The average American will use 20 gallons of toothpaste in their lifetime, and a new study by the Cornucopia Institute, a non-profit organization that studies ecological best practices, makes clear we should all be concerned about exposure to toxic ingredients found in toothpastes. Chemicals in toothpaste are readily absorbed through the membrane that lines the mouth (oral mucosa), meaning that, regardless of whether you swallow toothpaste or not, you are exposing yourself to some level of absorption. Children, who we know often do swallow toothpaste, are even more at risk.

When we use personal care products, we make the assumption that what we have purchased is safe and won’t harm us. We might be assuming wrong. Look no further than the current problems faced by some users of Wen hair products. Unlike pharmaceuticals, which are regulated closely by the Food and Drug Administration, the cosmetic industry, which includes personal care products like shampoos, hair care and toothpaste, is free from scrutiny from the FDA. The regulatory agency has no power of review or recall over products, nor are industry products required to even list all of their ingredients. Instead, the $71 billion industry regulates itself. And that always works out great!

Self-regulation results in a startling difference between products sold in the U.S. and those sold in Canada, Europe and Japan, where personal care products are more closely regulated. “We have a very weak regulatory system in the United States, compared to Europe and other industrialized countries, in terms of evaluating synthetic compounds in our food and personal care products,” says Mark Kastel of the Cornucopia Institute. “Other countries operate on the ‘precautionary principle,’ assuring that chemicals are safe before they are authorized for use. In our system of government, dominated by corporations funding congressional campaigns and employing legions of lobbyists and lawyers, we don't end up evaluating dangerous chemicals until after they have already been introduced into our bloodstreams.”

For instance, of the more than 12,000 ingredients used in cosmetics, most with chemical names unintelligible to the average consumer, just 11 of them are restricted for use in the U.S. Contrast that with over 1,300 ingredients banned in Europe. (The industry, in fact, reformulates its products for sale abroad, substituting banned ingredients.) Last year, senators Dianne Feinstein from California and Susan Collins from Maine introduced the Personal Care Products Safety Act of 2015, mandating that the FDA begin regulating ingredients in personal care products, but even if it eventually passes, removal of any toxic ingredients is likely many years away.

Meanwhile, many of those banned-abroad chemicals show up in U.S. products that Americans use every day. Consider that an average man uses up to seven personal care products a day, including toothpaste, containing up to 85 unique chemicals. An average woman uses up to 12 products containing up to 168 chemicals, and a teenage girl can use up to 17 products with over 200 chemicals. That’s a lot of exposure to ingredients that may be toxic, at least as far as other developed countries are concerned.

Don’t be fooled by toothpaste labels like “natural” either. The label is meaningless, and does not preclude the possibility that potentially harmful ingredients may be present. In fact, some “natural” toothpastes are owned by the same companies that produce conventional toothpastes (Tom’s of Maine, for instance, is owned by Colgate). And that American Dental Association Seal of Approval? The ADA is partially subsidized through acceptance fees by the personal care industry, and the seal of approval does not necessarily mean the toothpaste is harmless.

In the early 1900s, toothpaste contained natural food colorings derived from plants, but as artificial colorings began to be developed from petroleum sources, these natural dyes were phased out due to their higher costs. Artificial dyes may contain up to 10 percent impurities, and some of these undesired ingredients include lead, arsenic, mercury, and carcinogens. Additionally, artificial colorings have been linked in some studies to behavioral problems in children. And even in natural toothpastes, which do not contain artificial colorings, most contain metal oxides like zinc, titanium and iron. These metals can build up in the body, and while some of them, like iron, are important for optimal bodily function, they are required in tiny doses, and in excess, can cause harm.

Toothpastes both conventional and “natural” are chock full of other suspect ingredients.

Carrageenan: an additive derived from seaweed that is used as a thickener. Carrageenan has been shown to cause intestinal inflammation, which can potentially lead to cancer.

DEA (diethanolamine): a compound used to make your toothpaste foam. It has been shown to cause eye and skin irritation, and worse, has been linked (in mice) to liver cancer. DEA can also react with other compounds not present in toothpaste to form nitrosamines, another known carcinogen.

Fluoride: a mineral used in toothpaste to strengthen tooth enamel and help prevent cavities. Although the debate over fluoride safety is an old one, it is known that fluoride is poisonous, and ingesting it can cause tooth discoloration and pits in the tooth enamel. Some studies have linked it to bone cancer in men, skeletal fluorosis and even impaired brain function.

Formaldehyde-releasing preservatives: these include a whole list of chemicals used to preserve the toothpaste. These chemicals release small amounts of formaldehyde that can be absorbed through the mouth membrane. Formaldehyde can cause eye and skin irritations and can also trigger allergies. It is also a known carcinogen.

GMO-based ingredients: which can include glycerin, xylitol, sorbitol, lecithin, xanthan gum, citric acid and maltodextrin. Like fluoride, ingredients that have been genetically modified have long been the subject of widespread debate over their safety.

Parabens: are used as preservatives, as well as in fragrance formulas. These compounds can act like the hormone estrogen, and are suspected to be endocrine disruptors. Endocrine disruptors are thought to potentially lead to cancer, as well as developmental and reproductive issues.

The list gets longer: polyethylene glycol, propylene glycol, sodium lauryl sulfate, sodium laureth sulfate, triclosan, among others. Add to these the various abrasives, flavorings, detergents, and whiteners, all of which have, to one extent or another, been linked to potential health issues.

It is important to note that all of the ingredients above have their supporters as well as their detractors. Supporters will point to the fact that many of the studies linking the chemicals to health issues are small scale, flawed or misinterpreted. Additionally, drawing conclusions about human health from testing on animals is fraught with uncertainty.

Nevertheless, for the concerned consumer who may not want to leave her health or her child’s to chance, there are ways to avoid introducing possibly toxic ingredients into an area of your body that readily absorbs them. “The annual cost difference between buying one of the safest, organic choices, in comparison to mass-market toothpaste, is incredibly small and I would suggest worth the investment,” notes Kastel. A few brands of organic toothpaste manage to clean your teeth without potential harm to your health. Or you can actually make your own toothpaste.

Most important of all, you should make your concerns known. As an essentially self-regulated industry, the personal care companies mostly respond to their bottom line. If sales are good, they will see no reason to upset the apple cart. However, if enough consumers complain about the issues they are concerned about, and back it up by making it known they are not purchasing a product until changes are made, rest assured the industry will respond.