Beware of Charcoal Toothpaste!

According to Samantha Via of “Today’s RDH”, the new fad of Charcoal Toothpaste for whitening teeth is just that– a fad.  It is one that, she explains, will hopefully go away soon!

The first thing that comes to my mind when I hear the word “charcoal,” is a great tasting chargrilled burger. What I do not think about is rubbing a charcoal powder to cleanse my face or use as a facial peel. I also don’t think about plastering black clumps of charcoal all over my teeth to try to whiten them. This fad is sparking a lot of attention on social media, but I would rather see this trend fade away. People may be hypnotized by the cheap and quick possibility of being able to improve their beauty or smile, but I won’t be jumping on the bandwagon anytime soon. I am fully aware of its negative long-term effects, and I want to make sure everyone else is aware too.

Charcoal vs. Activated Charcoal

What is Charcoal exactly? It is mostly made of carbon. Once heated and burned with high intensity in a low oxygenated environment, it eventually turns into black clumps and powder. This is called Char. The production of Char began in the early Ancient Egyptian times, and they believed that it had a unique property that could be used as a preservative. Once activated, they used it as an antibacterial product to treat certain illnesses and diseases4. “Activated charcoal” is a carbon-rich material that has increased surface area (which is very absorbent) due to processing charcoal at high temperatures, or by exposing it to gas or chemicals to “activate” it11.

In 1963, activated charcoal was first medically recognized by the Journal of Pediatrics7. They recognized it as a way to treat toxic poisoning and drug overdose, as long as the health professionals used it within one hour of an incident4. Activated charcoal is not effective in poisonings caused by strong acids or bases; these include cyanide, organic solvents, ethanol, methanol, iron, lithium, among other substances1.

Disadvantages of Orally-ingested Activated Charcoal

There are side effects to ingesting activated charcoal orally. Side effects include diarrhea, vomiting, gastrointestinal damage, black tongue, and it can even counteract medication absorption. Some medications that interact with charcoal are digoxin, acetaminophen, theophylline, tricyclic antidepressants, diabetes medications, and even birth control1,8. When taken with a laxative, toxicologists have stated that serious side effects can occur such as dehydration (which can lead to kidney damage), electrolyte imbalances, and low blood pressure1.

As a hygienist, many of the patients we treat could have interactions with ingesting charcoal due to the medications they take. I would especially warn my diabetic patients against brushing with activated charcoal because even the slightest chance they ingested it, could lead to the risk of it interacting or counteracting with their life-saving diabetes medication. It’s just not worth the risk. The bottom-line is patients should speak with their prescribing physician before ingesting charcoal.

Disadvantages of Using Charcoal as a Whitening Agent 

 As far as the use of charcoal in oral care products, there isn’t much scientific or clinical research to back up the claim of efficacy and safety2,9,10. Due to the possible abrasiveness of charcoal whitening toothpaste, and the increase of surface roughness of enamel that can occur, there are disadvantages in using activated charcoal10. Disadvantages include dental erosion (increased surface roughness which could lead to even more retention of stain), dentin exposure, and gingival recession. These can all lead to sensitivity to cold or hot and an increased target for decay3. How? With the use of any abrasive substance on enamel, leading to the loss of enamel, yellowing, and darkening of teeth can occur due to dentin exposure. This completely undermines the use of using charcoal to whiten in the first place. Further, when dentin is exposed, it becomes more decay-prone. Dentin demineralizes at a pH of 6.5, whereas enamel demineralizes at a pH of 5.5. It is very important that patients understand that when enamel is gone, it’s gone. It doesn’t grow back. Only a restoration can cover the discoloration and damage. Further, charcoal may become lodged subgingivally. This may cause inflammation and tissue trauma.

So while a patient may be enjoying brushing their teeth with charcoal and feeling fresh and clean now, I hope they take into consideration the possible long-term damage and side effects and put these above the superficial, temporary benefits. It is not worth saving a few bucks. As a dental professional, I would treat my family, friends, and patients how I would want to be treated. If I won’t use it, I would definitely not recommend it to anyone else. I would suggest investing a little more money and purchase either an over-the-counter, low-dose hydrogen or carbamide peroxide whitening product or have a dental professional whiten a patient’s teeth in-office.

The difference between hydrogen or carbamide peroxide whitening and charcoal whitening is that hydrogen and carbamide peroxide whiten your teeth by penetrating the enamel and breaking molecular bonds. Charcoal only removes surface stain through abrasion. I would only recommend using caution with any product that contains an abrasive powder. As for me, the only thing I plan to use charcoal for is to grill a great tasting burger.



  1. Activated Charcoal: Bottom Line Monograph. (Aug 2013). Retrieved from
  2. Brooks, J.K., Bashirelahi, N., Reynolds, M.A. Charcoal and Charcoal-Based Dentifrices: A Literature Review. The Journal of The American Dental Association. 2017 Sept;148(9):661-670. Retrieved from
  3. Dentist Warns Against Charcoal Teeth Whitening Trend. (Aug 2015). Retrieved from
  4. Goldwyn, M. The Science of Charcoal: How Charcoal is Made and How Charcoal Works. Retrieved from
  5. Hubbard, L., Tunell, A. Is Charcoal Toothpaste Safe to Use? (Aug 2017) Retrieved from
  6. Lapus, R.M. Activated Charcoal for Pediatric Poisonings: The Universal Antidote. Curr Opin Pediatr.2007 Apr;19(2):216-22. Retrieved from
  7. Lowry, J. (Jan 2008) Use of Activated Charcoal in Pediatric Populations. (Jan 2008). Retrieved from
  8. Mayo Clinic. (March 2017). Charcoal, Activated (Oral Route). Retrieved from
  9. Natural Teeth Whitening: Fact vs. Fiction. Mouth Healthy brought to you by the American Dental Association. Retrieved from
  10. Pertiwi, U.I., Eriwati, Y.K., Irawan, B. Surface Changes of Enamel after Brushing with Charcoal Toothpaste. Journal of Physics. Retrieved from
  11. WebMD. Activated Charcoal. Retrieved from

Article written by Samantha Via of “Today’sRDH”.

Photo credit:

February is Children’s Dental Health Month

Today marks the beginning of Children’s Dental Health Month.  Dr Bell and Holly had the pleasure of speaking to a group of preschoolers at St. Michael’s School in Cary.  Lessons included brushing, flossing, nutritious foods, plaque germs, and what to expect when visiting the dentist.   What a fun morning!


A bundle of joy!

Bell Family Dentistry would like to announce its newest dental patient “Harper LaSmith!”  Our Office Manager Claudia LaSmith gave birth to a sweet little girl, 7lbs 6oz, on November 29.  We would like to congratulate Claudia and her husband Landon on their bundle of joy.

Congratulations to our Honors Intern student!

Beles and Holly at AFHS’s Internship Presentation and Gallery Walk on January 8.

Bell Family Dentistry had the pleasure of welcoming Beles Abebe to our team last semester.  She participated in the Honors Internship Program at Apex Friendship High School.  On Monday, January 8, the Honors Internship students prepared an interactive presentation and gallery walk that demonstrated their unique experiences and knowledge that they gained over the course of their internship.  Beles chose to focus on Infection Control in Dentistry as her showcase topic, and she discussed the infection control process and the sterilization of dental instruments.  Great job, Beles!  And thank you for interning with us!

Have you made your New Year’s Resolutions?

Turning over a new leaf in the New Year can be tricky, but finding a way to stick with it is important when that new leaf benefits your health. If you want to take better care when looking after your teeth and gums this year, these five resolutions can keep you diligent.

Schedule a Dental Appointment

If it’s been a while since you’ve seen a dentist, you’re not alone. About one third of people in the U.S. don’t see a dentist yearly, according to the ADA. But booking this appointment is one of the most important things you can do when looking after your teeth. According to the ADA, some conditions – such as sensitivity in the teeth or bleeding gums – are sure signs that it’s time to see a dentist. Even if your teeth look and feel fine, enter a reminder in your phone or calendar for January 1 so that you can call your dentist on January 2 for an appointment.

To make the process of scheduling visits easier, book your next one before you leave the office.

Commit to Flossing

Brushing your teeth twice a day isn’t enough to keep plaque from building up on your teeth, or to completely remove bits of food from your mouth. To take the best care of your teeth, you need to floss too. If you’re not in the habit of flossing, the new year is a great time to start.

One way to make it easier to remember is putting a container of floss on top of or directly next to your toothpaste. Position the container so that you have to touch it when taking your toothpaste out of the drawer or cabinet. Stash another container of floss in your purse or desk drawer at work, so that you can floss on the go if you forget to do it at home.

Cut Back on Sugar

A study published in “BMC Public Health” in September 2014 confirmed a direct link between the amount of sugar a person eats and the amount of tooth decay he has. Cutting back on sugar can cut your risk for tooth decay considerably. The most convenient way to cut back on sugar is to reduce the number of sugary treats you buy. Simple swaps will help you cut back as well: Drink sugar-free seltzer water instead of soda, or chew a piece of sugar-free gum when you have a craving for something sweet.

Kick the Habit

Smoking doubles your risk for gum disease, according to the CDC, and is linked to a host of other health issues. Pick a date to give up the habit, get rid of all the tobacco products from your home and solicit the support of your friends and family to help you quit. There will be cravings along the way, so it’s important to find a healthy activity to engage in when a craving kicks in. Feel free to see your general practitioner if you struggle to curb the addiction by yourself.

Eat More Mouth-Healthy Foods

When you cut back on sugar, resolve to add more orally healthy foods to your diet to solidify your diet’s benefit to your teeth. Dairy products, which are high in calcium, are great for your teeth, as are fibrous foods that call up saliva and scrub away plaque and other food bits.

Making your new year’s resolutions as easy as possible to stick with will help you keep them. Take things one step at a time, and if you forget to floss one day or eat a big piece of caramel the next, don’t give up. Remember that there’s always tomorrow!


Credit:, “Looking After Your Teeth: Five New Year’s Resolutions For A Healthier Mouth” by Amy Freeman.  Photo credit:


How to whiten your teeth in-office with Philips ZOOM

Bell Family Dentistry offers ZOOM in-office whitening for our patients.  Read here to learn more, and call us today to set up your appointment for a brighter, whiter smile!

With Philips Zoom in-office whitening, you can unlock a smile up to 8 shades whiter in just 60 minutes. The added bonus? You get outstanding results with little to no sensitivity.


No wonder millions of people have already trusted us with whitening their smiles.


Why choose Philips Zoom in-office whitening?

When you choose in-office tooth whitening, stronger whitening ingredients are used to safely complete your treatment. The result? Instantly brighter teeth, with little to no sensitivity.


How do I get started?


When it comes to Philips Zoom, you’ll get the most dramatic results with our in-office treatment. In 60 minutes your teeth could be up to 8 shades whiter, reversing stains from food and drinks, aging, even discoloration from some types of medication.


You’ll leave the dentist chair with an instantly brighter, more confident smile.

How to whiten your teeth with Philips Zoom

If you choose ZOOM, your treatment starts with your dentist checking your current shade, so you can both see the dramatic difference after your treatment is complete.


Once you’re ready, just sit back as your dental professional handles the next steps:


  • Your dentist preps your mouth for whitening and applies a layer of advanced whitening gel to your teeth.
  • To speed up the whitening process, they’ll shine our LED lamp onto your teeth. This accelerates the whitening, plus the lamp’s variable settings ensure you’ll get a comfortable experience.
  • This can be repeated up to 4 times – and is completed in just 60 minutes!
  • Once you’ve reached your desired shade, your dentist will apply our post-treatment gel to help protect enamel and reduce sensitivity.


Before you leave your dentist’s office, you’ll receive customized whitening trays and a take home whitening kit, which is included in the price of your treatment. This way, you can top-up the brightness of your smile whenever you want to.


The History of Dentistry — Innovations in Techniques and Technology (20th Century)

We conclude this historical dental timeline with Part 5 of a 5-part series with fun facts and interesting inventions in the field of dentistry.  For more information, you can visit the website of the American Dental Association. Part 5 will focus on innovations in techniques and technology (20th century).


Charles Land devises the porcelain jacket crown.


Alfred Einhorn, a German chemist, formulates the local anesthetic procain, later marketed under the trade name Novocain.


William Taggart invents a “lost wax” casting machine, allowing dentists to make precision cast fillings.


Greene Vardiman Black, the leading reformer and educator of American dentistry, publishes his monumental two-volume treatise Operative Dentistry, which remains the essential clinical dental text for fifty years. Black later develops techniques for filling teeth, standardizes operative procedures and instrumentation, develops an improved amalgam, and pioneers the use of visual aids for teaching dentistry.


The first formal training program for dental nurses is established at the Ohio College of Dental Surgery by Cyrus M. Wright. The program is discontinued in 1914 mainly due to opposition by Ohio dentists.


The U.S. Army Dental Corps is established as the first armed services dental corps in the U.S. The Navy institutes its Dental Corps in 1912.


Alfred C. Fones opens the Fones Clinic For Dental Hygienists in Bridgeport, Connecticut, the world’s first oral hygiene school. Most of the twenty-seven women graduates of the first class are employed by the Bridgeport Board of Education to clean the teeth of school children. The greatly reduced incidence of caries among these children gives impetus to the dental hygienist movement. Dr. Fones, first to use the term “dental hygienist,” becomes known as the Father of Dental Hygiene.


Irene Newman receives the world’s first dental hygiene license in Connecticut.


The American Board of Orthodontics, the world’s first dental specialty board, is founded.


Alvin Strock inserts the first Vitallium dental screw implant. Vitallium, the first successful biocompatible implant metal, had been developed a year earlier by Charles Venable, an orthopedic surgeon.


The nylon toothbrush, the first made with synthetic bristles, appears on the market.


The water fluoridation era begins when the cities of Newburgh, New York, and Grand Rapids, Michigan, add sodium fluoride to their public water systems.


President Harry S. Truman signs the Congressional bill formally establishing the National Institute of Dental Research and initiating federal funding for dental research. Dr. H. Trendley Dean is appointed its first director. The Institute is renamed the National Institute of Dental and Craniofacial Research in 1998.


Oskar Hagger, a Swiss chemist, develops the first system of bonding acrylic resin to dentin.


The first fluoride toothpastes are marketed.


Michael Buonocore describes the acid etch technique, a simple method of increasing the adhesion of acrylic fillings to enamel.


John Borden introduces a high-speed air-driven contra-angle handpiece. The Airotor obtains speeds up to 300,000 rotations per minute and is an immediate commercial success, launching a new era of high-speed dentistry.


fully reclining dental chair is introduced.


  • Sit down, four-handed dentistry becomes popular in the U.S. This technique improves productivity and shortens treatment time.
  • Lasers are developed and approved for soft tissue work, such as treatment of periodontal disease.
  • The first commercial electric toothbrush, developed in Switzerland after World War II, is introduced in the United States. A cordless, rechargeable model follows in 1961.


Rafael Bowen develops Bis-GMA, the thermoset resin complex used in most modern composite resin restorative materials.


Per-Ingvar Branemark describes techniques for the osseointegration of dental implants.


The first commercial home tooth bleaching product is marketed.


New tooth-colored restorative materials plus increased usage of bleaching, veneers, and implants inaugurate an era of esthetic dentistry.


FDA approves the erbium YAG laser, the first for use on dentin, to treat tooth decay.


The National Institute of Dental Research is renamed National Institute of Dental and Craniofacial Research to more accurately reflect the broad research base that it has come to support.

Credit:  Photo credit:;


The History of Dentistry — Advances in Science and Education (19th Century)

We will continue with Part 4 of a 5-part series with fun facts and interesting inventions in the field of dentistry.  The following historical timeline is presented by the American Dental Association. Part 4 will focus on advances and science and education (19th century).


Richard C. Skinner writes the Treatise on the Human Teeth, the first dental book published in America.


Samuel Stockton begins commercial manufacture of porcelain teeth. His S.S. White Dental Manufacturing Companyestablishes and dominates the dental supply market throughout the 19th century.


James Snell invents the first reclining dental chair.


The Crawcours (two brothers from France) introduce amalgam filling material in the United States under the name Royal Mineral Succedaneum. The brothers are charlatans whose unscrupulous methods spark the “amalgam wars,” a bitter controversy within the dental profession over the use of amalgam fillings.


  • The American Journal of Dental Science, the world’s first dental journal, begins publication.
  • Charles Goodyear invents the vulcanization process for hardening rubber. The resulting Vulcanite, an inexpensive material easily molded to the mouth, makes a excellent base for false teeth, and is soon adopted for use by dentists. In 1864 the molding process for vulcanite dentures is patented, but the dental profession fights the onerous licensing fees for the next twenty-five years.


  • Horace Hayden and Chapin Harris found the world’s first dental school, the Baltimore College of Dental Surgery, and establish the Doctor of Dental Surgery (DDS) degree. (The school merges with the University of Maryland in 1923).
  • The American Society of Dental Surgeons,the world’s first national dental organization, is founded. (The organization dissolves in 1856.)


Alabama enacts the first dental practice act, regulating dentistry in the United States. The act called for the assignment of a dentist to the state’s medical board in order to grant licenses for practicing dentistry in the state, however, the act was never enforced, few dentists are ever assigned a seat on the medical board and only a couple of dental licenses are ever granted during the forty years it was on the books.


Dentist William Morton conducts the first successful public demonstration of the use of ether anesthesia for surgery. The previous year Horace Wells, also a dentist, had conducted a similar demonstration that was regarded a failure when the patient cried out. Crawford Long, a physician, later claims he used ether as an anesthetic in an operation as early as 1842, but he did not publish his work.


Robert Arthur originates the cohesive gold foil method allowing dentists to insert gold into a cavity with minimal pressure. The foil is fabricated by annealing, a process of passing gold through a flame making it soft and malleable.


Twenty-six dentists meet in Niagara Falls, New York, and form the American Dental Association.


Sanford C. Barnum develops the rubber dam, a piece of elastic rubber fitted over a tooth by means of weights. This simple device isolates the tooth from the oral cavity, a troublesome problem for dentists.


Lucy Beaman Hobbs graduates from the Ohio College of Dental Surgery, becoming the first woman to earn a dental degree.


The Harvard University Dental School, the first university-affiliated dental institution, is founded. The school calls its degree the Dentariae Medicinae Doctorae (DMD), creating a continuing semantic controversy (DDS vs. DMD).


Dr. Robert Tanner Freeman, graduating from Harvard University Dental School, becomes the first African-American to earn a dental degree.


  • James B. Morrison patents the first commercially manufactured foot-treadle dental engine. Morrison’s inexpensive, mechanized tool supplies dental burs with enough speed to cut enamel and dentin smoothly and quickly, revolutionizing the practice of dentistry.
  • The American George F. Green receives a patent for the first electric dental engine, a self-contained motor and handpiece.


The Wilkerson chair, the first pump-type hydraulic dental chair, is introduced.


The collapsible metal tube revolutionizes toothpaste manufacturing and marketing. Dentifrice had been available only in liquid or powder form, usually made by individual dentists, and sold in bottles, porcelain pots, or paper boxes. Tube toothpaste, in contrast, is mass-produced in factories, mass-marketed, and sold nation-wide. In twenty years, it becomes the norm.


The National Association of Dental Examiners is founded by the members of the dental boards of several states in order to establish uniform standards in the qualifications for dental practitioners, the administration of dental boards overseeing licensing and the legislation of dental practice acts.


The first female dental assistant is employed by C. Edmond Kells, a prominent New Orleans dentist. Her duties include chair-side assistance, instrument cleaning, inventory, appointments, bookkeeping, and reception. Soon “Lady in Attendance” signs are routinely seen in the windows of 19th century dental offices. The American Dental Assistants Association is founded in 1924 by Juliette Southard and her female colleagues.


Stowe & Eddy Dental Laboratory, the first successful industrial-type laboratory in the U.S., opens in Boston, marking the ascendancy of the modern commercial dental laboratory. The earliest known dental laboratory in the U.S. was Sutton & Raynor which opened in New York City around 1854.


  • Ida Gray, the first African-American woman to earn a dental degree, graduates from the University of Michigan School of Dentistry.
  • Willoughby Miller an American dentist in Germany, notes the microbial basis of dental decay in his book Micro-Organisms of the Human Mouth. This generates an unprecedented interest in oral hygiene and starts a world-wide movement to promote regular toothbrushing and flossing.


Wilhelm Roentgen, a German physicist, discovers the x-ray. In 1896 prominent New Orleans dentist C. Edmond Kells takes the first dental x-ray of a living person in the U.S.


Edward Hartley Angle classifies the various forms of malocclusion. Credited with making orthodontics into a dental specialty, Angle also establishes the first school of orthodontics (Angle School of Orthodontia in St. Louis, 1900), the first orthodontic society (American Society of Orthodontia, 1901), and the first dental specialty journal (American Orthodontist, 1907)

Dr. Charles Edmund Kells wrote that he “believed the Roentgen ray [x-ray] is the greatest asset of the oral diagnostician.”
James Snell of London designed and created the first fully adjustable dental chair in 1832.


The History of Dentistry — The Development of a Profession (18th Century)

We will continue with Part 3 of a 5-part series with fun facts and interesting inventions in the field of dentistry.  The following historical timeline is presented by the American Dental Association. Part 3 will focus on the development of the dental profession (18th century).

Paul Revere engaged in America’s first instance of forensic dentistry. After examining bodies found in a mass grave, Revere recognized the dental bridge he had created for his friend Dr. Joseph Warren, and was therefore able to identify his body.



Pierre Fauchard, a French surgeon publishes The Surgeon Dentist, A Treatise on Teeth (Le Chirurgien Dentiste). Fauchard is credited as being the Father of Modern Dentistry because his book was the first to describe a comprehensive system for the practice of dentistry including basic oral anatomy and function, operative and restorative techniques, and denture construction.


Claude Mouton describes a gold crown and post to be retained in the root canal. He also recommends white enameling for gold crowns for a more esthetic appearance.


John Baker, the earliest medically-trained dentist to practice in America, immigrates from England and sets up practice.


Isaac Greenwood practices as the first native-born American dentist.


Paul Revere places advertisements in a Boston newspaper offering his services as a dentist. In 1776, in the first known case of post-mortem dental forensics, Revere verifies the death of his friend, Dr. Joseph Warren in the Battle of Breed’s Hill, when he identifies the bridge that he constructed for Warren.


Frenchman Nicolas Dubois de Chemantreceives the first patent for porcelain teeth.


  • John Greenwood, son of Isaac Greenwood and one of George Washington’s dentists, constructs the first known dental foot engine. He adapts his mother’s foot treadle spinning wheel to rotate a drill.
  • Josiah Flagg, a prominent American dentist, constructs the first chair made specifically for dental patients. To a wooden Windsor chair, Flagg attaches an adjustable headrest, plus an arm extension to hold instruments.


The History of Dentistry — The Beginnings of a Profession (Middle Ages)

We will continue with Part 2 of a 5-part series with fun facts and interesting inventions in the field of dentistry.  The following historical timeline is presented by the American Dental Association. Part 2 will focus on the beginnings of a profession (Middle Ages).

Published in Paris in 1585, illustrations of dental instruments from Ambrose Pare’s Ouvres, Complete Works.


A medical text in China mentions the use of “silver paste,” a type of amalgam.


Guild of Barbers is established in France. Barbers eventually evolve into two groups: surgeons who were educated and trained to perform complex surgical operations; and lay barbers, or barber-surgeons, who performed more routine hygienic services including shaving, bleeding and tooth extraction.


A series of royal decrees in France prohibit lay barbers from practicing all surgical procedures except bleeding, cupping, leeching, and extracting teeth.


The Little Medicinal Book for All Kinds of Diseases and Infirmities of the Teeth (Artzney Buchlein), the first book devoted entirely to dentistry, is published in Germany. Written for barbers and surgeons who treat the mouth, it covers practical topics such as oral hygiene, tooth extraction, drilling teeth, and placement of gold fillings.


In France Ambrose Pare, known as the Father of Surgery, publishes his Complete Works. This includes practical  information about dentistry such as tooth extraction and the treatment of tooth decay and jaw fractures.

Credit:  Photocredit: