Essential Oils – The Potentially Unhealthy Ingredient in your “Healthy” Toothpaste

Essential oils seem like a safer, natural alternative to the harsh antibacterial ingredients in toothpaste and mouthwash, right?

Wrong.

Some essential oils have been found to be as powerful as chlorhexidine—the active ingredient in many prescription mouthwashes.

Essential oils have been used for hundreds of years for their powerfully antibacterial properties in cleaning products, wound disinfection, and infection treatment precisely due to their effectiveness in killing microbes.

Whenever we use antibacterial ingredients in the mouth—whether “natural” like an essential oil, or made in a chemical plant such as chlorhexidine—the effect the oral microbiome is the same.

What the research says about essential oils in oral care products

If you read the research on essential oils in oral care products, you’ll notice that most of the studies deem essential oils “effective” if they kill bacterial or fungal infections. But there’s a major problem with this line of thinking. Essential oils indiscriminately kill bacteria in the mouth; the essential oil doesn’t know the difference between beneficial and harmful strains of bacteria.

There are claims that some essential oils are capable of killing only the bad bacteria and leaving the beneficial.

The better studies go one step further and measure the effectiveness of various essential oils in a variety of concentrations and their effect on specific organisms in the mouth.

Other studies have found mouth rinses with essential oils to be damaging to healthy gums and in some cases, they can prevent gums from functioning normally.

This study found that tea tree mouth rinses were effective at killing bacteria and volatile sulphur compound, known to cause bad breath. It seems like good news until the same study concluded that tea tree oil was as effective as chlorhexidine.

Another problem with essential oils is that there isn’t nearly as much funding for research when compared to pharmaceuticals. Most of the studies on the effects of essential oils on the oral microbiome are examining their ability to kill oral pathogens or how effective they are in comparison to conventional ingredients (such as chlorhexidine).

When essential oils might be safe to use in oral care products

In the case of harmful bacterial or fungal overgrowth, such as candidiasis, essential oils could be an effective and safe as a short term option. This is why my Love Your Gums Neem DIY Toothpaste recipe contains an essential oil as one of the ingredients. My concern with essential oils in oral products is daily exposure that could lead to a disrupted microbiome.

What’s confusing for consumers is that we don’t know the exact concentration or amount of the essential oil used in a particular formulation of toothpaste or mouthwash, nor do we know the therapeutic dose of the essential oil.

What we do know is that just one drop can potentially pack a major antibacterial punch.

Essential oils to avoid during pregnancy

Toothpastes are a source of essential oils that many pregnant mothers don’t consider and the concerns demonstrate the medicinal power and efficacy of essential oils.

Due to their therapeutic potency, there are valid concerns for essential oil use during pregnancy. There are a few essential oils that carry warnings from ancient folklore but due to the delicate nature of pregnancy, a better ‘safe than sorry’ attitude has been adopted for many essential oils (peppermint and clary sage are two of these).

The National Association for Holistic Aromatherapy (NAHA) recommends the following essential oils be avoided during pregnancy:

• Aniseed
• Basil
• Birch
• Camphor
• Mugwort
• Parsley seed
• Pennyroyal
• Sage
• Tansy
• Tarragon
• Thuja
• Wintergreen
• Wormwood

Factors that contribute to essential oil safety

‘Essential oils’ is a blanket term that can be misleading when discussing safety and effectiveness. There are thousands of essential oils available on the market.

Additionally, the production of essential oils is not regulated by the FDA and so therefore they vary in purity.

With these variables in mind, there are five important considerations when it comes to essential oil safety:

1. Species of the plant and its therapeutic use: Some oils are great for certain health factors but terrible for others. An example of this is fennel oil is great for improving colic in infants but capable of causing seizures in people with epilepsy – two dramatically opposing effects of the same oil.
2. Quality of the essential oil: I urge you to only use high-quality essential oils from trusted sources. When it comes to your natural toothpaste, sticking with a reputable brand is usually a safer bet.
3. Application method – How you use an essential oil will influence how much you should use. Using essential oils in a diffuser is generally safe and there aren’t as many limits. Once you start applying oils to your skin, your mouth or begin consuming them, the amount you can use significantly decreases. In fact, using essential oils orally (such as in toothpaste) has the lowest recommended dosage when compared to dermal or internal use.
4. Chemical composition – For many oils, the compounds contained in the oil are what give it its therapeutic properties. Many of the compounds have been isolated and studied while others could use more research.
5. Bactericidal Effect — Some EOs are more antibacterial than others. Some of the most antibacterial essential oils are…
   1. Peppermint
   2. Tea tree
   3. Wintergreen
   4. Spearmint
   5. Clove

Some essential oils found in toothpastes are not very antibacterial and might be totally acceptable, such as Aniseed (anise). Surprisingly Cinnamon oil has the most potential bactericidal properties and is found in many toothpastes.

Should I throw out my toothpaste if it contains essential oils?

While there are plenty of toothpastes that I recommend, there is still no perfect formulation for sale on the market today.

Should you throw out your toothpaste containing essential oils? It depends.

For patients with gut health issues, oral dysbiosis, or any other oral microbiome concerns, I recommend switching to an EO-free toothpaste or going with homemade toothpaste.

Otherwise, your options are:

1. Switch to an EO-free toothpaste. Going homemade is the only way to achieve this, at least in the United States where I live, where I’m currently unaware of any EO-free toothpaste or mouthwash formulations.
2. Switch to a toothpaste with lower levels of EO. Check your toothpaste ingredients to see where on this list essential oils falls—the lower on the list, the better. While this isn’t a hard and fast rule for knowing exactly how much essential oils are in your toothpaste, it can help you when you’re making a decision between two different formulations.
3. Use a hydroxyapatite toothpaste. The upsides of hydroxyapatite for preventing tooth decay and remineralizing tooth structure greatly outweigh the negative impact on the oral microbiome. Like I said, compromises must be made—this it the compromise I’ve landed on for myself and the vast majority of my patients without oral dysbiosis.

The toothpaste I use every day, Boka, contains peppermint, anise, wintergreen, and peppermint.

But because Boka contains the active ingredient hydroxyapatite, which I’m not willing to live without, I use it.

Compromises must always be made when going store bought. That’s why the DIY recipes on my website have been a tremendously popular way to control exactly what ingredients you’re putting into your body every day.

That being said, the concern behind essential oils in toothpaste is warranted. If you’re actively working on improving your oral microbiome health, you might want to opt for a homemade toothpaste.

In writing this article, I fully realize that there are hardly any essential oil-free options out there on the market.

But if consumers are aware of essential oils and their impact on the oral microbiome, we can let toothpaste manufacturers know that we’d like to see EO-free options in our oral care products.

Dr. Mark Burhenne

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