Dental Hypotheses

: 2015  |  Volume : 6  |  Issue : 3  |  Page : 123--125

Enlightened advertising: A role for dental marketing in enhancing dental literacy

Carolyn Bradford 
 School of Dental Medicine, University of Connecticut, Farmington, Connecticut, USA

Correspondence Address:
Carolyn Bradford
School of Dental Medicine, University of Connecticut, Farmington, Connecticut


This commentary discusses the importance of accuracy in toothpaste advertising and explores ways in which ensuring such accuracy could help to address the present need for improved dental literacy among the general public.

How to cite this article:
Bradford C. Enlightened advertising: A role for dental marketing in enhancing dental literacy.Dent Hypotheses 2015;6:123-125

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Bradford C. Enlightened advertising: A role for dental marketing in enhancing dental literacy. Dent Hypotheses [serial online] 2015 [cited 2022 Aug 18 ];6:123-125
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Full Text

 What is Wrong with this Picture

A molar with four roots? Not entirely unknown but hardly the image expected in a national TV advertisement for a well-known toothpaste brand. Yet, there it was. To make matters worse, as if trying to draw attention to this anatomical oddity, it was conspicuously rotating next to a pretty lady with a blindingly white smile. She was looking directly at the audience - the TV camera actually - and while her manner and intensity said, "Believe every word I say," the four-rooted tooth said, at least to me, "I have no credibility."

Please do not misunderstand. I certainly do not expect every viewer to have painstakingly studied the intricate details of tooth morphology; I would, however, expect some homework to be done on the part of those hired by the toothpaste company to make the commercial. Much has been written about increasing the dental literacy of the underserved but how about programs enhancing the dental literacy of Madison Avenue?

Factual commercials are important to me as a dental student. Why? I am committed to increasing the dental literacy of my patients so that they may care for themselves better when not in my chair. Standard lectures on brushing and flossing are met with smiles, nods, and vows of fulfillment. Yet, the glazed expressions accompanying the often-hollow promises convey a lack of true internalization of the importance of a careful oral hygiene regimen.

This insufficient degree of patient dental literacy has been demonstrated to me on multiple occasions, during the standard dental history section of a prophylaxis appointment, when asking the simple question, "Do you know what's in your toothpaste?" More than once, my query has been met with looks of confusion. Even reframing my question to ask, "Does your toothpaste contain fluoride?" resulted in the same blank stare. I find it both shocking and depressing that many people could tell you which brands of ketchup contain high fructose corn syrup but many of those same people could not tell you if their tooth paste contained fluoride. We are so consumed by the airbrushed images of garishly white smiles and computerized graphics that we neglect to see and understand the substance of what we are actually buying.

 Distilling the Options - In the USA and Worldwide

The quintessential supermarket aisle, in the USA and in many nations worldwide, contains an overwhelming variety of toothpaste options. There are myriad flavors, ranging from classic mint to cinnamon and bubble gum. The benefits, ostentatiously displayed on the boxes in bold lettering, range from simple "cavity protection" to "multibenefit" to "extreme whitening."

A cursory scan of toothpastes bearing the American Dental Association (ADA) seal of approval - asserting that the paste "is effective in helping to prevent and reduce tooth decay, when used as directed" - reveals that the vast majority boasts a single active ingredient: "fluoride." Whether in the form of sodium fluoride, sodium monofluorophosphate, or stannous fluoride, the "effective fluoride concentration" in these nonprescription pastes varies only minimally, mostly between 0.13% and 0.15% weight by volume. Pastes formulated to combat sensitivity may contain additional active ingredients but even these preparations contain comparable fluoride concentrations to their shelfmates. Though prescription dentifrices can contain significantly higher concentrations of fluoride, the average person should - in theory - rest easy knowing that it is hard to go wrong when buying fluoridated toothpaste. Yet, this fact that is well-masked by cartoon teeth and airbrushed models remains elusive to the masses.

 Monitoring Fluoride Content in Toothpaste

In the USA, the scientific accuracy of claims by pharmaceutical companies is monitored by the Food and Drug Administration (FDA). The contents of advertisements from companies must be consistent with what the FDA has approved for the drug. Should an advertisement contain content that goes beyond what the FDA has approved, it must be withdrawn. In the USA, toothpastes containing fluoride are classified as both cosmetics and as drugs; therefore, they are subject to FDA approval. [1] As part of this regulation, the FDA mandates specific statements regarding active ingredient(s), use(s), and warning(s) that must appear on the packaging of fluoride-containing toothpastes. [2] Further, an Internet search suggests that dental associations in other countries have a similar oversight for monitoring toothpastes for public consumption, including the UK's Medicines and Healthcare Products Regulatory Agency (MHRA) and recently, China's Health Ministry and Certification and Accreditation Administration. [3]

In the USA, the American Dental Association (ADA) offers an additional opportunity for oversight yet these regulations, such as those from the FDA, fall short of apprehending a four-rooted molar before it hits the press. The ADA Council on Scientific Affairs offers a voluntary seal of approval for oral hygiene products. According to the ADA website, companies wishing to earn the ADA Seal must provide an ingredients list, evidence to substantiate effectiveness claims, demonstrate sound manufacturing practices, and "packaging and advertising claims that are supported by science." [4] While this last requirement might initially appear to be the answer to inaccuracies in toothpaste advertising, it is not so in practice. Advertising assessments prior to seal-granting simply look for misleading claims while the monitoring of advertisements following the dubbing of a product as ADA-approved only consider accuracy in display and use of the bestowed seal. [4]

 Harnessing Advertising's Educational Potential

Though it may be difficult at first to see the connection between my dismay regarding the anatomically inaccurate molar and the fluoride content of various toothpastes, a connection does indeed exist. It is crucial to address the appalling lack of dental literacy in the USA and worldwide. As the professional community aims to develop programs to increase general understanding of oral health and its importance, it is important to recognize that a prime avenue by which to do so already exists - yet untapped - in dental advertising. In the USA, advertising is so pervasive in all aspects of life that more number of people are likely see dental advertisements in print and on television than visit a dentist. Thus, the first task is to make sure that the scientific content of these commercials is accurate, and - to take it one step further - make this content instructive. Unfortunately, at this time, there appears to be a disconnect between the scientific community and those who create the advertisements.

One recommendation would be the establishment of an ADA panel of dental professionals to review each advertisement for accuracy, correct any errors that may be present, and provide feedback for incorporating educational content. A consumer survey cited by the ADA claims that over 60% of those questioned reported favorable feelings toward the current ADA Seal of Acceptance, with a large fraction claiming "they would pay more for an oral care product that displays the Seal." [4] These results suggest that the current Seal program is effective in its goal of instilling consumer confidence. Therefore, capitalizing on the apparent success of the ADA Seal, the creation of an auxiliary panel focusing on advertisement content could further communicate with consumers and even benefit the toothpaste companies. By allowing companies to display a certified ADA-approved stamp for accurate advertising, not only would product efficacy be further reinforced to consumers but consumers could also have confidence in the fact that educational information in the advertisements is accurate. Since the ADA Council on Scientific Affairs already considers advertisements when considering a product's worthiness of its seal, why not take this part of the process one step further and make it a requirement for advertisements to advertise what makes them effective? Such a seal could easily be designed to prominently indicate the fluoride content of the toothpaste on the front of the box in an effort to increase the general awareness of what is inside the box.

Though we are a long way from the day when anyone can perform his/her own root canal, there is no reason whatsoever why anyone should be ignorant of whether or not he/she is using a toothpaste containing fluoride. Also, if consumers could have even a cursory understanding as to why the use of a fluoridated tooth paste is recommended, the potential for success would skyrocket.

Financial support and sponsorship

The author do not have any financial support.

Conflicts of interest

There are no conflicts of interest.


1FDA: Protecting and Promoting Your Health. Silver Spring (MD): U S Food and Drug Administration. Is It a Cosmetic, a Drug, or Both? (Or Is It Soap?); 2002 Jul 8; [about 2 screens]. Available from: [Last accessed on 2015 Jul 12].
2CFR Title 21 - Food and Drugs. Silver Spring (MD): U S Food and Drug Administration. 21CFR355.50, Labeling of anticaries drug products. Available from: [Last accessed on 2015 Jul 12]. Montpellier (FR): William Reed Business Media SAS, part of the William Reed Group; 2007 Jul 6. Available from: [Last accessed on 2015 Jul 12].
4ADA: America′s leading advocate for oral health. American Dental Association. How to Earn the ADA Seal Acceptance. Available from: [Last accessed on 2015 Jul 12].