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Hydroxyapatite Vs. Fluoride: How Do They Evaluate?

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Dentists have advisable fluoride toothpaste for stronger cavity-resistant enamel for many years.1 It’s nonetheless thought-about the “gold commonplace” in dental colleges, regardless of its security issues.

However there’s a brand new ingredient on the town confirmed to be simply as efficient as fluoride and utterly non-toxic.

It’s known as hydroxyapatite. Hydroxyapatite toothpaste has changed fluoride toothpaste as what I like to recommend to all of my sufferers. However what’s hydroxyapatite toothpaste?

On this weblog publish, we’ll study hydroxyapatite and check out how fluoride compares with it. 

How Does Fluoride Toothpaste Work?

Your enamel have an outer protecting known as enamel that’s made up of calcium and phosphate. Your saliva additionally incorporates calcium and phosphate that consistently bathe your enamel. These minerals preserve your enamel robust.

Micro organism present in cavities can break down meals particles and create an acidic atmosphere in your mouth. This acidic atmosphere is harsh and may strip away these helpful minerals from the surfaces of your enamel. This course of known as demineralization.  

The fluoride in fluoridated toothpaste works by:

  1. Teaming up with the calcium and phosphate in your saliva and enamel to type a compound known as fluorapatite. This compound appears to be like like a crystal lattice (apatite crystal lattice).
  2. Protecting demineralized enamel with the extra acid-resistant fluorapatite. This remineralizes the enamel, restores their energy, and protects it from additional injury by acid. 

How Does Hydroxyapatite Toothpaste Work?

Hydroxyapatite is a type of calcium that makes up 97% of your tooth enamel and almost 70% of the dentin of your enamel. 

The remainder of your enamel is definitely composed of water, collagen, and different proteins.

Hydroxyapatite is absorbed by the enamel and fills the enamel fissures attributable to demineralization.

Probably the most broadly studied kind of hydroxyapatite is nano-hydroxyapatite. Toothpaste that incorporates nano-hydroxyapatite has particle sizes between 20-80 nanometers (nm). Due to its small measurement, it may possibly insert into actually small areas, which results in higher advantages. 

Not like fluoride, hydroxyapatite works by:

  1. Remineralizing enamel from inside, reaching the innermost a part of a dental cavity
  2. Binding to plaque and dangerous micro organism in our mouth

How does Hydroxyapatite Evaluate to Fluoride in Efficacy?

With regards to which toothpaste is extra environment friendly, there may be actually no distinction between hydroxyapatite and fluoride toothpastes.

One research in contrast 10% hydroxyapatite with 500 ppm F− (amine fluoride), which dentists usually prescribe.2 The researchers found that the ten% hydroxyapatite labored simply in addition to 500ppm F− for remineralization and lesion depth (LD) discount.

The conclusion of the research was that hydroxyapatite toothpaste is the same as fluoride toothpaste relating to efficacy.

Advantages of Hydroxyapatite over Fluoride Toothpastes

Each fluoride and hydroxyapatite can remineralize tooth construction, however right here’s why I desire to advocate hydroxyapatite over fluoride:

  1. Oral microbiome pleasant: Though each have antibacterial properties, fluoride kills decay-causing micro organism and a few good micro organism. However, hydroxyapatite doesn’t kill the micro organism. It prevents dangerous micro organism from attaching to the enamel.3
  2. Fortifies enamel: Hydroxyapatite can enhance the microhardness of enamel.4 The coating of hydroxyapatite reinforces the enamel higher than the fluorapatite coating.
  3. Non-toxic: Hydroxyapatite is biomimetic.5 There aren’t any negative effects with hydroxyapatite—the truth is, it’s secure sufficient to swallow the whole tube of toothpaste! With fluoride, alternatively, there’s a poison management label on the tube, and overexposure causes dental and skeletal fluorosis.
  4. Child-friendly: At an early age, youngsters don’t have full management over swallowing and may ingest massive quantities of toothpaste.6 When this occurs, the fluoride in toothpaste can get absorbed into the bloodstream and trigger dental fluorosis (a change within the look of tooth enamel). Toothpaste that incorporates hydroxyapatite reduces the danger of fluorosis.
  5. Whitens: Hydroxyapatite toothpaste has been proven to lighten the shade of the enamel with out the assistance of any extra abrasives or whitening brokers.7

Is Fluorapatite Stronger than Hydroxyapatite?

Fluorapatite is much less soluble than hydroxyapatite. Because of this in acidic circumstances, fluorapatite is stronger and extra immune to demineralization. 

Nonetheless, this doesn’t imply that fluorapatite toothpaste is best than hydroxyapatite toothpaste. In reality, research present that hydroxyapatite toothpaste is simply nearly as good as fluorapatite toothpaste, with an additional advantage — it helps with dental hypersensitivity.8 

Ought to I Swap to Hydroxyapatite Toothpaste?

To me, this can be a no-brainer. When you have a greater various to fluoride toothpaste and it’s non-toxic, why wouldn’t you? 

To most dentists, this can be a no-brainer as effectively—nonetheless, fluoride remains to be taught because the “gold commonplace” in dental colleges, and there are nonetheless some dentists on the market who may be leery of hydroxyapatite. If that is your dentist, ship them the analysis!

I like to recommend everybody discuss to their dentist about switching to a hydroxyapatite toothpaste, particularly the next classes of individuals:

  • Pregnant girls
  • Individuals who dwell in areas with fluoridated water provide
  • Infants and kids, particularly if they’re beneath the age of six.
  • Folks with delicate enamel, as hydroxyapatite treats the foundation explanation for sensitivity.9

Which Toothpaste Manufacturers Include Hydroxyapatite?

There are two manufacturers of hydroxyapatite toothpaste manufacturers I like to recommend to readers as a result of I exploit them myself they usually even have an applicable focus of hydroxyapatite to be efficacious. There are numerous hydroxyapatite toothpastes on the market, sadly, that don’t include sufficient of the ingredient to have an impact—should you’re undecided, e-mail the corporate and ask for the focus. It needs to be 15% or extra.

Boka Ela Mint Toothpaste

RiseWell Mineral Toothpaste

RiseWell Children’ Mineral Toothpaste (birthday cake taste)

Backside line

The most important benefit of utilizing toothpaste with hydroxyapatite is that it remineralizes your enamel with none negative effects, not like fluoride that’s poisonous in massive portions.

Hydroxyapatite is of course current inside our physique and constitutes most of our enamel.

Each fluoride and hydroxyapatite are scientifically confirmed to reverse dental decay—why not select the much less poisonous one? 


1. Marinho VC, Higgins JP, Sheiham A, Logan S. Fluoride toothpastes for stopping dental caries in youngsters and adolescents. Cochrane Database Syst Rev. 2003;(1):CD002278. doi:10.1002/14651858.CD002278

2. Amaechi BT, AbdulAzees PA, Alshareif DO, et al. Comparative efficacy of a hydroxyapatite and a fluoride toothpaste for prevention and remineralization of dental caries in youngsters. BDJ Open. 2019;5(1):18. doi:10.1038/s41405-019-0026-8

3. Meyer F, Enax J. Hydroxyapatite in Oral Biofilm Administration. Eur J Dent. 2019;13(2):287-290. doi:10.1055/s-0039-1695657

4. Pepla E, Besharat LK, Palaia G, Tenore G, Migliau G. Nano-hydroxyapatite and its functions in preventive, restorative and regenerative dentistry: a evaluate of literature. Ann Stomatol (Roma). 2014;5(3):108-114.

5. Enax J, Epple M. Artificial Hydroxyapatite as a Biomimetic Oral Care Agent. Oral Well being Prev Dent. 2018;16(1):7-19. doi:10.3290/j.ohpd.a39690

6. Bossù M, Saccucci M, Salucci A, et al. Enamel remineralization and restore outcomes of Biomimetic Hydroxyapatite toothpaste on deciduous enamel: an efficient choice to fluoride toothpaste. J Nanobiotechnology. 2019;17(1):17. doi:10.1186/s12951-019-0454-6

7. Niwa M, Sato T, Li W, Aoki H, Aoki H, Daisaku T. Sprucing and whitening properties of toothpaste containing hydroxyapatite. J Mater Sci Mater Med. 2001;12(3):277-281. doi:10.1023/a:1008927502523

8. Pajor Okay, Pajchel L, Kolmas J. Hydroxyapatite and Fluorapatite in Conservative Dentistry and Oral Implantology-A Evaluate. Supplies (Basel). 2019;12(17). doi:10.3390/ma12172683

9. Vano M, Derchi G, Barone A, Covani U. Effectiveness of nano-hydroxyapatite toothpaste in lowering dentin hypersensitivity: a double-blind randomized managed trial. Quintessence Int. 2014;45(8):703-711. doi:10.3290/j.qi.a32240



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