The Truth About Fluoride Toothpaste: Should You Switch to Fluoride-Free? -

Fluoride in water and in toothpaste products is a hot topic in the health and wellness space at this time. Is fluoride toothpaste the backbone of healthy teeth? Turns out this may not be the case.

Disclaimer: Please note that I am sharing information based on my research and personal experience. I am not a dental professional, and the information provided in this blog post should not be considered medical or dental advice. The effectiveness of fluoride and fluoride-free toothpastes can vary depending on individual circumstances, oral health, and other factors. Always consult with your dentist or other qualified healthcare professional for personalized recommendations regarding your oral care routine.

Let’s jump into it!

Fluoride works as a topical agent on the teeth, with the mechanism of strengthening the enamel, or the outermost layer of our teeth.

The mechanism of action is actually quite complex. The mouth is a very intelligent environment, your saliva is full of enzymes and free ions whose job it is to break down your food and maintain balance.

But first, what happens when you eat?

Well, the surface of your tooth enamel is composed of this compound called Hydroxyapatite, which is maintained through a buffer system in your saliva.

When the tooth surface becomes acidic after eating, phosphate in saliva combines with hydrogen ions (H+). Under these conditions, phosphate is “pulled” from tooth enamel to restore phosphate levels in the saliva, and the hydroxyapatite dissolves. This is called demineralization. As pH returns to normal, the calcium and phosphate in saliva can recrystallize into the hydroxyapatite, remineralizing the enamel.

In essence, we have this dance of demineralization and remineralization determining the composition of our teeth. So you may be asking, how do cavities form? Cavities or “dental caries” are seen when the demineralization process dominates.

But what actually is causing the acidic demineralization state to be prominent?

Shocker! It’s our diet.

The ultra-processed foods in the American diet are feeding the harmful bacteria in our mouth and elongating the acidic state. In turn, this encourages the demineralization of our teeth, increasing the likelihood of cavities.

Let’s now return to the role fluoride plays in this dance.

In the demineralization and remineralization process, fluoride works to increase the enamel’s resistance to demineralization in acidic conditions. This is due to the formation of fluorapatite in enamel rather than the naturally occurring hydroxyapatite. It is mostly believed that this fluorapatite form is more stable in acidic conditions and thus promoting the remineralization state.

For a considerable period, fluoride has been the globally prevalent active component in toothpastes aimed at preventing tooth decay. Numerous clinical studies with placebo controls have proven the effectiveness of fluoride toothpaste in decreasing dental caries.

To enhance these formulations beyond cavity prevention and address issues like gingivitis and periodontal disease risk, various supplementary ingredients are incorporated. Among these are pyrophosphates, which aid in the reduction of tartar buildup; bicarbonate, used for the removal of dental plaque; and antibacterial substances such as stannous salts, zinc salts, and low-concentration chlorhexidine.

However, the potential of natural elements, including herbal extracts and plant-derived antimicrobials, has been explored, primarily within toothpastes that do not contain fluoride.

Now the question I know everyone is waiting for…

What else is there to use?

There is actually strong evidence supporting the use of hydroxyapatite (HAP) containing toothpastes instead of fluoride. (Yes this is the same compound naturally composing your enamel!) Many fluoride toothpaste formulations contain calcium phosphate additives in an attempt to improve the remineralization and protection of tooth enamel, but recent studies have shown that some ingredients, such as hydroxyapatite, perform as well if not better than fluoridated toothpaste

I would like to quote the analysis from a review paper by Limeback, Hardy et al. “Improving Oral Health with Fluoride-Free Calcium-Phosphate-Based Biomimetic Toothpastes: An Update of the Clinical Evidence.

These studies evaluated 3 different formulations of flouride free toothpastes including hydroxyapatite formulations (HAP) and found strong favorable outcomes.

Dental fluorosis has been an increasing concern, particularly in those countries that continue to fluoridate their drinking water supplies. In addition, there are concerns that prenatal and even postnatal exposure to fluoride is linked to interference with brain function during early development and growth. For these reasons, it is worthwhile to seek alternatives to fluoridated toothpaste.

The fluoride-free, calcium-phosphate-containing toothpaste formulations tested in the studies summarized in this review show great promise in that they have been shown in clinical trials to prevent dental decay, reverse white spot lesions, remineralize tooth enamel, protecting it from erosion, desensitize hypersensitive root surfaces and even improve gingival health, all while whitening and brightening the dentition.

As you can see here, there is strong evidence to support the use of HAP based toothpastes in contrast to those containing fluoride, and the evidence is not just few and far between. This review was performed with 145 individual studies researching this matter.

Find the link to the full article here

What are these alternative, more natural ingredients?

Nano-hydroxyapatite (n-HA): Studies suggest n-HA can remineralize enamel and prevent cavities, potentially as effectively as fluoride in some cases, and is considered biocompatible.

Xylitol: This natural sweetener can inhibit the growth of cavity-causing bacteria.

Baking Soda: Acts as a mild abrasive to help remove plaque and stains.

Essential Oils and Herbal Extracts: Some have antibacterial and anti-inflammatory properties.

Calcium and Phosphates: To help remineralize teeth.

Each of these perform a function just like those used in typical fluoridated toothpastes but are based on natural compounds rather than the synthetics.

My Experience

I have been using a fluoride free n-HA based toothpaste for the last 6 months or so. I can confidently say that my teeth and gums are healthy, and my teeth even appear whiter and brighter than before. While limiting my processed food intake, this has been an effective way to keep my teeth healthy!

If you are thinking about making the switch for a number of reasons, from dental or bone fluorosis to neurotoxicity, I would suggest you give it a try.

No affiliation with the team but I do use toothpaste from Cocolab as well as their ultrasoft bamboo toothbrush!

But first, what happens when you eat?

Let’s now return to the role fluoride plays in this dance.

What else is there to use?

What are these alternative, more natural ingredients?

My Experience

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