Triclosan has surfaced in the news again â€“ this time, for its impact on the environment and as a potential contributing factor to the prevalence of antibiotic resistance. Dental care providers should remain abreast to the changing information surrounding chemicals commonly found in dental hygiene products.
Dr. Jianhua Guo conducting experiments on the affects of triclosan on bacteria (Photo is taken by EAIT Faculty Marketing team, The University of Queensland)
Results of a study out of the University of Queensland (UQ) suggest that non-antibiotic, antimicrobial (NAAM) chemicals found in hand soap and toothpaste, such as triclosan, may be contributing to the prevalence of antibiotic resistant bacteria.
Researchers focused on concentrations of antibiotic resistant bacteria in residential wastewater. According to Dr. Jianhua Guo from UQ's Advanced Water Management Centre, "wastewater from residential areas has similar or even higher levels of antibiotic resistant bacteria and antibiotic resistance genes compared to hospitals, where you would expect greater antibiotic concentrations.” Guo went on to explain, "these chemicals are used in much larger quantities at an everyday level, so you end up with high residual levels in the wider environment,” leading him to wonder whether chemicals in household products, like triclosan, can have an effect on antibiotic resistance.
Dental professionals are well aware of the controversy surrounding chemicals like triclosan — a substance used in many commercial toothpastes. Clients with alternative health philosophies have dismissed dental products containing the ingredient long ago for more holistic means of hygiene. Sometimes, they sacrifice their oral health in the process.
While some major brands have sworn off triclosan to attract consumers, others are confident in its effectiveness and think the benefits outweigh the drawbacks. Colgate-Palmolive, manufacturer of Colgate Total®, is the leading toothpaste brand in the United States and is the only product with both the American Dental Association (ADA) seal of approval and Food and Drug Administration (FDA) acceptance as safe and effective.
When asked about the research on triclosan, a representative from Colgate-Palmolive said: “After an exhaustive review, the FDA concluded that Colgate Total provides a meaningful therapeutic benefit and is safe for consumers. Colgate Total’s NDA approval has not changed in any way, and triclosan’s use at 0.3% in toothpaste has been reviewed as safe and effective by regulatory bodies around the world.”
Specifically addressing the recent study, he added “the experiments were conducted at 98.6° F -- higher than found in waterways -- and with levels of triclosan 100 to 1000 times more than the concentrations in waterways,” citing these weaknesses as evidence for Colgate’s claim that no “real-world antibacterial resistance can be drawn from this preliminary research.”
One troubling detail surrounding the triclosan debate is the FDA’s ban on the substance in antibacterial hand soaps, leaving consumers to wonder why it is still considered safe for use in the oral cavity. And with antibiotic resistance becoming a prominent threat to public global health, this additional information is another strike against the substance.
When asked about the potential future harm to the environment, Guo acknowledged the cumulative effect of triclosan concentrations as the largest threat. “The low efficiency of [waste water treatment facilities] to degrade triclosan results in its presence in receiving water bodies and its accumulation in biosolids and hence release into the environment. Based on pure culture experiment, our findings indicate environmental residues of TCS could facilitate selection for antibiotic-resistant bacteria through mutation.”
Guo went on to say that further investigation into the effects of triclosan, and other NAAM chemicals, is necessary to determine the potential long-term effects. “I would like to suggest people look for triclosan-free personal-care products,” he concluded, adding “antimicrobial resistance is a major threat for human beings, all of us need to fight against it together as a team.”
It is essential for dental providers to stay abreast on the changing regulations surrounding all chemicals used in dental products. Frequently checking FDA regulations is advisable to best inform patients about the most current recommendations.
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