Microplastics In Your Oral Care And What To Do About It

Hi everybody, I'm Dr. Sanda Moldovan, periodontist and nutritionist. Welcome to the Holistic Dentistry Podcast, the show that gives you the tips and tools to detoxify your mouth for a healthier body as we explore together the root cause of disease. Remember, you're not healthy until your mouth is healthy, so take care of it in the most Welcome to another episode of the Holistic Dentistry Podcast. This is part 2 of microplastics and nanoplastics in dentistry. Today I want to discuss the microplastics and nanoplastics in your everyday oral care. Last week we actually discussed these plastics in the dental products and what you can do to avoid them. We cannot avoid completely all microplastics and nanoplastics that are around us today. However, we can learn where they're located and we can learn to minimize our exposure to them. The bathroom shelf is a plastic factory. Toothbrushes have plastic handles and bristles. Floss thread is essentially a plastic string packed in a plastic container. Mouthwash comes in a plastic bottle and toothpaste comes in a plastic tube. Even mouthguards, retainers, fillings, and whitening strips, and some of which we talked about last time, are produced from plastic. The microplastic shedding from these products is something almost nobody is talking about yet. Let's look at the one oral care item that is the most microplastic infested. Answer: the toothbrush. Mouthwash by population scale and environmental output, but by individual exposure, it is the toothbrush according to some of the research that I've done. A landmark study assessing microplastics across all commercially available oral healthcare products— toothbrushes, toothpaste, mouthwash, and dental floss— found that toothbrushes had the maximum particle count at about 30 to 120 particles per brush. However, when you you're looking at the population scale, the mouthwash had the highest daily microplastic emission projected at 74 billion particles per day. This is a study that was done in India. On an individual annual exposure basis, toothbrushes topped the chart at approximately 48,910 particles per person per year. So which one is the most infested with microplastics? And the most released is from the toothbrush, your number one personal exposure vehicle. So how can you minimize this? Well, be careful how you choose your toothbrush. You might think just any toothbrush is created equal, but choose something like the OraSana products. Even though, you know, the handle itself is bamboo, the bristles can be plastic, but they're infused with charcoal. So you have a slower release of microplastics. There are some toothbrushes on the market that are made from plant-based bristles, but there are very few right now available. What about mouthwashes? Well, as you very well know, I don't recommend mouthwashes on a regular basis. If you can take care of your microbiome through a healthy diet and fermented foods or chewable probiotics such as the OraSana Probiotic Mints, You really don't need a mouthwash. However, if you have gum disease or you have dry mouth, then you may look at buying mouthwashes with glass bottles. Now, what happens to the toothbrushes? Among all currently available toothbrushes, traditional plastic manual brushes have the greatest overall environmental impact because they're made from propylene plastic and nylon, both derived from non-renewable fossil fuels, and the manufacturing process of nylon bristles releases nitrous oxide, a greenhouse gas 310 times more potent than carbon dioxide. The brushing action itself is the problem. Friction against teeth and gums causes the nylon bristles to shed. Hard-bristled brushes release more than soft-bristled brushes. Research found that the release rate of microplastics from hard-bristled toothbrushes increases rapidly at first, and then gradually levels off during use. Meaning a new brush sheds more aggressively than an old one, which is kind of counterintuitive, but it's because a lot of these loose plastic particles are released first. The polypropylene handles don't biodegrade and are rarely recyclable, piling into landfills where they continue breaking down into secondary microplastics. Now the electric toothbrush question. Electric brushes still have plastic bristles and heads, and the replaceable heads mean more plastic waste per year, not less. You heard me say a lot that I don't think electric brushes are for everyone. Some people actually do a better job with a manual brush. So, um, make sure you use the right technique when you're using a manual bamboo handle brush. If you're going to use an electric brush, you can, especially if you have dexterity problem or arthritis issues and you can't really brush well. Let's talk about toothpaste. The microbead myth is a lie, or is it? This is one of the most important myth-busting moment for a lot of you. Most people believe microplastics in toothpaste were solved in 2015 by the US Microbead-Free Waters Act. But they weren't. The key misunderstanding is that all microbeads are microplastics, but not all microplastic ingredients are microbeads. Global bans only targeted microbeads, the visible spherical scrubbing beads. Microplastics are still widely used in all kinds of oral care products as texture agents, film formers, fillers, and whitening agents. Toothpaste contain microplastics to enhance scrubbing and cleansing action, to improve whitening properties, and to act as polishing aids. The constituents include polyethylene, cellophane, polypropylene, PVC, and polyamide, the most prevalent being polyethylene, which can make up as much as 1.8% of the product. The scale of this is staggering. The mean yearly release of plastic from toothpaste into the environment in India alone was gauged at 1.4 billion grams per year. Now, how do you know the toothpaste you're using has microplastic? Let's look at your label. Look for polyethylene or PE, polyethylene glycol, which by the way, most toothpastes contain polyethylene glycol, even some of the natural ones. Polymethyl methacrylate, or PMMA. This is one of the worst ones. It's also used in dentistry, and it actually can release a lot of the toxic monomer as well. Polypropylene, or PP, can also be in your toothpaste. Polyethylene terephthalate, PET, could be also on the ingredient list. These are all plastics. The whitening toothpaste problem in particular I want to talk about. Some of them actually use microbeads, which are supposed to be removed. Research has directly compared whitening toothpaste using activated charcoal, hydrogen peroxide, and microbeads for efficacy and found that the microbeads version aren't even the most effective option. So what can you do with the toothpaste? How can you avoid it? Number one, read the ingredients, and secondly, use a tooth powder. That's one of the reasons I don't like using toothpaste, and I created a tooth powder in the OraSana line because of all the fillers present inside the toothpaste. Let's talk about mouthwash. A lot of you like to use mouthwash because it gives you that nice, fresh taste in your mouth. At the individual level, mouthwash is easy to overlook. You swish it around, spit it out, and move on. But at the population scale, mouthwash has the highest daily microplastic emission of all oral care products studied, projected at 74 billion particles per day. This dwarfs every other category in this product line when you factor in how much liquid volume people use. The plastics come from two sources in a mouthwash: microplastic particles intentionally or accidentally present in the liquid itself, and the plastic bottle, which begins leaching nanoplastic from the moment it's manufactured. Home-use products like toothpaste, toothbrushes, floss, and mouthwashes all contribute to chronic oral exposure, and polymeric residues consistent with microplastics have been recovered from the sputum and saliva of individuals using standard oral hygiene products. The fact is most people swish and partially swallow or absorbed through mucosa, makes mouthwash especially concerning as a direct exposure route, as opposed to something like a toothbrush where particles are theoretically rinsed out. Now let's look at dental floss. I'm building on my previous episode when I talked about PFAS in the dental floss or Teflon. Not only does PTFE-based floss carry PFAS, But all conventional floss, nylon or polyester, sheds microplastic fibers mechanically as it's worked between the teeth. Particles from sources like toothpaste, toothbrushes, and floss are generated through mechanical friction, pH changes, and thermal fluctuation. These processes can cause surface stress, weakens the material integrity, and induces wear, even of that nylon floss. The friction of sliding nylon thread through tight contact points essentially shaves off microscopic fibers that are then either swallowed or absorbed by oral mucosa. In a bleeding gum situation, those particles have direct access to the bloodstream. So what can you do? Should you stop using dental floss? You can switch now to a healthier floss. I know there are some silk flosses out there if you're really a fan of the string. Silk floss is not the best because it shreds a lot. However, I am a big fan of Water Flossers. Why water flossers? Because it's using the power of just water, and it keeps your gums healthier too. Now, if you have really tight contacts and thick gums, you definitely will need to use even the little, um, rubber tip and put it just underneath the gum in between the contacts of your teeth if you have tight contacts. Otherwise, just using the universal tip might not be enough for you to clean the interproximal spaces. What about whitening strips? Even whitening treatments like strips, trays, pens are produced from plastic and represent a growing exposure concern, particularly when they sit directly on your tooth surface and gum tissue for extended periods, like 30 minutes or more, sometimes daily for weeks. Whitening strips are made from a thin polyethylene film. The strip itself is in direct, prolonged contact with enamel, dentin, and gum margins. As the strip is worn, the friction of chewing, saliva flow, and the chemical environment can degrade the film. At present, there's essentially no specific research on microplastic release from whitening strips, making this a compelling— here's a research gap talking point for your audience. It's an area where precaution must be taken. So be careful with using too many whitening strips. You are better off doing a whitening in the dental office. Baking soda is also a great thing to use. In between whitenings to actually pick up the stains that are there. So you could just take a little bit of baking soda and sprinkle it on your toothbrush, uh, and tooth powder or toothpaste in order to give you that white without using whitening strips. So why does it matter? Because you're saying, oh, we have a bunch of microplastics in the environment anyway. Micro and nanoplastics can accumulate in vital organs. Kidneys, liver, spleen, gastrointestinal tract, lungs, brain, and even reproductive tissues. Microplastics have been detected in colonic tissues at higher levels in individuals with inflammatory bowel disease compared to healthy controls. So there is a relationship between chronic inflammation and microplastic retention. Nanoplastics are the most alarming subcategory. These concerns are especially relevant when microplastics break down, even into smaller particles called nanoplastics, which can enter organs and tissues and the cells more easily, crossing the gut lining, the blood-brain barrier, and even the placenta. Existing evidence suggests microplastics may induce periodontal pathology through at least 5 different mechanisms: mechanical irritation of gingival tissues, toxic additive emissions causing oxidative stress, activation of DNA damage response pathway, microbial community imbalance, and immune regulation disruption. Meaning your oral microbiome is being affected right at the source. Now, I mentioned what you can do to minimize the exposure. We cannot completely eliminate micro and nanoplastics. Plastics, but we can definitely reduce the exposure. How do you do this? Toothbrush: use a bamboo handle, soft nylon bristles infused with charcoal, such as the OraSana toothbrush. For toothpaste, read the ingredient label, avoid the plastics that I mentioned earlier, and even better, use a mineralizing tooth powder such as the OraSana one. Mouthwash: if you really like mouthwash, switch to a plastic bottle. And there are some good options out there. You can also consider using the OraSana Oral Detox, which comes in a plas— in a, a glass bottle, and it's an ozonated oil, great for people with inflammation. Regarding floss, you can choose silk or plant fiber floss, or better yet, the OraSana Waterjet as a water flosser to eliminate microplastic fibers problem entirely. In terms of whitening, opt for professional in-office treatments over prolonged daily strip use and ask about some peroxide-free alternatives, although there are not many and they're not very effective. Now, you might be asking, how do we detoxify from microplastics? Um, not really, uh, an exact science at this point. But your body's already working on this. That's the good news. How does these microplastics exit from your body? Well, number one, through digestion and feces. This is the primary route. Larger microplastic particles, greater than 115 micrometers, are especially likely to pass through the gut and be excreted in the stool rather than absorbed into the bloodstream. The problem is the nanoplastics, which are far smaller and can cross the gut wall into the systemic circulation. So what's my recommendation? An EBOO because of the blood filtering that this treatment offers. So blood comes out through one arm, goes through a filter, it get, you know, filters a lot of the microplastics and nanoplastics and then goes back into the other arm ozonated. This is a treatment that I've actually done myself and my filter was absolutely filthy. It actually had a bunch of white beads on it, and I didn't know if it was plastics or it was actually a biofilm. Another way that our body excretes microplastics is through the liver and kidneys. The liver and kidneys play a role in metabolizing and excreting foreign substances. However, studies suggest that microplastics can accumulate in these organs, actually impairing their detoxifying ability over time. So the organs meant to clean you up can themselves become compromised. Through sweat, with an important caveat, you can eliminate these plastics through sweat. This is where a lot of wellness content gets it wrong. There's no credible evidence that microplastic particles can eliminate through sweat. Sweat is a fluid. And cannot carry solid particles out of the body. However, a few small studies have found plastic-associated chemicals like BPA in sweat, which is not the same thing as removing the plastic itself. Worth clarifying loudly for your— for my audience, as sauna brands are aggressively marketing microplastic detox sessions. The jury is still out on this, so more is needed to see if this actually is the case. Dietary strategies. Can we actually eat things to help us eliminate the microplastics? Yes, dietary fiber. Dietary fibers may reduce the res— residence time of microplastics in the GI tract and facilitate their rapid elimination from the body. Insoluble dietary fiber in particular increases intestinal transport rate, water-holding capacity, and absorption, helping to bind toxic substances in the intestine. Increase intestinal peristalsis, inhibit intestinal absorption, and accelerate excretion. Most of us don't get enough fiber, so let's up that fiber. Foods to emphasize would be oats, legumes, whole grains, vegetables, but you can also take some psyllium fiber in the morning. What about chlorella and activated charcoal? There's some intriguing animal research showing that chlorella and activated charcoal may help bind microplastics in the gut. However, these studies are animal-based and no human clinical trials exist yet. The best way is still decreasing exposure and improving gut mucosal integrity. What about antioxidant-rich foods? Cruciferous vegetables, berries, leafy greens, citrus, and garlic all support the liver's detoxification enzymes. None of them directly remove plastic particles, but they help the body manage oxidative stress caused by microplastic exposure, which is one of the primary damage mechanisms. Probiotics. In order to maintain a healthy gut, a study in 2025 in Frontiers in Microbiology found that these specific probiotic strains could increase microplastic excretion by 34%. And reduce residual gut particles by 67%. These are two specific probiotic strains, Lactocasei bacillus paracasei and Lactiplantibacillus plantarum. But of course, we need more studies on this, and maybe other microbes are beneficial as well. Now, the gut microbiome connection, why this matters in dentistry. Microplastic exposure induces gut dysbiosis, which is a loss of beneficial bacteria genera and enrichment of pathogenic species, which in turn disrupts metabolic pathways related to cholesterol, bile acids, short-chain fatty acids. The oral microbiome and the gut microbiome are directly connected through the oral-gut axis, meaning what starts in the mouth doesn't stay in the mouth. Oral care products depositing microplastics directly into the mouth are feeding these particles into a system that is already struggling to cope with environmental plastic exposure from food and water. The dental profession sits at the very beginning of this exposure, which is exactly why practitioners need to be part of the solution conversation. The most exciting emerging research is blood filtration or aphoresis. We're going to have to pay attention to this, and I'm gonna bring you more information once we get more confirmation that this treatment, um, will help release the micro and nanoplastics. And with that, I conclude the second part on microplastics and nanoplastics in dentistry. I hope you found this episode helpful. If you did, please share it with a friend or a family member. And if you want to leave a comment, you can do so on my Instagram @DrSandaMoldovan. And as always, stay healthy and stay away from microplastics and nanoplastics.

Thank you so much for joining me this week. Please make sure you check out the show notes. For any links mentioned in the show. If you like today's show, please invite your friends to listen as well. That would mean a lot to me. Do you have a question you'd like me to answer? Message me on Instagram @drsandamoldovanova. This is Dr. Sanda Moldovanova, and remember, your mouth is the gateway to your health, so take care of it in the most natural and best way possible.