Being the new kid on the block isn’t easy. While hydroxyapatite toothpaste is (rightfully) gaining popularity, it doesn’t come without a little skepticism.
After all, fluoride has been on the market for so long. Does hydroxyapatite even compare? If it does, why haven’t you heard of it before now? Is there even a real need to change from fluoride to hydroxyapatite? Change is hard.
We know, change is hard. But keeping an open mind about your oral care and holistic health is important. And don’t worry, we’re here to answer all your questions. That’s why we’re diving deeper into one of the most common questions: how does hydroxyapatite compare to fluoride?
First, let’s start with the history.
why has fluoride been the go-to for so long?
Fluoride was the first one to the party.
In the early 20th century, dental professionals began to investigate the effects of fluoride on tooth decay. Once they realized it could do the job, local governments started adding fluoride to their drinking water (around 1950), and these cities saw impressive tooth decay reduction.
Boom, fluoride became a hero ingredient, and it’s been famous in the oral care world ever since.
This makes sense, tooth decay rates were dwindling, but at what cost? In our humble opinion, there wasn’t enough evidence to fully understand the long-term effects of fluoride consumption and use. At that point, there was such a great need for relief and fluoride was the only reasonable answer. Dental professionals didn’t have the time to wait around for another safer, more natural ingredient that could get the job done.
Fast forward to 1970. While fluoride is flourishing in the eyes of the public, with nearly 45% of Americans drinking fluoridated water and the ADA promoting fluoride toothpaste, NASA (yes, space NASA) began to experiment with hydroxyapatite. Scientists at NASA experimented with hydroxyapatite, testing its effectiveness in repairing the teeth and bones of astronauts returning from microgravity environments. Hint: hydroxyapatite proved to be super effective, so a Japanese company named Sangi Co. LTD purchased the rights from NASA and made the first commercial nano-hydroxyapatite toothpaste in 1978.
Since then, hydroxyapatite has proven to effectively remineralize enamel to prevent tooth decay and provide tooth sensitivity relief. In fact, it’s still considered the gold standard of oral health in Japan. But in other parts of the world, it’s up against a much bigger superstar, fluoride, that has been dominating the market for decades.
Dominating the market for decades means we have years and years’ worth of data on fluoride. Hydroxyapatite simply hasn’t had a fair chance.
how do hydroxyapatite and fluoride differ in action?
It’s no secret that hydroxyapatite and fluoride are both effective in preventing and repairing tooth decay and strengthening the enamel.
Fluoride works by mixing with the calcium and phosphate in your saliva to create a powerful substance called fluorapatite. When fluoride is present in your saliva (emphasis on when, because it doesn’t stick around), it forms a barrier on the surface of your tooth to protect it from acid attacks and harmful bacteria. Fluoride is only effective when you get it from multiple sources several times per day....through your drinking water, toothpaste, mouthwash, etc. because it has to be present and readily available for your saliva to transport it.
Hydroxyapatite, on the other hand, already exists in your enamel, so when you use hydroxyapatite toothpaste, it feels “at home,” effortlessly mimicking your existing enamel and effectively binding to your tooth’s surface. Once it binds to the enamel, it repairs and remineralizes, fortifying your enamel at the source. In fact, research shows that hydroxyapatite has the ability to increase the microhardness of your enamel.
A few other key distinctions between hydroxyapatite and fluoride are listed below.
- toxicity exposure: too much exposure to fluoride can lead to fluoride toxicity, aka dental and/or skeletal fluorosis, which both have unpleasant side effects. That’s why fluoride toothpastes sport a poison control label. In contrast, hydroxyapatite is non-toxic and biomimetic, so there’s no risk of overexposure or need for a poison control label. This is great news for everyone, but even more so for children, pregnant women, and people whose water supply is highly fluoridated.
- naturally occurring: both ingredients are found in nature. Fluoride naturally exists in the earth’s crust, but only hydroxyapatite naturally exists in your body.
- microbiome compatibility: because hydroxyapatite is biocompatible (aka it already exists in your body and works with your body’s natural systems and materials) it’s better for your oral and gut microbiomes. Unlike fluoride, hydroxyapatite also doesn’t automatically kill off the good, essential bacteria in your oral and gut microbiomes.
- teeth sensitivity relief: some research and first-hand claims confirm that hydroxyapatite may be better at relieving teeth hypersensitivity. In our own third-party lab tests, we’ve seen that Davids Sensitive + Whitening Nano-Hydroxyapatite Toothpaste was more effective at plugging tubules and repairing the enamel than leading fluoride toothpastes Colgate Sensitive and Sensodyne Pronamel.
- whitening: unlike fluoride, hydroxyapatite has the ability to whiten your teeth without any help from other whitening ingredients. It does so by penetrating the enamel, repairing imperfections, and replenishing minerals at the source. The result is a pearly white smile.
To us, trying this revolutionary formula is a no-brainer.
what does the research say?
We’ve already mentioned that the evidence supporting hydroxyapatite is strong, but here are a few scientific studies that confirm this.
- Comparison of hydroxyapatite and fluoride oral care gels for remineralization of initial caries: a pH-cycling study reveals that hydroxyapatite was as effective at remineralizing dental caries as fluoride.
- Remineralization of early caries by a nano-hydroxyapatite dentifrice concludes that nano-hydroxyapatite toothpaste is an effective alternative to fluoride toothpaste.
- Remineralization Potential of New Toothpaste Containing Nano-Hydroxyapatite shows that nano-hydroxyapatite is effective at remineralization, and the addition of fluoride had no further effect on remineralization.
- Enamel remineralization and repair results of Biomimetic Hydroxyapatite toothpaste on deciduous teeth: an effective option to fluoride toothpaste compared hydroxyapatite toothpaste with two toothpastes with different fluoride concentrations, and concludes that hydroxyapatite toothpaste is an effective, non-toxic substitute for fluoride.
Science has spoken! You can find more scientific studies on hydroxyapatite linked within the following article.
what could the future hold?
Hydroxyapatite is still up against fluoride’s decades of marketing, but that’s all the more reason to give it a try. In fact, Dr. B of Ask the Dentist reveals in his latest podcast episode that many children already exceed the recommended dose of fluoride from toothpaste alone. Consider fluoridated drinking water and the fluoride treatments given in a traditional dental visit....and you have a recipe for toxicity.
For reasons like this, Dr. B (and we) see a bright future for hydroxyapatite....one where hydroxyapatite reduces our reliance on fluoride toothpaste, treatments, and drinking water and opens our minds to new natural and non-toxic methods of preventive and restorative oral care.
Looking for a change of paste? Try Davids Sensitive + Whitening Nano-Hydroxyapatite Toothpaste. It provides all the benefits of fluoride toothpaste....naturally, without any side effects.