Cancer myth: Toothpaste, antibacterial wash and cancer

Background to the controversy

In August 2014, there was a worldwide media focus on the use of triclosan in Colgate Total toothpaste, with some articles drawing a link between the ingredient and cancer.1 Despite triclosan being deemed as safe for use in toothpaste by the FDA (at regulated levels), Colgate relaunched Colgate Total in 2019 without triclosan.2

In 2016 the US Food and Drug Administration (FDA) banned triclosan in antibacterial soaps, not for fear of it causing cancer, but because it was deemed as no more effective than plain soap and water.3  There have also been suggestions that triclosan could potentially make bacteria resistant to antibiotics or adversely affect the immune system, however these findings have not yet been proven in human studies.4,5

Current evidence

Triclosan is an antibacterial and antifungal agent that may be found in some personal care products and toothpastes to reduce or prevent bacterial contamination5. It has been proven to prevent gingivitis (gum disease.6

In Australia, the use of triclosan in cosmetics is limited to a maximum concentration of 0.3%7. In May 2009, triclosan was the subject of a full risk assessment by the National Industrial Chemicals Notification and Assessment Scheme (NICNAS) within the Department of Health. The report concluded that, "under normal conditions of consumer use, the risk of adults and children being exposed to levels of triclosan that would lead to chronic health effects is low."7

Nevertheless, some Australian manufacturers have voluntarily chosen to remove triclosan from their products following the ban in the US.8

Summary

At this stage, there is no evidence of sufficient quality to prove that triclosan in toothpaste and hand wash causes cancer, however the product has disappeared from many products due to poor public perception and concerns around emerging evidence.5, 8

References

1. Bagshaw, E. Colgate Total toothpaste under scrutiny over ingredient. The Sydney Morning Herald [Internet]. 2014 Aug 20 [cited 2019 Sep 26]. Available from: https://www.smh.com.au/national/nsw/colgate-total-toothpaste-under-scrutiny-over-ingredient-20140820-1062ws.html


2. Kary, T. Colgate Total Toothpaste to Relaunch Without Controversial Chemical. Bloomberg [Internet]. 2019 Jan 16 [cited 2019 Sep 26]. Available from: https://www.bloomberg.com/news/articles/2019-01-15/colgate-total-toothpaste-to-relaunch-this-time-sans-triclosan


3. ABC. US FDA bans chemicals in antibacterial hand soap over health concerns. ABC News [Internet]. 2016 Sep 4. Available from: https://www.abc.net.au/news/2016-09-03/us-fda-bans-chemicals-in-anti-bacterial-hand-soap/7812182


4. Weatherly, LM, Gosse, JA. Triclosan exposure, transformation, and human health effects. Journal of toxicology and environmental health 2017; 20(8): 447-469. doi:10.1080/10937404.2017.1399306


5. U.S. Food & Drug Administration. 5 Things to Know About Triclosan. FDA [Internet]. 2019 May 16 [cited 2019 Sep 26]. Available from: https://www.fda.gov/consumers/consumer-updates/5-things-know-about-triclosan


6. Davies, RM, Ellwood, RP, Davies, GM. The effectiveness of a toothpaste containing Triclosan and polyvinyl‚Äźmethyl ether maleic acid copolymer in improving plaque control and gingival health. Journal of Clinical Periodontology 2004; 31: 1029-1033. doi:10.1111/j.1600-051X.2004.00614.x


7. Australian Government, Department of Health, National Industrial Chemicals Notification and Assessment Scheme. Triclosan. NICNAS [Internet]. 2013 May 1 [cited 2019 Sep 26]. Available from: https://www.nicnas.gov.au/chemical-information/factsheets/chemical-name/triclosan


8. Chettle, N. Antibacterial soap in spotlight as companies clamber to remove ineffective chemicals after US ban. ABC News [Internet]. 2016 November 20 [cited 2019 Sep 26]. Available from: https://www.abc.net.au/news/2016-11-20/antibacterial-soaps-in-spotlight-as-companies-remove-chemicals/8040054