As an orthodontist, I'm often asked which toothpaste is best, usually by patients who are in treatment with braces or aligners. I generally recommend toothpastes with stannous fluoride. Stannous means it has tin, which has been shown to be antimicrobial. There are many toothpastes that contain stannous fluoride, including Crest Pro-Health, Crest Gum, Oral-B Pro-Health, Colgate Total, and Parodontax. For patients who want stain removal, there are whitening variants for most of these toothpastes. On the other hand, patients with gum recession may want to minimize whitening, as whitening toothpastes are more abrasive and may wear down the cementum layer below the gum line. If patients with recession want to whiten, they should look for toothpastes with low Relative Dentin Abrasivity (RDA) ratings. Sensodyne Pronamel Gentle Whitening, for example, has an RDA of 35 (an RDA of under 70 is considered gentle). Sensodyne and similar toothpastes are also great for patients with sensitivity. This is because they also contain potassium nitrate. Both fluoride and potassium nitrate have been shown to reduce nerve sensitivity. For patients at high risk for cavities, I recommend a stronger concentration of fluoride. PreviDent 5000 is a prescription toothpaste that can help prevent cavities and white spots. I find a high concentration fluoride toothpaste more effective than adding a fluoride mouthrinse, since adding a mouthrinse increases the number of steps in daily maintenance. Since flossing is more time-consuming with braces in particular, shortening the rest of the maintenance regime increases the odds it will be completed when the patient is in a hurry. There is some evidence that toothpastes with baking soda are beneficial as well. Baking soda offers gentle stain removal and whitening, plaque and bacteria reduction, neutralizes acid, and supports gum health. Baking soda in significant concentrations can increase the abrasiveness of the toothpaste, however, so those with significant sensitivity or recession may want to avoid it. Toothpastes with both stannous fluoride and baking soda are uncommon, with SmileSense Fluoride Toothpaste being one of the few with both ingredients. The best toothpaste depends on your personal needs: sensitivity, risk of decay, gum health, and personal preference. Top priorities are cavity prevention, white spot prevention, and gum health. However, no matter the fluoride toothpaste, consistency matters more than the brand.