After Reading This, You Might Stop Buying Plastic Toothbrushes

During my lifetime, I’ve used and thrown away about 200 toothbrushes (around four per year, like my dentist has always advised). Each one, made entirely of plastic, is still sitting in a landfill somewhere. I imagine them buried like corpses in a graveyard family plot alongside all the brushes my parents, grandparents, and great grandparents used, because they’re all still there, too. Plastic toothbrushes take 500 or more years to decompose.

On the whole, if every American changes toothbrushes every three months, as the American Dental Association (ADA) recommends, that means we trash about 1 billion plastic toothbrushes annually. That’s about 50 million pounds of plastic waste (not even inclusive of packaging) that just doesn’t need to exist. 

Which Toothbrushes Are Best for the Planet?

While there’s no definitive answer here, my research has led me to switch to bamboo-handled toothbrushes. Bamboo toothbrushes work just as well as plastic, are affordable (around $5), don’t contribute to the plastic crisis or support oil and gas drilling, and have less impact on climate change via greenhouse gas emissions than manual and electric plastic toothbrushes, and plastic toothbrushes with a replaceable head, according to a 2020 life cycle analysis published in the British Dental Journal, which analyzed data on four types of brushes: traditional plastic manual, plastic electric, plastic manual with replaceable heads, and bamboo manual toothbrushes.  (Notably, the overall environmental sustainability scores were very similar for both bamboo and plastic manual replaceable-head brushes. 

Electric toothbrushes have proliferated in recent years, and they’ve been a revelation for people with manual dexterity issues. And many of us feel certain that they give us cleaner teeth. But Dr. Donna Hackley, assistant professor in Oral Health Policy and Epidemiology at Harvard School of Dental Medicine, told me that electric and manual, in terms of performance, are equal. The key is proper use. “While people with certain periodontal or manual dexterity conditions could benefit from an electric toothbrush,” says Hackley, “manual toothbrushes are perfectly adequate with good brushing technique and proper duration.” (The ADA recommends soft bristles and brushing for at least two minutes.)

For those who need or prefer an electric version, and want to avoid plastic, there are a few rechargeable bamboo options. I’ve been testing this one by Sustainable Tomorrow ($99). It works great, and I love the automatic two-minute run time that vibrates at 30 second intervals, prompting me to shift to a different section of my mouth.

Whatever You Do, Don’t Buy These Popular Plastic Toothbrushes

The worst choice you can make in a toothbrush seems clear to me: disposable, plastic battery-powered ones. I’m talking about the plastic drugstore brushes with the vibrating heads that run on AAAs and can be had for as little as five bucks if you buy more than one. Oral-B Pulsar, Colgate 360 Vibrate, and Arm & Hammer Spinbrush are a few common examples.

Not only are they made of all plastic, they include alkaline batteries, which rarely get removed before trashing and can leak toxic materials into our groundwater. Just don’t buy them unless you have to for affordability and dexterity reasons.

What’s the Most Sustainable Toothpaste?

My quest for finding a toothpaste that’s both good for my teeth and the planet brought me down a deep rabbit hole. Let’s start with what the dentists say. For starters, dentists unequivocally recommend brushing with fluoride, despite some controversy around health concerns when too much is ingested. 

“Any toothpaste without fluoride is a waste of money,” Dr. Lindi Ezekowitz, who echoes the ADA recommendation.

If you google “sustainable toothpaste” you’ll get hit after hit of zero-waste toothpaste powders and bites. The majority of them forgo plastic tubes in favor of glass or tin containers, which is undisputedly a good thing. But many include two ingredients that are up for debate: charcoal (to remove stains) and nano-hydroxyapatite (NHAP) as a fluoride substitute.

Dentists warn against charcoal. “It’s like using sandpaper on your teeth,” says Ezekowitz. “You’ll get less staining but are way more susceptible to decay.” And the jury is still out on NHAP—the ADA has not yet endorsed it as a recommended ingredient. “NHAP can be helpful for remineralization and hardening of spots on teeth that have begun to break down toward a cavity,” says Hackley. “But we need more long-term studies on it.”

Another common and controversial ingredient in toothpaste—traditional and many “eco-friendly” ones, too— is sodium lauryl sulfate (SLS) which is a foaming agent. It’s also used in laundry soaps, shampoos, and other cleaners to give us those thick bubbles that we associate with cleanliness. Ezekowitz prefers SLS-free toothpastes. “It’s not needed and it can cause aphthous ulcers (a.k.a. canker sores) in some patients,” she says.

Over the last month, I’ve tested about a dozen tooth powders, bites, and pastes that are marketed as sustainable alternatives, and also shared my samples with family and friends to get their takes. Here’s what I found.

Tooth Powders

I tried several brands of loose tooth powders, none of which I was crazy about. Although I love the plastic free packaging, I didn’t like the process, which entails wetting my brush and dipping it into the container. I ended up with powder all over my bathroom and one tin even leaked in my dobb kit. As for the performance, it felt kind of meh. Tooth powders rely on a myriad of clays, which allegedly absorb toxins, remineralize teeth, and polish them. Problem was, it felt like brushing my teeth with, well, clay and they all lack flouride.

Tooth Tablets

I can get on board with these. You pop them into your mouth, crunch them up a bit till they start to liquify, and start brushing. It took a bit of practice to get the dissolving tablets to make their way around my mouth, but after a few tries I felt like it was working. And while I didn’t get the nice foamy action I’m used to from paste, my mouth felt clean. What I love: Tablets travel extremely well. I like Bites with Fluoride ($32 for 248 tabs) and Huppy Peppermint Toothpaste Tabs ($48 for 248 tabs) which instead use NHAP. (Note both companies offer discounts for subscriptions.)

Toothpaste with “Sustainable Packaging”

You’ll find toothpaste brands that claim recyclable, biodegradable, or compostable plastic packaging. Be skeptical. From what I can tell, it’s all greenwashing. Plastic just doesn’t degrade unless it’s collected and brought to a commercial facility. Period. And even toothpaste tubes and caps that are technically recyclable, like Tom’s of Maine, have a very low chance of actually making it through sorting facilities and into the bales of plastic destined for recycling. They literally fall through the cracks.

I found two toothpaste brands that use metal tubes that can be recycled with your beer cans. They’re both surfactant-free, so while they don’t foam up like Colgate and Crest (I’ll admit, I kind of miss the foam), they both left my mouth feeling clean and fresh. Davids comes in several different formulas ($10-12 per 5.25-ounce tube), but uses NHAP instead of fluoride and has plastic caps. It comes with a handy metal key to eke all the paste from the tube, negating the need to cut it open and rinse. Poppits PopGel (three 3.2-ounce tubes for $30) has a fluoride option and the entire tube and cap is all metal and recyclable. (They recommend cutting it open and rinsing.)

What Floss Is Sustainable?

I confess, I used to be addicted to those little plastic flossers. So easy to use (with one hand!), so fuss-free. But, of course, they were terribly wasteful. So I quit them (though when I find a stray one in a drawer every now and then it feels like finding a $20 bill in my pocket). Now I look for non-plastic floss in a non-plastic, refillable container. There are plenty of brands to choose from. My faves were Huppy Floss and Bite Floss. They’re virtually identical, made from corn starch and candelilla wax, and both cost $12 for two little glass jars which will last a good long time.

Talking to Your Dentist

Like all industries, oral health care is evolving (albiet slowly) with the health of the planet in mind. Dr. Hackley, who sits on the FDI World Dentistry Foundation’s Sustainability in Dentistry Task Force, told me that dental students around the globe are highly motivated to find a sustainable path forward and are galvanizing around collective efforts.

Ezekowitz, who practices pediatric dentistry in Newburyport, Massachusetts, has been taking steps to make her dental practice more sustainable. “We use paper, not plastic cups and give out bamboo toothbrushes in paper bags,” says Ezekowitz. “We no longer give out floss because of the amount of plastic waste for such a small amount of floss doesn’t feel right.”

I spoke with my own dentist, Dr. Patrick Murphy of Milton, Massachusetts, about plastic waste and sustainability. For quite some time now I’ve been politely refusing his plastic gift bags that contain a plastic brush, mini plastic floss container, and mini plastic toothpaste tube. Murphy concedes that his profession relies heavily on plastic, as do all medical fields, for sterility and safety. “In our practice, we’ve made some sustainability strides–digitizing our business to reduce paper, investing in sterilization units that let us re-use certain instruments, and things like that,” he told me. “I’m committed to investigating bamboo toothbrushes, paper cups, and other ways we can reduce plastic waste.”

Dentistry is slowly changing and the big oral health care brands will have to follow. And we have the influence to edge it along.

Doing right by the planet can make you happier, healthier, and—yes—wealthier. Outside’s head of sustainability, Kristin Hostetter, explores small lifestyle tweaks that can make a big impact. Write to her at climateneutral-ish@outsideinc.com.