Wrestle beteween fluoride and fluroride free toothpastes


Wrestle No More Between Fluoride and Nano-hydroxyapatite Toothpaste. They Both Work.



How does nano-hydroxyapatite (nHA or n-HAp) compare to fluoride in terms of protecting teeth, and how can you make the best decision for yourself on whether to use fluoride?

First, let’s start with why fluoride is in toothpaste and why more individuals seem to be asking their dentists whether they should use a fluoride-alternative.

Fluoride is popular in toothpaste because it has consistently demonstrated an ability to prevent development of dental caries (tooth decay) and it effectively remineralizes lesions. It has been one of the longest-standing proven ingredients for effective oral care.

So, why are people asking about fluoride-free toothpaste?

Although the positive effects of fluoride in oral care are clear, when using fluoride, it is important to follow recommended dosage to prevent risk from excess amounts. Excess fluoride may cause fluorosis, which is cosmetic damage to teeth in children from overexposure to fluoride. Additionally, there are instances of fluoride overexposure stemming from ingesting water that may contain high levels of fluoride.

We understand that these systemic effects from fluoride may cause concern in some patients, which is why we use the fluoride alternative, nano-hydroxyapatite.

Then what is nano-hydroxyapatite (nHA), the fluoride-alternative?

Hydroxyapatite is a material that naturally occurs in our bones, teeth and saliva. And nano-hydroxyapatite has been shown to remineralize enamel by replacing minerals such as calcium and phosphate, that are lost from acid produced by bacteria. NASA was the first to medically apply nHA in 1970 to repair and remineralize astronauts’ teeth and it has been adapted for use in Japanese oral care products for many years to restore enamel and alleviate teeth sensitivity.

Clinical studies published have shown that nano-hydroxyapatite is comparable to fluoride in remineralizing teeth, though both do so in different ways. These remineralizing agents are crucial in maintaining healthy teeth. With fluoride, teeth are strengthened and protected from decay as fluoride forms a protective material around teeth called fluorapatite by binding to calcium and phosphate ions found in saliva. Nano-hydroxyapatite (nHA) is a crystalline calcium phosphate that directly binds to tooth surfaces and replaces lost minerals. Nano-hydroxyapatite is highly resistant to acid and is ideal for restoring demineralized tooth structures and smoothing surfaces, hence yielding brightened, more opaque teeth and alleviating teeth sensitivity.

Why or when should I use fluoride-alternative toothpaste?

Nano-hydroxyapatite toothpaste is a great choice for anyone who wants to prevent tooth decay or needs to restore their enamel. It is an especially great choice for children or anyone who is looking for more natural toothpaste. Nano-hydroxyapatite toothpaste is also ideal for xerostomia patients who have less amounts of calcium and phosphate available from reduced saliva, or patients with thyroid conditions who are sensitive to fluoride. In European and Asian countries, nano-hydroxyapatite is a very widely used natural material in oral care products for the reasons mentioned above.

We understand that these systemic effects from fluoride may cause concern in some patients, which is why we use the fluoride alternative, nano-hydroxyapatite.

We hope this article helps you have a better understanding of fluoride and nano-hydroxyapatite toothpaste. Our goal is to allow you to decide on which type is the best choice for you and your family with confidence. The answer could be fluoride, or it could be nano-hydroxyapatite (nHA), or it may be both for different purposes or different members of your family.

For more detailed research on Nano-hydroxyapatite and its applications in preventive, restorative and regenerative dentistry, please check National Center for Biotechnology Information here.


Bossù, M.,et al. A. Enamel remineralization and repair results of Biomimetic Hydroxyapatite toothpaste on deciduous teeth: an effective option to fluoride toothpaste. Journal of nanobiotechnology, 17(1) (2019).

Dass, Issa, et al. Comparison between Fluoride and Nanohydroxyapatite in Remineralizing Initial Enamel Lesion: An in vitro Study. JCDP. 19 (3): 306-312 (2018) Ramis, J. M., Coelho, C. C., Córdoba, A., Quadros, P. A., & Monjo, M. Safety assessment of nano-hydroxyapatite as an oral care ingredient according to the EU cosmetics regulation. Cosmetics, 5(3), 53. (2018).

Swarup, J. S. & Rao, A. Enamel surface remineralization: using synthetic nanohydroxyapatite. Contemp. Clin. Dent. 3, 433–436 (2012)