Chapter 25: Modern Trends — Charcoal, Coconut, and Marketing¶

We've spent the last several chapters exploring botanical remedies with centuries or millennia of traditional use, most of which have been at least partially validated by modern science. Now let's turn to the opposite phenomenon: modern trends that leverage the aesthetics of natural health without necessarily delivering the substance.

I've watched humans fall for marketing for as long as there has been marketing. But the current era—with its Instagram influencers, "clean beauty" movements, and algorithmically-amplified trends—has created a particularly fertile ground for products that promise natural solutions while often delivering confusion, wasted money, or occasionally actual harm.

Let me walk you through some current trends with my honest assessment of each.

Activated Charcoal: The Black Paste Problem¶

Nothing in recent oral care has been more visually striking—or more scientifically concerning—than the rise of activated charcoal toothpastes and treatments. The images are arresting: people brushing with jet-black paste, grinning with temporarily blackened teeth, promising dramatic whitening results.

The pitch is seductive: activated charcoal is "natural" (it's carbon, after all), has legitimate uses in medicine (poison adsorption, emergency toxicology), and its porosity gives it remarkable surface area for binding substances. Surely those properties translate to oral health?

Let's examine the reality.

What Activated Charcoal Actually Does¶

The legitimate properties:

Enormous surface area (500-3,000 m² per gram)
Excellent adsorption of organic molecules
Used medically to bind toxins in overdose situations
FDA-approved for specific medical indications

The oral health claims:

Whitens teeth by adsorbing stains
Removes toxins from the mouth
Freshens breath by binding odor compounds
"Natural" alternative to peroxide whitening

The Evidence (or Lack Thereof)¶

A 2017 systematic review in the Journal of the American Dental Association examined all available evidence on charcoal dental products.¹ The conclusion was damning:

"There is insufficient clinical and laboratory data to substantiate the safety and efficacy claims of charcoal and charcoal-based dentifrices."

The authors found:

No controlled clinical trials demonstrating whitening efficacy
No studies examining long-term safety
Concern about abrasivity damaging enamel
Potential interference with fluoride (charcoal may adsorb the fluoride from toothpaste, negating its benefit)

A 2019 study in the British Dental Journal tested five charcoal toothpastes and found:²

High variability in charcoal content
Several products had abrasivity levels high enough to damage enamel with regular use
No evidence of superior stain removal compared to conventional toothpastes

My Specific Concerns¶

Abrasivity: Relative Dentin Abrasivity (RDA) is the standard measure of toothpaste abrasiveness.³ The ADA recommends RDA below 250 for daily use; most regular toothpastes are 70-150. Many charcoal toothpastes have never been tested, and those that have often show high RDA values.

Enamel doesn't regenerate. Every particle of enamel you abrade away is gone forever. Using a highly abrasive paste to remove surface stains may create a briefly whiter appearance while permanently thinning the enamel—revealing the yellower dentin beneath and increasing sensitivity and decay risk.

Fluoride interference: Charcoal is excellent at adsorbing organic molecules—including fluoride ions. If your charcoal toothpaste also contains fluoride (some do, marketed as "best of both worlds"), the charcoal may simply bind the fluoride before it can contact your teeth. You get neither the charcoal benefits (unproven) nor the fluoride benefits (well-proven).

False confidence: The dramatic visual of black paste and the "natural" marketing may lead people to believe they're doing something special for their oral health, when they may actually be doing harm while neglecting proven approaches.

My Verdict¶

Activated charcoal toothpaste is not recommended. The evidence for benefit is absent, the evidence for potential harm is concerning, and the marketing preys on the understandable desire for "natural" solutions without delivering substantive value.

If you want whiter teeth, there are safer approaches:

Reduce staining substances (coffee, tea, wine, tobacco)
Brush with standard toothpaste after consuming them
Peroxide-based whitening (has actual evidence, though different safety considerations)
Professional cleaning and whitening through a dentist

If you want "natural" oral care, you've already read about options that actually work: salt, baking soda, green tea, neem, proper botanical preparations.

The charcoal trend will pass. Your enamel needs to last forever.

Coconut Oil Toothpaste: Better Than Charcoal, But Questions Remain¶

The popularity of coconut oil in oral care has two distinct manifestations: oil pulling (discussed in the previous chapter, with reasonable evidence) and coconut oil toothpaste (more mixed).

The Claims¶

Coconut oil toothpaste proponents argue:

Lauric acid provides antimicrobial protection
The oil base is gentler than detergent-based conventional pastes
"Chemical-free" (a meaningless term—everything is chemicals)
Can be made at home with simple ingredients

The Reality¶

Lauric acid is genuinely antimicrobial. Laboratory studies confirm activity against oral pathogens including S. mutans. However, whether the concentration in toothpaste provides meaningful clinical benefit during the brief contact time of brushing is unestablished.

The lack of fluoride is the main concern. Most coconut oil toothpastes don't contain fluoride—either because the manufacturers are ideologically opposed, or because formulating stable fluoride in an oil base is technically challenging.

If you're in a category where fluoride is particularly important (high caries risk, children with developing teeth, dry mouth), substituting coconut oil toothpaste for fluoride toothpaste may increase your cavity risk.

DIY formulations vary wildly. The internet is full of recipes for homemade coconut oil toothpaste, typically combining:

Coconut oil
Baking soda
Essential oils (peppermint, etc.)
Sometimes added charcoal (problems already discussed)

These can range from reasonable (coconut oil + baking soda is essentially oil pulling plus pH buffering in a paste form) to problematic (adding abrasives, using excessive essential oils, etc.).

My Verdict¶

Coconut oil toothpaste is acceptable as a supplement but problematic as a sole dentifrice. If you want to use it:

Continue using fluoride toothpaste at least once daily
Use coconut oil toothpaste for the other brushing if desired
Avoid formulations with charcoal or high-abrasive additions
Recognize that you're trading proven benefit (fluoride, detergent cleaning) for plausible but less-proven benefit (lauric acid)

The better integration is oil pulling (where the extended contact time makes more sense for oil-based antimicrobial action) plus conventional or n-HAp toothpaste for brushing.

"Natural" Toothpaste: What the Label Means (and Doesn't)¶

The word "natural" on oral care products is essentially meaningless from a regulatory standpoint.⁵ There is no FDA definition, no required standard, no certification process. Any product can claim to be natural.

Common "Natural" Toothpaste Ingredients¶

Ingredient	What It Does	Actually Natural?	Evidence Base
Sodium bicarbonate	pH buffer, mild abrasive	Yes (mined or synthesized)	Good
Xylitol	Sweetener, antimicrobial	Derived from plants	Good
Calcium carbonate	Abrasive	Yes (mined)	Modest
Hydrated silica	Abrasive	Processed from sand	Moderate
Glycerin	Humectant	Plant or synthetic	Safe, neutral for teeth
Sodium lauryl sulfate	Detergent/foaming	Derived from coconut	Safe, some sensitivity issues
Essential oils	Antimicrobial, flavor	Plant-derived	Variable
Stevia	Sweetener	Plant-derived	Safe, neutral
Carrageenan	Thickener	Seaweed-derived	Safe (oral use)
"Natural flavors"	Flavor	Can mean almost anything	Unspecified

The Fluoride Question in "Natural" Products¶

Many consumers seeking "natural" toothpaste are specifically avoiding fluoride, based on concerns ranging from legitimate (fluorosis risk with excessive ingestion during tooth development) to conspiratorial (government mind control, etc.).

I want to be clear: fluoride is the single most evidence-supported intervention for caries prevention.⁴ Topical fluoride (in toothpaste) has an excellent safety profile and strong efficacy data. The concerns about fluoride toxicity apply to systemic ingestion, not topical oral use in adults.

If you choose a fluoride-free "natural" toothpaste, you should:

Have another source of topical fluoride (rinse, professional application)
OR accept increased caries risk
OR be in a genuinely low-risk category (excellent diet, robust saliva, no history of caries, using n-HAp as alternative)

Choosing "natural" without understanding these trade-offs is how people end up with cavities while congratulating themselves on avoiding "chemicals."

The Microbiome Oral Care Trend¶

A newer wave of products claims to support the oral microbiome—essentially the marketing application of the ecological paradigm I've been describing throughout this book. This is... complicated, because the underlying science is sound but the product applications are often premature.

The Legitimate Science¶

Everything I've told you about the oral ecosystem, the problems with scorched-earth antiseptics, the importance of beneficial bacteria—all of that is well-supported by research. The microbiome revolution is real.

The Premature Products¶

Translating microbiome science into effective consumer products is much harder than it sounds:

Probiotic toothpastes and rinses: We discussed oral probiotics earlier. The challenge is delivering viable organisms in shelf-stable products at sufficient doses to meaningfully colonize. Most products either can't demonstrate survival or can't demonstrate oral colonization.

Prebiotic oral care: The idea of providing substrates that beneficial bacteria prefer. Arginine-containing toothpastes are the legitimate version of this. But many "prebiotic" marketing claims are vague and unstudied.

"Microbiome-friendly" positioning: Sometimes this just means "not antibacterial"—which is fine, but hardly revolutionary. Your salt and baking soda rinse is microbiome-friendly too, and costs pennies.

My Verdict¶

Be skeptical of microbiome marketing; the science is outpacing the products. The ecological approach to oral care doesn't require buying expensive new products—it requires understanding your mouth and using simple tools wisely.

The best "microbiome-friendly" oral care is what we've already discussed:

Avoid antiseptic mouthwashes for routine use
Use gentle, pH-supportive rinses
Include arginine if you want prebiotic benefit
Consider proven oral probiotics (S. salivarius K12/M18)
Focus on diet and timing over products

Wellness Culture and Oral Health: The Bigger Picture¶

I've lived long enough to watch health trends cycle through again and again. Some observations:

The pendulum always swings too far. The rejection of "chemicals" and embrace of "natural" is in many ways a healthy correction to the over-medicalized, antiseptic-obsessed approach of the late 20^th century. But it swings past the optimum when it rejects genuinely beneficial interventions (fluoride) while embracing unproven ones (charcoal).

Marketing exploits genuine intuitions. Your instinct that gentle, ecologically-aware approaches might be better than burning alcohol rinses is correct. The problem is that marketers exploit that correct instinct to sell products that don't deliver on the promise.

Tradition has value, but isn't automatically right. The miswak tradition works because the plant contains genuinely beneficial compounds. Other traditions (bloodletting, mercury treatments) didn't work. The question is always: what's the mechanism, and what's the evidence?

The best solutions are often boring. Salt, baking soda, green tea, xylitol, proper technique, attention to diet and timing. These aren't exciting. They don't photograph well. They don't generate influencer content. But they work.

Summary: Separating Signal from Noise¶

Trend	Verdict	Reasoning
Activated charcoal	Avoid	No efficacy evidence; abrasivity concerns
Coconut oil toothpaste	Acceptable supplement	Missing fluoride; better as oil pulling
"Natural" toothpaste	Depends on formulation	Read ingredients; don't fear-avoid fluoride
Microbiome products	Mostly premature	Science is sound; products often aren't
Oil pulling	Worth trying	Genuine (modest) evidence
Salt/baking soda rinse	Recommended	Well-supported, cheap, ecological
Green tea consumption	Recommended	Good evidence, pleasant, easy
Traditional botanicals	Selective use	Evaluate each on its evidence

The common thread: simple, well-understood interventions often outperform complex, heavily-marketed products. The most "natural" approach is often the most ancient—and the most boring.

In the next section, we'll turn to modern innovations that actually do represent genuine advances: hydroxyapatite, CPP-ACP, and emerging technologies that may define the future of remineralization.

Brooks, J. K., et al. (2017). Charcoal and charcoal-based dentifrices: A literature review. Journal of the American Dental Association, 148(9), 661-670. ↩
Greenwall, L. H., et al. (2019). Charcoal-containing dentifrices. British Dental Journal, 226(9), 697-700. ↩
Relative dentin abrasivity — Wikipedia. The standardized measure of toothpaste abrasiveness, with values under 250 considered safe for daily use. ↩
Marinho, V. C., et al. (2003). Fluoride toothpastes for preventing dental caries in children and adolescents. Cochrane Database of Systematic Reviews, (1). CD002278. Meta-analysis confirming 24% caries reduction. ↩
U.S. Food and Drug Administration. The FDA does not define or regulate the term "natural" on cosmetic or oral care product labels. ↩