A peer-reviewed journal that offers evidence-based clinical information and continuing education for dentists.

Peer to Peer: Solving the SnF2 Problem

Through stabilizing stannous fluoride with zinc phosphate, Colgate has created a toothpaste with all of the benefits of SnF2, but few of the downsides.


Stannous fluoride (SnF2) has been used in toothpaste for several decades due to its effectiveness in caries prevention. In addition, SnF2 offers antibacterial activity, leading to reduced plaque formation and lower risk for gingivitis, as well as occlusion of dentin tubules, decreasing hypersensitivity. However, traditional toothpastes containing SnF2 have been known for their poor taste and propensity to stain due to oxidation of the tin from a 2+ state to 4+ state. This oxidation also leads to a decrease in the toothpaste’s clinical performance.

Traditionally, scientists have endeavored to increase the stability of SnF2 in toothpaste formulations by reducing water content, adding additional stannous salts (such as stannous chloride) to act as a sacrificial source of stannous ions, or adding stabilizing agents. All of these approaches limit the effectiveness of the paste. Low-water formulations typically lead to poor esthetics, in addition to creating foaming and a negative taste and texture, which hurt patient compliance. The addition of sacrificial sources of stannous leads to increased risk of staining and poor taste.

Colgate-Palmolive has developed a break­through with respect to SnF2 toothpaste formulations to effectively solve the problems associated with its use. The addition of zinc phosphate stabilizes the SnF2 in the 2+ active state. This allows the development of a high-water formulation and eliminates the need for sacrificial sources of stannous. The resulting new toothpaste — Colgate TotalSF — provides a positive patient experience, which is critical for compliance.

Staining is a well-known byproduct of poorly stabilized stannous fluoride toothpaste. In a six-week stain removal clinical study, participants using Colgate TotalSF demonstrated statistically significant reductions in extrinsic stain of 17.5% at three weeks and 27.8% at six weeks, compared with regular fluoride toothpaste.1 Rather than causing staining, Colgate TotalSF reduces staining when used regularly over six weeks.

Whole Mouth Health

Colgate TotalSF is an innovative toothpaste to help people achieve Whole Mouth Health. The formulation took more than a decade to develop due to the novel approach of stabilizing SnF2 with zinc phosphate. The formulation has more than 40 patents and 86 patents pending, as well as a comprehensive clinical support dossier. The resulting toothpaste, Colgate TotalSF, provides patients with a pleasant user experience, reductions in bacteria on 100% of mouth surfaces, and protection against caries, plaque, gingivitis, calculus, stains, malodor and dentinal hypersensitivity.


  1. Li Y, Suprono M, Mateo LR, et al. Solving the problem with stannous fluoride: extrinsic stain. J Am Dent Assoc. 2019;150:S38–S46.



From Decisions in Dentistry. June 2019;5(6):8.

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