Toothpaste Ingredients and Potential Carcinogenic Risks: A Systematic Review and Meta-Analysis

Toothpaste is universally used for oral hygiene, but several of its ingredients have raised concerns over long-term health effects, including carcinogenic potential. This systematic review evaluates commonly used components- fluoride, triclosan, parabens, surfactants, preservatives, titanium dioxide, artificial sweeteners, carrageenan, and heavy metals- based on in vitro, in vivo, and epidemiological studies. While many compounds are considered safe at regulated levels, emerging evidence indicates possible genotoxic, endocrine-disruptive, or tumor-promoting effects with chronic or high-dose exposure. Using PRISMA methodology, 1,248 records were screened, and 92 studies were included. Forest plots and comparative risk analyses reveal that while most ingredients remain within safe margins, specific compounds- triclosan, formaldehyde-releasing preservatives, DEA, parabens, TiO? nanoparticles, and heavy metals- pose plausible long-term health risks. Consumers and clinicians should weigh benefits against risks and favor safer alternatives when available.