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KARACHI, July 27: Reports suggesting that certain toothpaste brands flooding the local markets contain harmful elements have sounded alarm bells for traders and consumers alike.
The concern reflects a global check a couple of months ago, following a warning issued to consumers by the US Food and Drug Administration (FDA), which increased its scrutiny and testing of imported toothpaste and other dental products after receiving complaints against contaminated Chinese toothpaste brands marketed in several countries.
The FDA issued an import alert last month against certain Chinese toothpaste brands which, according to it, contained dangerous levels of diethylene glycol (DEG), a thickening agent. The FDA said that the relevant safety limit for DEG is 0.1 per cent, as recognised by the US Pharmacopoeia monograph for glycerine.
Potentially harmful ingredients
The Pakistani market is flooded with imported brands of toothpaste and dental products, which are being used by millions of people. Consumers do not have the required awareness to discern whether the product they opt for is free from harmful ingredients. Before using any product, a consumer must satisfy himself about its overall toxicity level and possible effects on oral hygiene and health, said a health-conscious consumer.
It was suggested that the federal and provincial health authorities should keep a strict check on consumer products that may pose a threat to public health. They should ask the manufacturers or importers of all toothpaste brands to print ingredient details on the tubes, prove that the product really contains advertised ingredients such as herbs, cool mint, fluoride, clove oil, stain-cleaner, gel, etc, as well as prove that the product contains no harmful elements.
Studies reveal that DEG, an odourless and colourless organic compound often used in antifreeze and as a solvent, is a liquid with a sharply sweetish taste. It is used as a solvent for vat dyes, glues, gelatine, casein and toothpastes to prevent them drying out.
The US Code of Federal Regulation allows no more than 0.2 per cent of DEG in polyethylene glycol when the latter is used as a food additive.
About the poisonous chemical, it is further learnt that deaths from medicines adulterated with DEG have been reported in South Africa, India, Nigeria, Argentina, Haiti and Panama in recent years. In 1990, about 340 children developed kidney failure in Bangladesh, and most died after being given Paracetamol syrup contaminated with DEG.
In July 2007, China asked its domestic enterprises not to use DEG as an ingredient in toothpaste. Most Chinese toothpaste firms have now stopped using DEG, according to a source.
Regulation necessary
A federal health ministry official confided to Dawn that toothpastes and other dental products cannot be regulated under the 1976 Drugs Act unless the manufacturer uses some synthetic substance or allopathic medicine as an ingredient and approaches the ministry for registration.
Contacted in Karachi, a Customs official said that there was no import alert against imported toothpaste containing DEG, which is frequently imported from the UAE, Thailand, Saudi Arabia, China, Kuwait, Iran and other countries.
Commenting on the unregulated sale of the dubious brands of toothpaste and mouthwash in Pakistan, Dr Mansoor Ahmad, a pharmacognosy professor at the University of Karachi, said that efforts should be made to ascertain the levels of chemical compounds in dental products, particularly those claimed as having anti-septic, anti-fungal, anti-bacterial and anti-spirochetes properties. Toothpastes should be tested for sensitivity and allergies as well, he added.
He said that the ministry of health or some other government agency should be tasked with regulating the toothpaste business since it is directly related to the oral hygiene of millions of people. Information pertaining to contraindications, side-effects, usage and dosage, dates of manufacture and expiry, and formulation should also be counter-checked.
Ishtiaq Ahmed Roomi of the Pakistan Dental Health Foundation said that manufacturers or importers of toothpaste brands should practice restraint for the sake of product credibility.
“Anybody can adopt this enterprise as a general trade activity, which is not in the interests of public health,” he said, adding that DEG is a cancerous chemical and must not be added to a toothpaste formula.
A qualified dentist, Dr A. Naqvi, said that the federal government should move for the certification and scrutiny of oral hygiene products since they are sometimes marketed with false claims. The chemical and pharmaceutical properties of the active constituents of the products used in oral hygiene should be made known to users, as is practised in developed countries, he added.
According to research conducted by a pharmacy student of the University of Karachi, out of nine evaluated oral hygiene products – toothpaste and mouthwash – eight gave no significant results as far as analgesic activity was concerned. In the context of the one showing analgesic activity, it suggested this may be due to the presence of a significant percentage of alcohol.
