soaps may be ineffective

For their part, Colgate have come out in defence of the product. An editorial published yesterday on Fox News by Dr. Patricia Verduin, Head of Colgate-Palmolive Research & Development claimed that "recent media reports...are not based on facts or science."

Drug-resistant diseases

The piece goes on to state that "An examination of the full body of evidence shows that triclosan as used in personal care products does not present a risk of endocrine related health effects." Unfortunately, the editorial does not cite the studies used in coming to these conclusions.

Other large toothpaste brands, including Aquafresh and Sensodyne as well as other Colgate brands, do not use Triclosan. Furthermore, companies have been working to remove the chemical in other products that contain it including face-washes, soaps and cleaning solutions. Johnson & Johnson and Proctor and Gamble are two billion-dollar companies who have pledged to remove Triclosan from all of their products by 2014 and 2015 respectively.

Colgate Total makes up a significant portion of Colgate's 44.8% share of the global toothpaste market, highlighting its financial importance to its parent companies, reported the Sydney Morning Herald. In South Africa, Colgate is owned and operated by Unilever.

Read: Breast cancer affecting more and more men

An additional concern, which stretches to all anti-bacterial products, is their role in the increasing issue of drug-resistant diseases. "Long-term use of any antibacterial ingredient may, however, cause more problems than benefits by promoting antibiotic resistant bacteria," says Prof. Johan Hartstone, visiting professor of Oral Health at the University of Pretoria.
The final word on this matter will likely come when the FDA concludes their review of the ingredient, though there is no deadline for this decision. They could reduce the 0.3% limit, ban its use altogether or decide that the current classification is accurate.  

The FDA is likely to come under pressure from another powerful US body, the Environmental Protection Agency, who are working with them on the review of Triclosan use. The EPA recently re-approved the use of Triclosan in pesticides, but banned it from being used in paints or stains, as it previously had been.

What does this mean for the consumer? The research isn't crystal clear either way so we can't recommend you stop using the product, nor can we say that it is completely safe. It comes down to personal choice, if you are worried about breast cancer, you should consider stopping until the research becomes clearer either way. If you aren't worried, it's worth remembering that Colgate Total does appear to be more effective than other toothpastes at treating gingivitis.

Read more:
Exposure to anti-bacterials may affect foetus growth  
How to conduct a breast self-examination 
New research on "Angelina Jolie" breast cancer genes 

Sources: Sydney Morning Herald/FDA/EPA/Fox/Environmental Health Perspective

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