If you’ve brushed your teeth in the past 70 years, chances are you’ve heard about fluoride and its role in preventing cavities. What you might not be as familiar with is hydroxyapatite (HA), a safe, natural, and incredibly effective alternative that has been growing in popularity.
In this guide, we’ll break down what hydroxyapatite is, why it’s a game-changer for your oral health, what to look for when picking an HA toothpaste, and why it just might be a better choice for your teeth.
But first, let’s address the elephant in the room...
what are the concerns with fluoride?
Fluoride has been a staple in dental care for decades due to its ability to prevent cavities. It works by pulling calcium and phosphate from your saliva to create fluorapatite, which hardens enamel and helps remineralize your teeth. But while fluoride can have its benefits, it also comes with a few important limitations, and growing concerns from consumers.
biological limitations
Saliva resources: For fluoride to be effective, your saliva needs to be rich in calcium and phosphate to form fluorapatite. If these minerals are lacking, even high-strength fluoride toothpaste might not work as well.
Dry mouth (xerostomia): Saliva is crucial for the remineralization process. People with dry mouth conditions may not get the full benefits of fluoride due to reduced saliva production.
dose dependent
Fluoride’s effectiveness depends on hitting just the right amount, but finding that balance can be challenging. The benefits of fluoride are highly dose-dependent, meaning that too little fluoride won’t provide sufficient protection, while too much can have negative consequences for both your teeth and overall health.
Too much fluoride: Excessive fluoride exposure can lead to conditions like dental fluorosis and, in more severe cases, skeletal fluorosis. Over time, consuming too much fluoride can harm developing teeth, resulting in visible white spots or streaks on the enamel. In extreme cases, excess fluoride can impact bone density and joint health.
Too little fluoride: On the other hand, if fluoride levels are too low, it won’t be able to effectively prevent tooth decay or remineralize enamel. This can lead to cavities and enamel erosion over time, especially if your oral environment (such as the levels of calcium and phosphate in your saliva) doesn’t naturally support remineralization.
The problem is, achieving the “optimal” fluoride dose varies from person to person, depending on factors like their oral microbiome, diet, and mineral levels. It’s hard to predict whether your fluoride toothpaste or treatment is giving you just the right amount or whether you’re inadvertently getting too much or too little from other sources, like drinking water.
potential health concerns
Dental fluorosis: Overexposure to fluoride during tooth development can result in dental fluorosis, which shows up as white spots or streaks on teeth.
Skeletal fluorosis: Long-term excessive fluoride intake can lead to skeletal fluorosis, a condition that causes joint stiffness and pain.
Neurotoxicity: Some studies have raised concerns about the potential neurotoxic effects of fluoride, with possible links to reduced IQ in children exposed to high levels during pregnancy.
environmental impact
Fluoride is also a potential concern for the environment. We all know that fluoride is commonly added to public water supplies and used in a variety of dental products. However, excessive amounts of fluoride that run off into groundwater, rivers, and lakes can accumulate in the environment over time, impacting wildlife and ecosystems. Certain regions have reported harmful levels of fluoride in water sources, contributing to soil and water contamination.
Fluoride toxicity can affect aquatic life, leading to reduced reproduction rates and growth in some species of fish and amphibians. It may also contribute to soil degradation and decreased agricultural productivity in areas where fluoride levels are high. While fluoride is beneficial in specific controlled applications for dental health, its impact on the environment is an increasing concern that warrants further research and consideration.
hydroxyapatite: more than just a fluoride alternative
Now that we know there are potential issues and concerns with fluoride, what can we do instead?
Some popular fluoride alternatives like xylitol, arginine, and calcium phosphates offer some benefits for oral health, but they don’t remineralize enamel or prevent cavities as effectively as fluoride by themselves.
Hydroxyapatite, especially in its nano form, is more than just a fluoride alternative, it actually outperforms fluoride at enamel repair and remineralization without the safety concerns.
what is hydroxyapatite?
Hydroxyapatite may be a long and tricky word to pronounce, but it’s actually a common and straightforward naturally occurring material. In fact, it’s a naturally occurring substance that plays a significant role in your body.
main component of bones and teeth
Hydroxyapatite (HA) makes up around 70% of human bone and 97% of tooth enamel, providing structural strength and hardness. In its purest form HA is white, which is why your bones and teeth are naturally white as well.
calcium and phosphorus based
To be a bit more scientific, hydroxyapatite is a naturally occurring form of calcium phosphate with the chemical formula Ca₁₀(PO₄)₆(OH)₂, known for its crystalline structure.
biocompatibility
Since it already exists in your body, hydroxyapatite is highly biocompatible. This means it can naturally integrate with human tissue, making it safe for use in medical implants and dental applications.
what is nano hydroxyapatite?
Originally developed by NASA to combat bone and enamel loss experienced by astronauts in microgravity, nano hydroxyapatite (nHA) is essentially a more refined, and much smaller, version of the hydroxyapatite that already exists in your body.
The nano scale allows deeper penetration into the enamel and dentin to repair damage and remineralize extremely efficiently.
not saliva dependent
Nano hydroxyapatite does not rely on the calcium and phosphate in your saliva to work. In fact, it is primarily made up of calcium and phosphate, introducing more of those elements into your saliva on its own. This means nHA works regardless of saliva conditions.
biocompatible / biomimetic
Nano hydroxyapatite feels right at home in your mouth. Since your teeth are primarily composed of hydroxyapatite, they naturally recognize and absorb the nano particles. This allows for remineralization from the inside out, unlike fluoride, which only coats the surface.
safe and non-toxic
Nano hydroxyapatite poses no risk of toxicity or overexposure since it is recognized by the body. This makes it safe for all ages, even children who tend to swallow toothpaste.
repairs as well as protects:
Whereas fluoride works to harden the enamel, nHA actually rebuilds enamel and repairs early-stage decay while smoothing out any imperfections in your tooth surface. This increases whiteness, reduces sensitivity, and strengthens your teeth for a longer lasting solution to oral health concerns.
remineralization and sensitivity relief
Independent third party lab tests show how exposed dentin tubules (the holes in enamel that cause sensitive teeth) are filled in and the enamel is strengthened after just 5 days of brushing with Davids nano hydroxyapatite toothpaste.
Before
After
nano vs. micro hydroxyapatite
does particle size really matter?
The short answer: yes, it absolutely does. The difference between nano hydroxyapatite (nHA) and micro hydroxyapatite (mHA) lies in their particle size, and that difference impacts how effectively each can interact with your teeth. nHA is much smaller, allowing it to penetrate the enamel more deeply, while mHA tends to remain on the surface.
penetration and remineralization
Nano hydroxyapatite’s smaller particle size allows it to penetrate deep into enamel, filling in microscopic cracks and restoring minerals more effectively.
Micro hydroxyapatite, while still beneficial, primarily remains on the tooth’s surface and doesn’t reach the same depths to effectively remineralize or give sensitivity relief.
sensitivity relief
Nano hydroxyapatite can occlude exposed dentin tubules more thoroughly, reducing tooth sensitivity at the source.
Micro hydroxyapatite provides some surface level relief but doesn’t penetrate as deeply, meaning it may not be as effective for more severe cases of sensitivity.
aesthetic benefits
Nano hydroxyapatite not only strengthens teeth but also helps smooth the enamel surface, enhancing the natural shine of your teeth.
Micro hydroxyapatite, though it offers some protection, doesn’t polish or brighten teeth to the same extent as nano particles can.
not all hydroxyapatite is created equal
Unfortunately, as hydroxyapatite gains popularity and mainstream appeal, many ineffective, inferior, and sometimes dangerous products are coming to the market. It is important for buyers to understand the differences and make informed decisions.
Here are some things to look out for:
particle size
Just because a toothpaste tube says “hydroxyapatite” does not mean that it contains the same ingredients as another. Only nano sized particles (around 50 nm) are small enough to fill in the dentin tubules and microscopic fissures in your enamel. Some companies use cheaper and much larger micro hydroxyapatite, or even calcium carbonate coated in hydroxyapatite (which is 100X larger than the particle size shown to be effective).
particle shape
There are many shapes of nano hydroxyapatite including rod, circle, needle, and irregular. However, only rod shaped
nHA is shown to be the most effective. Some companies use the cheapest needle shaped particles which are banned in the EU over concerns of causing cell damage!
percentage focused marketing
Many companies put a lot of emphasis on the percentage of hydroxyapatite in their products, but don’t talk about how well it performs. This is just a marketing ploy. Any product that focuses on percentage of hydroxyapatite should be looked at carefully, because they are likely using lower cost materials.
Davids focuses on the performance of products, not the percentage.
nano hydroxyapatite
The extremely small size of nano hydroxyapatite allows it to fill in and block exposed tubules leading to nerves in teeth. It also acts as a filler to repair small holes and depressions on the enamel surface creating a smoother, whiter smile. Davids uses nano hydroxyapatite in their Hydroxi™ formulations.
healthy enamel and gumline
Prevention is key when it comes to good oral health. Maintaining healthy, strong enamel and gums is easier than trying to fix problems later. While fluoride, and hydroxyapatite both serve to strengthen enamel and prevent cavities, nano hydroxyapatite may help to reduce inflammation in your gums and promote overall gingival health as well.
dentin layer
Dentin is the the softer, yellowish layer under the enamel. If your pearly whites are looking less pearly, it may be because your enamel has worn away and the dentin is now becoming exposed. Some other effects of exposed dentin are dentinal hypersensitivity, dentinal sclerosis, and a higher risk of tooth and bloodstream infection.
exposed dentin tubules
Tooth enamel is extremely strong, but over time it wears down due to age, improper brushing, acidic and/or sugary food and drink, and multiple other factors. Your gumline could also shrink. These issues cause your dentin tubules to be exposed, and leads to sensitive teeth and increased risk of cavities.
micro hydroxyapatite
Conventional micro hydroxyapatite particles are much too large to effectively seal dentin tubules, smooth the surface, or penetrate into the enamel for efficient remineralization. It is important to know that micro hydroxyapatite is NOT what was developed by NASA or what is shown to be effective.
choosing the best toothpaste
We have talked a lot about nano hydroxyapatite, micro hydroxyapatite, and fluoride. But, which is right for you and your family?
| nano HA | micro HA | fluoride | |
|---|---|---|---|
| prevents tooth decay |  | | |
| remineralizes enamel from the inside out | |  | |
| non-toxic and safe for all ages | | | |
| provides lasting sensitivity relief | | | |
| naturally whitens teeth | | | |
| biocompatible | | | |
| not dose dependent | | | |
the clean alternative to fluoride
Hydroxi™
Hydroxi™ is Davids proprietary blend of nano hydroxyapatite (nHA) and natural ingredients designed to provide superior enamel repair, sensitivity relief, whitening and overall oral health.
does your toothpaste have Hydroxi™?
Nano hydroxyapatite is only one piece of the puzzle when it comes to highly effective oral care. The rest of the equation is in how that ingredient is blended and formulated for maximum performance.
Hydroxi™ redefines oral care by combining naturally sourced and derived ingredients with cutting-edge science to deliver high performance products which effectively whiten teeth, fight plaque, and freshen breath better than the competition.
shop Hydroxi™
