Scientists discover “safe and effective” fluoride alternative mineral compound for toothpaste

20 Jul 2023 --- Hydroxyapatite – a calcium phosphate mineral compound found naturally in teeth and bones – could be just as effective as fluoride when it comes to protecting against dental cavities, potentially offering a new alternative ingredient for toothpaste, according to a new study. 

Hydroxyapatite is already known to help patients with gum disease and tooth hypersensitivity, and can easily be included as a part of people’s regular daily cleaning routines.

“It is a safe and effective alternative to fluoride in caries prevention for daily use," says Elzbieta Paszynska, co-author of the study and dental scientist from Poznan University of Medical Sciences, working alongside the Medical University of Bialystok.

“Previously published clinical trials also show the caries-preventing effect of hydroxyapatite in risk groups such as children and patients undergoing orthodontic therapy,” she highlights.

While fluoride is a widely used toothpaste ingredient, prolonged exposure to amounts above the recommended levels has been found to cause tooth enamel and skeleton fluorosis.Paszynska further details that the clinical trial also showed similar effects in adults. “This is important from a public health perspective.”

The study was conducted by Polish scientists and published in Frontiers in Public Health.

Offsetting fluoride risks
While fluoride is a widely used as a functional toothpaste ingredient, prolonged exposure to amounts above the recommended levels has been found to cause tooth enamel and skeletal fluorosis. 

“The ranges of intakes producing these opposing effects are not far apart,” warns the World Health Organization.

The risk is especially true for children who have a tendency to swallow more of their toothpaste, which is why younger children are advised to squeeze out a rice-grain-sized drop when it comes time to brush.

Hydroxyapatite, meanwhile, is a calcium phosphate mineral found in the human skeleton. The scientists highlight it is known to be “very safe” for consumption and has previously been shown to help with oral conditions like periodontitis. 

Study model
In the experiment, 171 participants between the ages of 18 to 45 were randomly given either hydroxyapatite toothpaste or fluoride toothpaste.

All patients had at least ten teeth without cavities, were willing to use an electric toothbrush, and had no pre-existing tooth problems in need of treatment.

Patients were provided with electric toothbrushes and replacement heads for these brushes, as well as neutrally packaged toothpaste that could have contained either the hydroxyapatite or fluoride toothpaste. 

They were also asked to brush their teeth at the same time every day – twice a day, after meals, for three minutes each time – but there was no need to change dietary patterns.

“We did not monitor the diet of each subject as the aim was to test two different toothpastes, not the influence of the diet on the caries progress,” says Paszynska.

Young children are particularly prone to overconsuming fluoride, due to the frequent accidental swallowing of toothpaste.After 18 months of brushing and regular check-ups by dentists, there was no significant difference in new cavities between the hydroxyapatite group or the fluoride group – around 90% of each had not developed any new cavities.

“Minimally invasive” dentistry
Paszynska explains that in dental care, there is currently the aim to use “minimally invasive dentistry” as often as possible. 

Frequent tooth cleaning with hydroxyapatite ties into this concept, as can both inhibit the demineralization of teeth – which leads to cavities forming – and contribute to remineralization, which reinforces damaged tooth surfaces.

“[Minimally invasive dentistry] means trying to preserve as much tooth tissue as possible, including those altered by initial caries that still show the ability to remineralize,” she notes. “The use of remineralization compounds is a boon, as it may limit the need for invasive treatment of carious lesions with a drill.”

Oral hygiene advances
Among recent significant developments in dental care, Unilever filed a patent earlier this year for its oral care instrument design claiming “better stain removal.” The filament or bristle is shaped like a double-concave lens instead of a circular cross-section to maximize surface area. 

This was also the year the third generation sonic Y-shaped toothbrush, Y-Brush – which reportedly has about 100,000 users in Europe – entered the US market. The device has the capacity to polish a set of pearly whites conveniently within ten seconds.

Earlier this month, Personal Care Insights caught up with Dr. Kourosh Maddahi, founder and CEO of Lumineux, on the brand’s microbiome-friendly toothpaste. Alongside switching out fluoride, the brand endorses a shift away from hydrogen peroxide and alcohol in toothpaste formulations, which can often end up effectively killing even the “good” bacteria essential to oral health.

By Benjamin Ferrer