Well, when people will pay $60 for a heatsink that'll drop the temp 10 C over a cheapo, it doesn't make a lot of sense not to put some TIM between the sink and the slug, which may drop the temp 30 degrees. The more heat the CPU puts out, the worse it gets.
Both the pads and goo are TIMs (Thermal Interface Material). They fill in the molecular irregularities of the interface at best. Ordinary processes cannot make a material flat at the molecular level, so the direct contact area is a small fraction of the apparent area. At worst they fill in major gaps of non-flat, junky HSs. The worse the HS, the more you need the TIM. On the other side, nobody but an idiot would leave out the TIM after paying the bucks for a great HS.
There is more than one kind of pad. The good kind are phase change material, so called because they change from a solid to a fluid under heat and/or pressure. After a week they flow and squeeze out till they are about as thin as AS. Most of the ones I have seen are gummy or rubbery at room temp. I just got a sink that has another kind. It is a tape, sticky on the side that is stuck to the sink, then a foil (aluminum?) and then a delicate waxy coating, about the consistency of chocolate and the thickness of paint, on the part going to the CPU slug. Unfortunately the waxy stuff is so delicate that I scraped it so the foil shows by brushing it up against the plastic package, rendering it useless. ( As if I were going to use it

But I would have liked to try it out.) I don't know how you could clip the HS on without trashing that coating in the process.
The supreme guru on the OC newsgroup when I used to read it used only pure margarine as his TIM. (Yes the butter substitute. But the newer crop of low calorie stuff has other junk in it besides pure hydrogenated oil.) Toothpaste ought to work as a temporary measure, at least until it dries out and hardens up. Even the low priced HSs I have got generally include a teeny pack of goo, enough for several applications to an Athlon. Put some plastic wrap on your finger and smear enough TIM on the CPU slug so it looks covered. No need to butter it up; it's going to squeeze out anyway, and it will make a mess. Put just enough on the HS where it will contact the slug to be visible but look almost dry.