A new kind of toothpaste has come onto the scene, challenging fluoride’s #1 seat at the cavity-defense table. But does hydroxyapatite (HAp) really work to protect and strengthen teeth? Is it safe? Should you use it?
If you’re done with fluoride and ready to move onto something better and fluoride-free, this is the toothpaste for you.
So, let’s start with the burning question: What exactly is hydroxyapatite, and why is it in toothpaste?
Hydroxyapatite (HAp), in its natural form, is a form of calcium that makes up 97% of your tooth enamel and 70% of the dentin of your teeth. The rest of your enamel is actually composed of water, collagen, and other proteins. The high HAp concentration in tooth enamel is the reason it’s so strong.
5 Benefits of Hydroxyapatite:
It can prevent and heal cavities.
Every time HAp has been pitted against fluoride toothpastes, it either performs equally well or better as a remineralizing agent.
It increases the microhardness of human enamel and prevents and reverses enamel erosion more effectively than over-the-counter fluoridated toothpaste.
A concentration of 10% hydroxyapatite was just as effective as an amine fluoride toothpaste in a December 2019 study for preventing and reversing tooth decay in children.
HAp was successfully able to shrink lesions of decay (called “caries lesions” or “carious lesions”) on teeth and improve enamel remineralization in a study conducted in Japan. According to the authors, the more hydroxyapatite in the toothpaste, the better it restored the enamel surface.
In 2019, a study found that the use of hydroxyapatite toothpaste actually created a coating on the teeth more sturdy than that formed by fluoride toothpaste. This helped to strengthen enamel for future resistance to breakdown.
And unlike fluoride toothpaste, hydroxyapatite toothpaste won’t ever cause fluorosis.
It’s non-toxic & biocompatible.
One of the biggest drawbacks of fluoride toothpaste is that fluoride, at high doses, is a neurotoxicant (a toxin that impacts the brain). However, hydroxyapatite toothpaste is a biocompatible substance that your body recognizes as something that belongs there.
The CDC found that most kids use far more toothpaste than they should. This is a big problem when you’re talking about toothpastes with hundreds of times the amount of fluoride than is found in water.
But it’s not a problem with HAp. Hydroxyapatite particles are “biomimetic,” meaning they mimic the body’s own familiar materials. They’re wildly unlikely to cause any sort of negative reaction.
Some kinds of HAp toothpaste are made with nano-hydroxyapatite. This tiny kind of particle is not naturally occurring and has to be created synthetically. However, there is no evidence that these synthetic particles are less biomimetic or toxic in any way. (You can read more about HAp sizes below.)
It may help teeth appear whiter.
Without any whitening ingredients, hydroxyapatite toothpaste may help to brighten and whiten your teeth.
Toothpaste is, as I’ve said many times before, a polishing dental product. This means that it isn’t necessary for the disorganization of the bacteria on your teeth (which is the point of brushing teeth) but is actually meant to polish teeth.
It can also be used for additional benefits, such as aiding remineralization (in a way similar, but not the same, to fluoride’s action).
One of these benefits is an increased whitening effect. While HAp doesn’t change the “polishing” activity of toothpaste, it adds a whitening element not otherwise seen by standard toothpaste.
HAp literally “fills in” the enamel of your teeth with healthy tooth structure, altering the appearance of teeth to be whiter.
It’s good for the oral microbiome.
Using HAp toothpaste will help protect your teeth from “acid attacks” by bacteria, but without wrecking your oral microbiome. Fluoride, on the other hand, is bactericidal and tends to kill off bacteria in the mouth. Many oral care products think that by eliminating bacteria, they’re improving the health of the mouth, but they’re not.
The oral microbiome needs a good balance of bacteria to function properly and keep your mouth healthy. Agents like chlorhexidine, alcohol, or triclosan may temporarily alleviate bacterial overgrowth problems, but they cause far more issues over time than they help.
Hydroxyapatite particles in toothpaste prevent bacteria from attaching to the enamel of teeth just as effectively as antibacterial agents, but without killing the actual bacteria.
This is a huge benefit, as bacteria congregating on your teeth in one area is what leads to “acid attacks” (when bacteria “poop” out the high-carbohydrate food particles in your mouth). Those attacks are what cause tooth decay.
It may improve gum health.
Preliminary results have found that the use of HAp toothpaste may help improve gum health in patients with gum disease. Improvements seen included plaque control, bleeding gums, and pocket depth.