Toothpaste with synthetic tooth minerals can prevent cavities as effectively as fluoride

Fluoride in toothpaste can pose health problems in some cases, especially for children who consume too much fluoride by swallowing most of their toothpaste: children normally use only a tiny dose of toothpaste to avoid these problems, but that reduces toothbrushing efficacy. In the search for alternatives, a team of international scientists and Polish clinicians have identified a hydroxyapatite toothpaste that works just as well as fluoride toothpaste to protect against cavities.

Hydroxyapatite is a calcium phosphate mineral found in the skeleton. It’s known to be very safe for human consumption and has previously been shown to help with oral conditions like periodontitis. It can both inhibit the demineralization of teeth, a key step towards a cavity, and contribute to remineralization, which reinforces damaged tooth surfaces.

To see if it would help patients without specific dental conditions, the clinicians recruited 189 adults aged 18-45 to take part in an 18-month-long double-blind randomized clinical trial. They aimed to see all patients through to the end of the study without an increase in cavities.

171 patients completed the trial, evenly split between the hydroxyapatite toothpaste group and the control group with fluoridated toothpaste. All patients had at least 10 teeth without cavities, were willing to use an electric toothbrush, and had no pre-existing tooth problems in need of treatment.

At the end of the trial, the scientists found that nearly 90% of patients in both groups had no new cavities. There was no statistical difference in efficacy between the patients using hydroxyapatite toothpaste and the control group using fluoride toothpaste: both worked equally well.

Reference: Caries-preventing effect of a hydroxyapatite-toothpaste in adults: A 18 months double-blinded randomized clinical trial, Frontiers in Public Health, DOI 10.3389/fpubh.2023.1199728