Toothpaste is a paste or gel dentifrice used with a toothbrush as an accessory to clean and maintain the aesthetics and health of teeth. Toothpaste is used to promote oral hygiene: it serves as an abrasive that aids in removing the dental plaque and food from the teeth, assists in suppressing halitosis, and delivers active ingredients (most commonly fluoride) to help prevent tooth and gum disease (gingivitis). Most of the cleaning is achieved by the mechanical action of the toothbrush, and not by the toothpaste. Salt and sodium bicarbonate (baking soda) are among materials that can be substituted for commercial toothpaste. Toothpaste is not intended to be swallowed due to the fluoride content, but is generally not very harmful if accidentally swallowed in small amounts; however, one should seek medical attention after swallowing abnormally large amounts.