Is Triclosan Antibacterial Toothpaste Safe?

Why do dogs lick their wounds? They even lick our wounds. This leads to a question posed in the medical literature nearly a half century ago: Might there be some healing property of dog saliva? Well, it appears that there are a number of immune defense mechanisms in saliva, one of which involves nitric oxide. Licking of human skin results in production of nitric oxide from salivary nitrite, which kills skin pathogens and comes from the nitrates we eat in our diet.

How do we know we can get nitric oxide from licked human skin? Researchers had a bunch of volunteers lick their hands all over, front and back. Today, we have a better way to clean wounds: soap and water. (And we should never let our pets lick open wounds because cases of serious infections have been reported).

The reason I bring it up is that this transformation of nitrates from our diet into nitrites in our mouth has important implications for our health. Insufficient nitric oxide production is recognized as the earliest event in the onset and progression of a number of chronic diseases, including high blood pressure, peripheral artery disease, and a number of inflammatory conditions.

Nitrates come from vegetables in our diets, such as beets and green leafy vegetables. Good bacteria on our tongue convert nitrates into nitrites which can circulate throughout the body to create nitric oxide, and any nitrates our tongue bacteria missed the first time around get pumped by our body back into our saliva to give our tongue bacteria a second chance. One way we can become nitric-oxide-production-deficient is by not eating enough vegetables in the first place. So, eating vegetables should be the first step. But, if our tongue bacteria die off, the cycle is broken no matter how many vegetables we eat.

That’s why we should not use antiseptic mouthwash. Previously, I profiled an important study in my video Don’t Use Antiseptic Mouthwash. The most protective food for our heart may be green leafy vegetables because, like beets, they have lots of nitrates. So, if you drink some beet juice, you can get a remarkable drop in blood pressure within just hours, but only if you swallow.

The nitric oxide pathway can be interrupted if you use an antibacterial mouthwash or by spitting and not swallowing beet juice because of the critical action of our tongue bacteria on the nitrates in our saliva. So, we have to eat our vegetables and keep our tongue bacteria happy––so, no antibacterial mouthwash. But what about antibacterial toothpaste?

There’s a toothpaste on the market that contains an antibacterial chemical called triclosan. In my video Antibacterial Toothpaste: Harmful, Helpful, or Harmless?, I present a study was done that showed there was no difference in the levels of nitric oxide, nitrite, and nitrate after brushing with regular toothpaste and triclosan toothpaste. Our good tongue bacteria live in the cracks on the surface of our tongue, so if you just brush your teeth and not your tongue, the chemical doesn’t seem to get down there. Does that mean triclosan toothpaste is safe?

The use of triclosan toothpaste may not be associated with any increase in serious adverse cardiac events. And though studies on rats suggest the chemical can affect thyroid function, the use of triclosan toothpaste does not seem to affect human thyroid function. A study funded by Colgate concluded that triclosan was both safe and effective, producing “a significant reduction in gingivitis, plaque, and bleeding.” However, an independent review by the Cochrane Group suggested the reduction may be statistically significant but may not be beneficial enough to yield clinical significance.

Regarding safety, states are starting to ban the stuff because of data showing that despite the lack of efficacy, triclosan is so ubiquitous that most of the U.S. population is exposed to it. “Because the rapid rise in obesity in the U.S. parallels the introduction of triclosan, and because triclosan has two potential mechanisms by which it might alter human weight”—that is, by mucking with our gut flora or our hormones––researchers at Stanford decided to assess the association between triclosan levels flowing through people’s bodies and how heavy they are. And, indeed, they found an association between triclosan levels and increase in body mass index, and suggested further studies on how this chemical could be altering human growth and well-being.


If we shouldn’t use antiseptic mouthwash, What’s the Best Mouthwash? (Spoiler alert: It’s green tea!)

I’ve created an extensive video library on the benefits of nitrate-containing vegetables for both athletic performance and cardiovascular benefits. Here are some of the latest:

For more on nontoxic ways to maintain oral health, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Best Foods for COPD and Peripheral Artery Disease

It’s great we can improve athletic performance by eating a few beets, but so what if you run 5% faster? It can be a fun experiment to eat a can of beets and maybe shave a minute off your 5k time, but there are people who could really benefit from a more efficient use of oxygen: those suffering from emphysema. Young, healthy adults eating greens and beets can swim, run, and cycle faster and farther, but what about those who get out of breath just walking up the stairs? Do nitrate-rich vegetables work where it counts? Yes–. Time on the treadmill in COPD pateints was significantly extended after two shots of beet juice. I discuss these benefits of nitrate-rich vegetables in my video Oxygenating Blood with Nitrate-Rich Vegetables.

Beet juice can also decrease blood pressure in young, healthy adults, but what about in those who need it––older, overweight subjects? Just one shot a day of beet juice (versus berry juice as a control) led to a significant drop in blood pressure in a few weeks. But within just a few days after stopping three weeks of beeting themselves up, blood pressure went back up. So we have to eat our vegetables and keep eating our vegetables.

Why did it take until 2015 to publish a study on using nitrates to lower blood pressure in people with high blood pressure? You’d think that’d be the first group to try it on. Who’s going to fund it, though—Big Beet? Blood pressure medications rake in more than $10 billion a year. You can’t make billions on beets.

But that’s why we have charities like the British Heart Foundation, which funded a study to give folks with high blood pressure a cup of beet juice a day for four weeks. After all, high blood pressure may be the number-one risk factor for premature death in the world. In ten years, it could affect nearly one in three adults on the planet. But put them on beet juice and blood pressures dropped and kept dropping until they stopped drinking it after a month. With so many people with high blood pressure even despite treatment, the researchers concluded, “an additional strategy, based on the intake of nitrate-rich vegetables, may prove to be both cost-effective, affordable, and favorable for a public health approach to hypertension.”

What about those with peripheral artery disease? There are tens of millions of people with atherosclerotic clogs impairing blood flow to their legs. This can cause a cramping pain in the calves called claudication, due to lack of blood flow through the blocked arteries, severely limiting one’s ability to even just walk around. But when they simply drink some beet juice, they can walk 18% longer. Researchers measured the actual oxygenation of blood within the calf muscle and found that patients were able to maintain more oxygen in their muscles after drinking beet juice.

The nitric oxide from vegetable nitrates not only improves oxygen efficiency but also oxygen delivery by vasodilating blood vessels—opening up arteries—so there’s more blood flow. I’m surprised beet juice companies aren’t trying to position themselves as veggie Viagra! It could certainly explain why those eating more veggies have such improved sexual function, though that study was a snapshot in time so technically you can’t tell whether eating veggies resulted in improved sexual function or improved sexual function led to eating more veggies. However, it seems more reasonable that low fruit and vegetable consumption contributes to erectile dysfunction, rather than the other way around.

What about the most important organ… the brain? Poor cerebral perfusion—lack of blood flow and oxygen in the brain––is associated with cognitive decline and dementia. Researchers showed that the nitrate in vegetables may be beneficial in treating age-related cognitive decline. They showed a direct effect of dietary nitrate on cerebral blood flow within the frontal lobes, the areas particularly compromised by aging. This is a critical brain area for so-called executive function, the basic task and problem solving important for day-to-day functioning. The nitrite from nitrate has been shown to not only increase blood flow to certain areas of the body but also to act preferentially in low oxygen conditions, allowing it to increase blood flow precisely in the areas where it is needed most, and that’s what they found in the brain: increased blood flow to the at-risk areas of the aging brain. The only side effect of beeting your brains out? A little extra color in your life (they noted some of the study subjects started peeing pink).


Nitrates are one of the reasons I recommend eating dark green leafy vegetables every day. See Slowing Our Metabolism with Nitrate-Rich Vegetables and “Veg-Table” Dietary Nitrate Scoring Method. Beets are another good option and not just drinking the juice; take a look at Whole Beets vs. Juice for Improving Athletic Performance.

What else can we do for high blood pressure? See the following videos:

Why is blood flow to the brain so important? I go into depth on the potential consequences in Alzheimer’s and Atherosclerosis of the Brain.

More on diet and pelvic blood flow in men can be found in:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

How to Use Canned Beets to Improve Athletic Performance

Vegetable nitrates, concentrated in green leafy vegetables and beets, underwent a great makeover a few years ago. They went from being understood as inert substances to having a profound effect on the power plants within our cells, reducing the oxygen cost during exercise. This means they can allow us to bust out the same amount of work with less oxygen. One little shot of beet juice allowed free divers to hold their breath for more than four minutes, or about a half-minute longer than usual. For others, improved muscle efficiency allowed athletes to exercise at a higher power output or running speed for the same amount of breath. I profiled this fascinating discovery in an unprecedented 17-part video series (see below), the longest I think I’ve ever done. That was back in 2012, but what does the new science say? That’s what I cover in my video, Whole Beets vs. Juice for Improving Athletic Performance.

Most of the studies were done on men, but it works on women, too, including African-American women who are an even more neglected research demographic. Drinking beet juice results in the same workload power outputs using significantly less oxygen. But what about whole beets? They are cheaper, healthier, and found in any produce aisle, but there had never been studies on actual beets… until now.

Whole beetroot consumption acutely improves running performance. They gave physically fit men and women a cup and a half of baked beets, which is equal to about a can of beets, 75 minutes before running a 5K. They started out the same, but during the last mile of the 5K race, the beet group pulled ahead compared to the placebo group, who were given berries instead. Though the beet group participants were running faster, their heart rate wasn’t any higher. If anything, they reported less exertion.

Faster time with less effort? They don’t call them block-rocking beets for nothing! 🙂

If nitrates are so good, then why not just take them in a pill? Although dietary nitrate supplements can work, their long-term safety is questionable. Non-vegetable sources of nitrates may have detrimental health effects, so if we want to improve our performance, we should ideally obtain nitrates from whole vegetables. The industry knows this, so instead it markets an array of nitric oxide-stimulating supplements. However, there is little or no evidence of a performance improvement following supplementation with these so-called NO boosters. The evidence is with the vegetables.

How much money can companies make selling beets, though? How about a novel beetroot-enriched bread product? We’ve tried to get people to eat their fruits and vegetables, and where has that gotten us? But, hey! Lots of people eat white bread, so why not have them eat red bread? And indeed it worked: red beet bread brought down blood pressures and improved the ability of arteries to relax and dilate naturally. Bread, therefore, may be an effective vehicle to increase vegetable consumption without significant dietary changes,” because heavens forbid people should have to change their diet to improve their health… 


If you want to put the whole discovery in context and get the detailed mechanism, see my 17-part video series:

How else can we support athletic performance? See

On the other hand, Paleo Diets May Negate Benefits of Exercise.

It’s great that we can improve athletic performance eating a few beets, but what about people who could really benefit from a more efficient use of oxygen? That’s the subject of my video Oxygenating Blood with Nitrate-Rich Vegetables. Also check out Slowing Our Metabolism with Nitrate-Rich Vegetables.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: