Dentists weigh in on rising popularity of hydroxyapatite toothpaste
While new research suggests the mineral can protect teeth as well as fluoride, experts caution that long-term data remains scarce.
By Rebecca Foster ·
Patients are increasingly asking their dentists about toothpaste that replaces fluoride with a mineral called hydroxyapatite.
Dental professionals note a shift in consumer preference, driven by social media marketing and a growing hesitation toward fluoride. Dr. Jin-Ho Phark, an associate professor at the University of Southern California, observes that students and patients frequently inquire about these alternatives. He attributes the surge to influencers promoting the products heavily online.
The debate over fluoride has intensified following public criticism from Health Secretary Robert F. Kennedy Jr., who has linked water fluoridation to various health issues, including bone cancer and neurodevelopmental disorders. While the Centers for Disease Control and Prevention states that fluoride in water reduces cavities by 25%, some consumers are now seeking fluoride-free options for their children. Bennett Amaechi, a professor of dentistry at the University of Texas at San Antonio, says he is seeing more people who are hesitant or refuse fluoride entirely.
Hydroxyapatite is a calcium phosphate mineral that mimics the structure of tooth enamel. Unlike fluoride, which forms a protective shield, hydroxyapatite is thought to penetrate tiny pores in the enamel to repair damage. Early research supports its effectiveness. A 2021 study in Scientific Reports tracked 177 children for a year and found that hydroxyapatite toothpaste performed similarly to fluoride in preventing decay. A subsequent 2023 study in Frontiers in Public Health with 171 adults reached the same conclusion after 18 months of testing.
Despite these positive results, experts emphasize that the evidence base for hydroxyapatite is still young. Dr. Livia Tenuta, a dentist at the University of Michigan, points out that most studies involve participants with low risk of tooth decay. She notes that long-term data for high-risk patients is limited. A 2019 study involving 133 high-risk individuals found similar results between the two ingredients after five months, but the sample size and duration remain smaller than decades of fluoride research.
The American Dental Association acknowledges that hydroxyapatite can contribute to remineralization but describes the clinical evidence as limited and ambiguous. The organization continues to recommend brushing twice daily with fluoride toothpaste and flossing daily. For consumers, the choice often comes down to cost, as hydroxyapatite products frequently cost more than a dollar per ounce more than their fluoride counterparts.
Dr. Amaechi advises patients who are open to both options to stick with fluoride due to the extensive volume of supporting evidence. He notes that while hydroxyapatite shows promise, the long-term safety and efficacy profile for fluoride is well established.
