I have gingivitis and I hate it. One day, my bleeding gums got so bad that I sought out to find the best way to treat my gingivitis. I found myself jumping down a rabbit hole of different products and misinformation. In this article, I will review the best stannous fluoride toothpastes.
Before I get into this article, I must state that I have a medical degree and DO NOT have a dentistry degree. That being said, I have asked multiple friends that are dentists and most of them do not even learn about stannous fluoride in dental school. In this article, I will go through what I have learned through peer-reviewed journal articles and different websites (that I deemed were respectable and trustworthy).
So lets jump in.
Comparison Table: The Best Stannous Fluoride Toothpastes
Below I have compiled the best stannous fluoride toothpastes in an easy-to-read table. Included in the table is my personal rating as well as the rating on Amazon (based on the time of reviewing the products when I wrote this article). Make sure to keep reading below for more information about stannous fluoride and its related research.
MedicalGeeker Rating 9.9/10
637 user ratings
|Crest Pro-Health Whitening Power Toothpaste|
MedicalGeeker Rating 9.0/10
94 user ratings
|Crest Toothpaste Gum Detoxify Deep Clean|
MedicalGeeker Rating 8.7/10
1,647 user ratings
|Sensodyne Complete Protection|
MedicalGeeker Rating 8.3/10
298 user ratings
What is Stannous Fluoride?
Stannous fluoride (SnF2) is a stannous ion (Sn2+) combined with a two fluoride ions(F22-). It provides a big range of benefits including protecting against caries, gingivitis, plaque, and dentin sensitivity. Most importantly, it is the most effective form of fluoride found in the active ingredients of toothpastes.
Stannous Fluoride Fights Gingivitis and Plaque
Stannous fluoride has antibacterial effects that fluoride found in its other forms does not have. It is thought to actively kill bacteria (bactericidal) that may be due to breaking the bacteria’s membrane. Stannous fluoride also inhibits metabolic enzymes to prevent bacterial growth (bacteriostatic).
The net effect of reducing bacteria (aka plaque) is the eventual decrease of inflammation in the mouth that leads to gingivitis.
As opposed to stannous fluoride, fluoride in its other forms (sodium fluoride and sodium monofluorophosphate) do not have antimicrobial properties. As such, toothpastes with SF2 have been shown to decrease gingivitis and gum bleeding more than toothpastes with sodium fluoride1.
Another antimicrobial active ingredients sometimes found in toothpaste is triclosan. Triclosan has been shown to decrease plaque but does not decrease gingivitis or gum bleeding2. As such, stannous fluoride has been shown to have much more significant results in reducing gingivitis and gum bleeding3.
Stannous Fluoride Also Prevents Enamel Erosion Better Than Other Fluorides
If you are looking for better enamel protection, then stannous fluoride again is the fluoride that you want. In a trial, stannous fluoride was significantly better at preventing enamel erosion compared to sodium fluoride and sodium monofluorophosphate4.
Stannous Fluoride – A Delve Into Its History
As you might imagine, stannous fluoride appears to be a godsend, but why is it not found in every toothpaste? Historically, it has been tough to stabilize the stannous fluoride ion, which resulted in significant teeth staining. For this reason, using stannous fluoride in toothpastes fell out of favor.
However, as time has passed, new ways to stabilize the compound has improved significantly. Initially, this was done by using little to no water in the toothpaste solutions. This worked, but resulted in a chalky toothpaste that most users did not like. More recently, other stabilizing agents have been added to the ingredients so that it has a similar feel to toothpaste without stannous fluoride.
These newer generation of toothpastes when compared to sodium fluoride toothpastes have been shown to not have any increased staining side effect5. In fact, many of them have been shown to have some increased whitening effects6, which we will go into next.
Colgate Total SF is the Winner
Frankly, your teeth and gums will be healthy if you use any of the aforementioned toothpastes with stannous fluoride. Stannous fluoride is so much better than other fluoride compounds at fighting that gingivitis. If you want to choose one based on how it feels to you and its flavor, that’s fine – just make sure it has stannous fluoride.
If I have to choose one winner it is Colgate Total SF. I base this on a head-to-head trial between Colgate Total SF and Crest Pro-Health Whitening Power6. Colgate Total SF showed the ability to prevent stains and help with stain removal. In fact, it worked 26% better than Crest Pro-Health.
Stannous Fluoride and Why it Stains
Stannous fluoride is composed of fluoride attached to a stannous ion. When the stannous ion is not properly stabilized, it can cause a yellowish brown extrinsic stain of the tooth. This occurs when the stannous ion oxidizes on the teeth. This oxidization can be further accelerated when there are certain foods for it to oxidize on. It can also be worsened with improper tooth brushing techniques.
Compounds to Prevent or Minimize Stains in Stannous Fluoride Toothpastes
Colgate has a patent on zinc phosphate when used as a whitening agent. They unexpectedly found that it is effective in both removing dental stains and also in preventing the deposition of chemical stains on a tooth surface. If you really want to know the gritty details, you can take a look at their patent from 2015.
It is this zinc phosphate that helps with preventing stains and removing stains in the head to head comparison.
Sodium Hexametaphosphate and Silica Systems
Most other SF2 toothpastes use abrasive agents (most typically hydrated silica) to help fight extrinsic staining. So as the SF2 oxidizes, it causes an extrinsic stain. The next time you brush the abrasive agents help remove any extrinsic staining that has occurred.
The last major ingredient worth mentioning that some companies use is stannous chloride. The stannous ion in the stannous chloride is meant to try to “catch” any unstable fluoride ions that fall off from its SF2 compound. Unfortunately, while helpful, it is not very efficacious.
Stannous Fluoride and Sensitive Teeth
Stannous fluoride has been shown to help with sensitive teeth.
That being said, I do want to point out that usually the active ingredients to help with sensitive teeth is Potassium Nitrate. It works by preventing your teeth’s nerves from relaying information about pain. Potassium Nitrate is the most common active ingredients found in Sensodyne toothpaste.
Please note, Sensodyne toothpastes that contain stannous fluoride do NOT have any additional ingredients to help with sensitive teeth (at least not from what I’ve seen). Sensodyne toothpastes with stannous fluoride simply have stannous fluoride as an active ingredients, just like any other SF2 toothpaste. It does not also contain potassium nitrate.
Whether the increase in price to buy a Sensodyne toothpaste with SF2 is completely up to you, but based on ingredients alone, it does not infer any extra benefits from a tooth sensitivity standpoint.
Proper Usage of Stannous Fluoride Toothpaste
Refer to my other page for details about everything I recommend to reverse gingivitis and proper dental hygiene routine. In brief, after you brush your teeth with your SF2 toothpaste, you do not want to rinse your mouth. You need to allow the stannous fluoride slowly act on your teeth. When you rinse it out, you are getting rid of most of the benefits of using stannous fluoride. The same technique must also be applied to regular fluoride toothpastes if you want to have its enamel protecting actions.
1. Perlich MA, Bacca LA, Bollmer BW, et al. The clinical effect of a stabilized stannous fluoride dentifrice on plaque formation, gingivitis and gingival bleeding: a six-month study. J Clin Dent. 1995;6 Spec No:54-8.
2. Grossman E, Hou L, Bollmer BW, et al. Triclosan/pyrophosphate dentifrice: dental plaque and gingivitis effects in a 6-month randomized controlled clinical study. J Clin Dent. 2002;13(4):149-57.
3. Mcclanahan SF, Beiswanger BB, Bartizek RD, Lanzalaco AC, Bacca L, White DJ. A comparison of stabilized stannous fluoride dentifrice and triclosan/copolymer dentifrice for efficacy in the reduction of gingivitis and gingival bleeding: six-month clinical results. J Clin Dent. 1997;8(2 Spec No):39-45.
4. Paepegaey AM, Day TN, Boulding A, Harris R, Barker ML, Bellamy PG. In vitro comparison of stannous fluoride, sodium fluoride, and sodium monofluorophosphate dentifrices in the prevention of enamel erosion. J Clin Dent. 2013;24(3):73-8.
5. Conforti N, Mankodi S, Zhang YP, et al. Clinical study to compare extrinsic stain formation in subjects using three dentifrice formulations. Compend Contin Educ Dent Suppl. 2000;(27):23-7.
6. Li Y, Suprono M, Mateo LR, et al. Solving the problem with stannous fluoride: Extrinsic stain. J Am Dent Assoc. 2019;150(4S):S38-S46.