Appendix B: Ingredient Glossary¶

This glossary covers the key compounds, botanicals, and materials discussed throughout this book. Entries are organized alphabetically and include chemical information where relevant, mechanisms of action, and evidence levels.

A¶

Activated Charcoal¶

What it is: Carbon that has been processed to have a highly porous surface, dramatically increasing its surface area.

Claimed mechanism: Binds to surface stains and toxins through adsorption.

Evidence for oral health: Weak. No reliable evidence for whitening efficacy; concerns about abrasivity and potential damage to enamel. May bind beneficial substances including fluoride.

The Tooth Fairy's verdict: A modern trend with more marketing than science. If you want whitening, there are safer approaches.

Aloe Vera (Aloe barbadensis)¶

What it is: A succulent plant whose inner gel contains polysaccharides, glycoproteins, and various bioactive compounds.

Mechanisms: Anti-inflammatory (inhibits prostaglandin synthesis), wound healing (stimulates fibroblast activity), antimicrobial (modest).

Evidence for oral health: Moderate. Some clinical trials suggest benefit for gingivitis and aphthous ulcers. More research needed.

Forms: Gel (direct application), juice (rinse ingredient), toothpaste additive.

Arginine¶

What it is: A semi-essential amino acid, one of the building blocks of proteins.

Mechanism: Substrate for the arginine deiminase system (ADS) in certain oral bacteria. ADS-positive bacteria convert arginine to ornithine, ammonia, and CO₂. The ammonia neutralizes acid, raising plaque pH.

Evidence for oral health: Strong. Clinical trials demonstrate reduced caries incidence with arginine-containing toothpastes. This is a genuinely prebiotic approach—you're feeding the beneficial bacteria.

Products: Available in some commercial toothpastes (often with calcium carbonate).

Azadirachtin¶

What it is: A complex limonoid compound found in neem (Azadirachta indica).

Mechanism: Antimicrobial, anti-inflammatory. Disrupts bacterial cell function.

Evidence for oral health: Moderate. In vitro activity demonstrated; some clinical trials support benefit for gingivitis. Traditional use is extensive.

See also: Neem

B¶

Baking Soda (Sodium Bicarbonate, NaHCO₃)¶

What it is: A mild alkaline salt, commonly used in cooking and cleaning.

Mechanism: Acts as a pH buffer. When dissolved in water, creates an alkaline environment (pH ~8.3 for saturated solution). Neutralizes acids produced by oral bacteria, raising plaque pH above the critical threshold for demineralization.

Evidence for oral health: Good. Toothpastes containing baking soda show plaque reduction and anti-gingivitis effects in clinical trials. As a rinse, mechanism is sound though less studied.

The Tooth Fairy's note: This is one of the pillars of the simple rinse I recommend—cheap, effective, and ecologically gentle.

Benzyl Isothiocyanate (BITC)¶

What it is: A sulfur-containing compound found in Salvadora persica (miswak) and various plants in the Brassicaceae family (mustard, horseradish).

Mechanism: Potent antimicrobial activity. Disrupts bacterial enzymes and membrane function.

Evidence for oral health: Strong. This is one of the key active compounds that makes miswak effective. Demonstrated activity against multiple oral pathogens.

See also: Miswak, Salvadora persica

C¶

Calcium Carbonate (CaCite, Cite)¶

What it is: A mineral salt; the main component of limestone, chalk, and marine shells.

Mechanism: Mild abrasive in toothpastes; provides calcium ions (limited, due to low solubility); buffers pH toward alkaline.

Evidence for oral health: Moderate as a toothpaste abrasive. As a remineralization agent in rinses, limited by very low water solubility (~15 mg/L). Your saliva already contains more calcium than you'll dissolve from CaCO₃.

The Tooth Fairy's note: I include it as an optional ingredient in the basic rinse—it won't hurt, and may contribute mild buffering, but don't expect remineralization miracles.

Calcium Phosphate (various forms)¶

What it is: The family of calcium-phosphate salts that form the mineral basis of teeth and bone.

Key forms:

Hydroxyapatite [Ca₁₀(PO₄)₆(OH)₂]: The primary mineral in enamel
Fluorapatite [Ca₁₀(PO₄)₆F₂]: Fluoride-substituted form, more acid-resistant
Amorphous Calcium Phosphate (ACP): Non-crystalline form used in some remineralization products

Relevance: These are the minerals you're trying to preserve and rebuild. Understanding their chemistry is central to understanding remineralization.

See also: Hydroxyapatite, Remineralization

Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP)¶

What it is: A milk-derived protein complex bound to amorphous calcium phosphate. Developed at the University of Melbourne.

Mechanism: The casein phosphopeptide stabilizes calcium and phosphate in an amorphous (non-crystalline) form, keeping them bioavailable for enamel remineralization. Delivers ions directly to tooth surface.

Evidence for oral health: Good. Multiple clinical trials demonstrate efficacy for remineralizing early carious lesions ("white spot" lesions). Best evidence is for use as adjunct to fluoride, not replacement.

Products: MI Paste, MI Paste Plus (with fluoride), various toothpastes.

Caution: Contains milk protein; not suitable for those with milk allergies.

Catechins¶

What it is: A family of flavonoid compounds found in tea, particularly green tea.

Key compound: Epigallocatechin gallate (EGCG)

Mechanisms: - Anti-adhesion (inhibits glucosyltransferase, preventing S. mutans from producing sticky glucan matrix) - Antimicrobial (direct activity at higher concentrations) - Anti-inflammatory - Antioxidant

Evidence for oral health: Good. Multiple studies demonstrate reduced plaque, reduced S. mutans counts, and improved gingival health with green tea consumption.

See also: Green tea

Chlorhexidine¶

What it is: A synthetic bisbiguanide antiseptic, available in various concentrations.

Mechanism: Broad-spectrum antimicrobial. Binds to bacterial cell walls, disrupts membranes, causes leakage of intracellular contents. Has "substantivity"—binds to oral tissues and releases slowly over 8-12 hours.

Evidence for oral health: Very strong. The gold standard for reducing plaque and gingivitis. Also effective against oral Candida.

Concerns: Staining of teeth, altered taste sensation, disruption of beneficial oral bacteria, potential blood pressure effects (by killing nitrate-reducing bacteria), promotes calculus formation.

The Tooth Fairy's note: Effective but not ecological. Appropriate for short-term use in specific clinical situations (post-surgery, active periodontitis), but not for daily maintenance in healthy mouths.

Cinnamon (Cinnamomum species)¶

What it is: Bark of various Cinnamomum trees; the spice you know from cooking.

Key compound: Cinnamaldehyde (gives cinnamon its characteristic flavor and smell)

Mechanisms: Strong antimicrobial activity (cinnamaldehyde disrupts bacterial membranes); anti-inflammatory; antifungal.

Evidence for oral health: Moderate. In vitro studies show strong antimicrobial effects. Clinical studies limited but traditional use is extensive.

Caution: Cinnamaldehyde can be irritating to mucosa at high concentrations. Cinnamon oil should be diluted; use sparingly.

Clove (Syzygium aromaticum)¶

What it is: Dried flower buds of the clove tree; used as a spice and medicine for millennia.

Key compound: Eugenol (70-90% of clove oil)

Mechanisms:

Analgesic (inhibits voltage-gated sodium channels—same mechanism as lidocaine)
Anti-inflammatory (COX-2 inhibition)
Antimicrobial (disrupts cell membranes)
Antioxidant

Evidence for oral health: Strong. Eugenol is used in conventional dentistry (zinc oxide eugenol cement, dry socket treatments). FDA has approved clove oil as a topical dental analgesic.

Use: Cotton swab application for toothache; dilute in carrier oil for sensitive individuals.

Caution: Can cause tissue irritation with prolonged use; do not swallow large amounts.

Coconut Oil¶

What it is: Oil extracted from coconut meat, composed primarily of medium-chain saturated fatty acids.

Key compound: Lauric acid (~50% of coconut oil)

Mechanisms: Lauric acid has antimicrobial properties; oil may physically trap bacteria; possible saponification with saliva creating soap-like molecules.

Evidence for oral health: Moderate. Clinical trials of oil pulling show reduced S. mutans counts and gingivitis scores. Mechanism not fully established.

See also: Oil pulling

E¶

Epigallocatechin Gallate (EGCG)¶

See: Catechins, Green tea

Essential Oils¶

What they are: Concentrated volatile aromatic compounds extracted from plants, typically through steam distillation or cold pressing.

General mechanisms: Most essential oils with oral health evidence work through disruption of bacterial cell membranes due to their lipophilic nature and specific active compounds.

Key essential oils for oral health:

Thyme oil (thymol)
Peppermint oil (menthol)
Eucalyptus oil (eucalyptol/1,8-cineole)
Clove oil (eugenol)
Tea tree oil (terpinen-4-ol)
Cinnamon oil (cinnamaldehyde)

Evidence: Varies by oil. Thymol, eucalyptol, and menthol are used in commercial mouthwashes (Listerine) with strong evidence base.

Cautions: Essential oils are potent; use sparingly. Many are toxic if swallowed in quantity. Do not use undiluted on mucosa. Require emulsifier to mix with water.

Eucalyptol (1,8-Cineole)¶

What it is: A monoterpenoid compound found in eucalyptus oil and many other plants.

Mechanism: Disrupts bacterial cell membranes; anti-inflammatory.

Evidence for oral health: Strong. One of the four active ingredients in Listerine; extensive clinical trial support for plaque and gingivitis reduction in that context.

Eugenol¶

See: Clove

F¶

Fluoride¶

What it is: The ionic form of fluorine, typically encountered as sodium fluoride (NaF), stannous fluoride (SnF₂), or sodium monofluorophosphate (MFP).

Mechanisms:

Incorporates into enamel crystal, replacing hydroxyl groups
Creates fluorapatite, which is more acid-resistant than hydroxyapatite
Fluorapatite has a lower critical pH (~4.5 vs 5.5)
Enhances remineralization rate
At higher concentrations, has antimicrobial effects

Evidence for oral health: Very strong. Decades of population-level evidence. Fluoride toothpaste is the single most evidence-supported intervention for caries prevention.

The Tooth Fairy's note: I've been watching your species for millennia, and fluoride is one of the genuine breakthroughs. You don't have to use it—the alternatives in this book are real—but the evidence is undeniable.

Fluorapatite¶

What it is: The fluoride-substituted form of hydroxyapatite [Ca₁₀(PO₄)₆F₂].

Significance: More acid-resistant than hydroxyapatite; critical pH is ~4.5 instead of 5.5. This is why fluoride exposure makes teeth more resistant to decay.

See also: Fluoride, Hydroxyapatite

G¶

Ginger (Zingiber officinale)¶

What it is: The rhizome (underground stem) of the ginger plant; used as spice and medicine worldwide.

Key compounds: Gingerols (fresh ginger), shogaols (dried/cooked ginger)

Mechanisms:

Anti-inflammatory (inhibits COX and LOX pathways)
Antimicrobial (modest; disrupts membranes)
Antioxidant
Stimulates saliva flow

Evidence for oral health: Moderate. Mostly in vitro and animal studies; some small clinical trials suggest benefit for gingivitis. Anti-inflammatory mechanism well-established from other applications.

Use: Tea (simmer sliced ginger), fresh slices applied to gums, or as part of rinse formulations.

Glycyrrhizin¶

What it is: The main sweet-tasting compound in licorice root (Glycyrrhiza glabra).

Mechanisms: Anti-inflammatory, antiviral, some antimicrobial activity.

Caution: Chronic high-dose ingestion can cause hypertension and hypokalemia. Topical oral use is likely safe.

See also: Licorice

Green Tea (Camellia sinensis)¶

What it is: Tea made from unoxidized leaves of the tea plant.

Key compounds: Catechins, especially EGCG; also contains fluoride naturally.

Evidence for oral health: Good. Multiple clinical studies demonstrate reduced plaque, reduced S. mutans, and improved gingival health. Drinking unsweetened green tea is an evidence-based oral health behavior.

See also: Catechins

H¶

Hydroxyapatite (HAp)¶

What it is: The primary mineral component of tooth enamel and bone [Ca₁₀(PO₄)₆(OH)₂].

Structure: Crystalline lattice of calcium, phosphate, and hydroxyl ions.

Significance: Understanding hydroxyapatite chemistry is key to understanding remineralization. The crystal exists in dynamic equilibrium with the surrounding fluid; pH and ion concentrations determine whether it dissolves or rebuilds.

See also: Nano-hydroxyapatite, Fluorapatite, Remineralization

L¶

Lauric Acid¶

What it is: A 12-carbon saturated fatty acid; comprises ~50% of coconut oil.

Mechanism: Antimicrobial activity—disrupts bacterial cell membranes; converted by some bacteria to monolaurin, which has additional antimicrobial properties.

Evidence for oral health: Moderate. Part of the rationale for coconut oil pulling. In vitro antimicrobial activity demonstrated.

Licorice (Glycyrrhiza glabra, G. uralensis)¶

What it is: Root of the licorice plant; used in traditional medicine across Europe and Asia.

Key compounds: - Glycyrrhizin (sweet taste, anti-inflammatory) - Licoricidin and licorisoflavan A (antimicrobial, anti-adhesion)

Mechanisms: Licoricidin and licorisoflavan A are potent inhibitors of S. mutans biofilm formation—they interfere with bacterial adhesion and glucan synthesis.

Evidence for oral health: Moderate-good. Studies show reduced S. mutans counts. Licorice lollipops have been studied for caries prevention (the licorice compounds may offset sugar exposure, though sugar-free would be better).

Caution: High-dose chronic use of glycyrrhizin-containing products can cause hypertension and electrolyte imbalances. Topical oral use is likely safe.

M¶

Manuka Honey¶

What it is: Honey produced by bees that pollinate the manuka bush (Leptospermum scoparium) native to New Zealand.

Key compound: Methylglyoxal (MGO)—responsible for unique antimicrobial activity

Mechanisms: Antimicrobial (MGO damages bacterial proteins); promotes wound healing; anti-inflammatory.

Evidence for oral health: Moderate. Despite being a sugar, manuka honey has shown antimicrobial effects and wound healing benefits in oral applications. The MGO content distinguishes it from regular honey.

Paradox: Yes, it's sugar. The antimicrobial and healing properties may offset this for therapeutic use, but it shouldn't be a daily habit.

Menthol¶

What it is: A monoterpenoid compound found in peppermint and other mint oils.

Mechanisms: Mild antimicrobial; activates cold-sensitive receptors (creates cooling sensation); mild analgesic.

Evidence for oral health: Moderate-good as part of essential oil mouthwashes. The cooling sensation also promotes the subjective feeling of freshness.

Miswak¶

What it is: A teeth-cleaning twig, traditionally from Salvadora persica but also from other species (neem, olive, walnut).

Key compounds (in Salvadora persica):

Benzyl isothiocyanate (antimicrobial)
Silica (abrasive)
Sodium bicarbonate (pH buffer)
Sodium chloride (antimicrobial environment)
Fluoride (~8-22 ppm)
Vitamin C, sulfur compounds, salvadorine

Evidence for oral health: Strong. WHO-recognized as valid alternative to conventional toothbrushing. Multiple comparative studies show equivalent or superior plaque and gingivitis reduction.

The Tooth Fairy's note: This is perhaps my favorite botanical intervention. Seven thousand years of use, validated by modern science, containing almost everything a tooth needs in one humble twig.

See also: Salvadora persica

Myrrh (Commiphora myrrha)¶

What it is: A resin obtained from various Commiphora species; used in traditional medicine since ancient times.

Key compounds: Terpenoids (furanodienes), polysaccharides

Mechanisms: Antimicrobial, anti-inflammatory, astringent.

Evidence for oral health: Limited modern clinical data, but extensive traditional use. German Commission E approved for mild oral inflammations.

N¶

Nano-Hydroxyapatite (n-HAp)¶

What it is: Synthetically produced hydroxyapatite particles at nanoscale (typically 20-100 nm diameter).

Proposed mechanisms:

Direct deposition into enamel defects
Calcium/phosphate reservoir for remineralization
Integration into acquired pellicle
Tubule occlusion for dentin sensitivity

Evidence for oral health: Moderate-good. Systematic reviews show non-inferiority to fluoride for remineralization of initial caries lesions. Long-term caries prevention data less robust than for fluoride.

Products: Apagard (Japan), various toothpastes marketed in Europe and increasingly worldwide.

The Tooth Fairy's note: A legitimate alternative to fluoride with sound science behind it, though fluoride has a longer track record.

Neem (Azadirachta indica)¶

What it is: A tree native to the Indian subcontinent; all parts have been used in traditional medicine.

Key compounds: Azadirachtin, nimbin, nimbidin, gedunin

Mechanisms: Antimicrobial, anti-inflammatory.

Evidence for oral health: Moderate. Traditional chew stick use (like miswak); some clinical trials support benefit for gingivitis. Fewer studies than for Salvadora persica.

Products: Neem toothpastes, mouthwashes, and the traditional twig form.

O¶

Oil Pulling¶

What it is: The practice of swishing oil (typically coconut or sesame) in the mouth for 15-20 minutes, then spitting.

Proposed mechanisms: Not fully established. May include saponification (soap formation with saliva), physical trapping of bacteria, antimicrobial effects of lauric acid (in coconut oil).

Evidence for oral health: Moderate. Several clinical trials show reduced S. mutans counts, plaque, and gingivitis—sometimes comparable to chlorhexidine. Mechanism unclear; duration may matter (extended swishing itself may be beneficial).

See also: Coconut oil, Lauric acid

P¶

Propolis¶

What it is: A resinous substance produced by bees from plant resins, used to seal hives and protect against pathogens.

Key compounds: Flavonoids (pinocembrin, galangin), phenolic acids, terpenoids—varies significantly by geographic origin.

Mechanisms: Antimicrobial (disrupts bacterial cell division, damages membranes), anti-inflammatory (COX/LOX inhibition), promotes wound healing.

Evidence for oral health: Good. Multiple clinical trials show benefit for gingivitis, periodontitis, oral candidiasis, and aphthous ulcers. Some studies show comparable efficacy to chlorhexidine.

Products: Tinctures (alcohol-based extract), mouthwashes, toothpastes.

Caution: Can cause allergic reactions in sensitive individuals, particularly those allergic to bee products. May stain teeth.

S¶

Sage (Salvia officinalis)¶

What it is: An herb native to the Mediterranean, used in cooking and medicine since antiquity. The genus name Salvia comes from Latin salvare, "to save/heal."

Key compounds: Thujone, 1,8-cineole (eucalyptol), camphor, rosmarinic acid, carnosic acid

Mechanisms: Antimicrobial (terpenoids disrupt membranes), anti-inflammatory, astringent (tannins).

Evidence for oral health: Moderate-good. Clinical trials show sage mouthwash reduces S. mutans counts comparably to chlorhexidine. German Commission E approved for mouth and throat inflammation.

Use: Tea (steep leaves 10-15 minutes), as a rinse.

Salvadora persica¶

See: Miswak

Sodium Bicarbonate¶

See: Baking Soda

Sodium Chloride (Salt, NaCl)¶

What it is: Common table salt.

Mechanism: Hypertonic salt solutions create osmotic stress on bacterial cells, drawing water out. Creates an environment less hospitable to bacteria. Also draws fluid from swollen tissues, reducing inflammation.

Evidence for oral health: Good. Salt water rinses are standard of care for post-extraction wound healing. Evidence supports use for mild gingival inflammation.

The Tooth Fairy's note: The other pillar of my simple rinse. Cheap, effective, and gentler than you might expect.

T¶

Tea Tree Oil (Melaleuca alternifolia)¶

What it is: Essential oil from the Australian tea tree.

Key compound: Terpinen-4-ol

Mechanism: Antimicrobial—disrupts bacterial cell membranes; antifungal.

Evidence for oral health: Limited oral-specific evidence. Antimicrobial properties well-established, but toxicity concerns limit oral use.

Caution: Toxic if swallowed in significant amounts. Medicinal taste. Not recommended for oral rinses at significant concentrations.

Thymol¶

What it is: A monoterpenoid phenol found in thyme oil.

Mechanism: Disrupts bacterial cell membranes; one of the most effective essential oil antimicrobials.

Evidence for oral health: Strong. One of four active ingredients in Listerine with extensive clinical trial support.

X¶

Xylitol¶

What it is: A five-carbon sugar alcohol naturally found in many fruits and vegetables; commercially produced from birch or corn.

Mechanisms:

Non-fermentable by S. mutans (they cannot metabolize it to produce acid)
S. mutans take up xylitol, wasting energy trying to process it—"futile cycling"
May disrupt S. mutans adhesion
Stimulates saliva flow

Evidence for oral health: Strong. Multiple systematic reviews support caries-preventive effect. Optimal exposure is approximately 5-6g daily, divided across multiple exposures.

Products: Gum, mints, toothpastes, rinses.

The Tooth Fairy's note: This is a genuinely prebiotic intervention—you're not killing bacteria, you're starving the problematic ones while providing a substrate they can't use. Smart, not scorched-earth.

Z¶

Zinc¶

What it is: An essential trace mineral.

Mechanism: In oral products, zinc salts (zinc chloride, zinc citrate) have antimicrobial effects and reduce volatile sulfur compound production (anti-halitosis).

Evidence for oral health: Moderate for anti-halitosis effects. Zinc is a component of some commercial mouthwashes and toothpastes.

This glossary covers the major compounds and botanicals discussed in this book. For further information on specific ingredients, consult the relevant chapters or the resources in Appendix D.