Hydroxyapatite Toothpaste For A Naturally White Smile
Looking for fluoride-free, SLS-free toothpaste? Make the switch to hydroxyapatite toothpaste for a brighter smile and glossy teeth. This enamel strengthening toothpaste is a great fluoride-free alternative with no harsh additives and it naturally whitens your teeth. We tested and reviewed 6 brands of hydroxyapatite toothpaste and found some that we love!
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As a dentist’s daughter, good oral hygiene was par for the course growing up. My dad’s dental office was attached to our house, and I could never skip out on fluoride treatments, biannual checkups and lectures on flossing and brushing. As an adult, I still keep up with my flossing and brushing, and I’m always on the lookout for new dental products that are safe for my whole family.
In my quest for new toothpaste options, I came across the ingredient hydroxyapatite. I was so impressed by the scientific literature on hydroxyapatite and dental care (see scientific study section below) that I took a deep dive into researching, testing and reviewing hydroxyapatite toothpaste. You can read more about the brands I tested below, but first, let’s have a closer look at hydroxyapatite.
What Is Hydroxyapatite?
Hydroxyapatite is the main substance in your teeth, making up 97% of enamel and 70% of dentin. Also known as calcium phosphate, this compound is non-toxic and biocompatible (not harmful to living tissue) (1). This safe fluoride alternative has been used in Japan for over 40 years. It works just as well as fluoride at preventing cavities (see scientific study section below).
The main draw of hydroxyapatite in toothpaste is that it helps to remineralize (rebuild) tooth structure without any known side effects. Hydroxyapatite can also aid in reducing tooth sensitivity and plaque buildup.
The History Of Hydroxyapatite
In the 1970’s, astronauts returning from space missions experienced weakened tooth enamel and bone loss due to the effects of weightlessness. In order to restore and strengthen softened, weak tooth enamel and bone, NASA created a synthetic version of hydroxyapatite.
The Sangi Company of Japan acquired the hydroxyapatite patent from NASA in 1978 and developed an enamel-restorative toothpaste that is still the gold standard for fighting cavities in Japan today.
How Does Hydroxyapatite Work?
Tooth enamel is constantly exposed to corrosive acids in your mouth. The acid creates small fissures in your tooth enamel, and this process is called demineralization. Hydroxyapatite works to fill in the microfissures (remineralization) and restore tooth enamel. It also works to rebuild areas where cavities are starting to form. A compilation of hydroxyapatite research studies from a 2021 review and meta-analysis concludes that hydroxyapatite is effective at reducing dental cavities (2).
What is Nano Hydroxyapatite?
Nano hydroxyapatite consists of rod or needle shaped particles with a size ranging from 20 nm to 100 nm. When comparing nano HA to micro HA, nano-HA is more effective at binding to surfaces better, and this enhances remineralization of the teeth while also reducing tooth sensitivity.
Is Nano Hydroxyapatite Safe?
The European Union Scientific Committee on Consumer Safety (SCCS) has spent the last 8 years systematically reviewing the research on nano-HA. The SCCS is an independent panel made up of experts in the field of toxicology, as well as pathology, biochemistry, chemistry and physics. They oversee the safety of cosmetics and consumer goods and investigate whether chemicals and ingredients pose safety risks.
Their final opinion after 8 years of research on nano-HA is that it is safe when used at concentrations up to 10% in toothpaste, and up to 0.465% in mouthwash. Nano-HA must be composed of rod-shaped particles of which at least 95.8% (in particle number) have an aspect ratio less than 3, and the remaining 4.2% have an aspect ratio not exceeding 4.9. Also, the particles cannot be coated or surface modified.
There is one lab in Portugal, Fluidinova, that synthesizes nano-hydroxyapatite in the proper formation that the SCCS endorses. Nano-HA made by Fluidinova is used in the products I recommend.
Scientific Studies On Hydroxyapatite In Dental Care
- Participants in a 2012 study had their teeth bleached with a 7% hydrogen peroxide gel for 14 days. Half the group used nano-hydroxyapatite paste after bleaching, leaving it on for 5 minutes, and the placebo had a paste applied with no hydroxyapatite added. The group treated with nano-hydroxyapatite paste had significantly lower sensitivity levels than the placebo group (4).
- Orthodontic patients in a 2016 study were treated with either a fluoride toothpaste, two brands of nano-hydroxyapatite toothpaste or a control toothpaste. The two brands of nano-hydroxyapatite toothpaste were found to be the most efficient at preventing tooth demineralization compared with the fluoride toothpaste and the control (5).
- In a 2017 study measuring tooth hardness, demineralized tooth surface coated with hydroxyapatite toothpaste was found to be harder after 2 weeks of application than tooth surface coated with fluoride toothpaste alone (6).
- A 2019 study found that toothpaste containing a 10% hydroxyapatite solution and toothpaste containing amine fluoride were equally effective for preventing and reversing tooth decay in children (7).
What Are The Benefits Of Using Hydroxyapatite Toothpaste
- It makes teeth whiter and glossier
- It reduces tooth sensitivity
- It helps fight and prevent cavities
- It remineralizes and repairs enamel
- It’s biocompatible and non-toxic
What To Expect From Hydroxyapatite Toothpaste
You won’t get the same foaming action that you may be used to from a conventional toothpaste with SLS (that goes for any natural toothpaste that doesn’t contain SLS). Most of the brands I tested felt more lotion-like in my mouth (you get used to this very quickly). Hydroxyapatite doesn’t have a flavor – you’ll taste the other added ingredients in the toothpaste such as essential oils.
Look below for 7 brands of fluoride-free hydroxyapatite toothpaste to strengthen your enamel, reduce sensitivity and whiten your teeth.
Risewell
Risewell Natural Hydroxyapatite Toothpaste
Cost: $17.95 for 4 oz ($4.49 per ounce)- Amazon, website is $12, but add on shipping cost
Flavor: Wild Mint
Cavity Fighting Ingredient: micro hydroxyapatite
From the Risewell website: Wild mint flavored. Fluoride-free, paraben-free, vegan & cruelty-free, No harsh foaming agents; SLS & sulfate-free. RiseWell strengthens and restores your tooth enamel, Antiplaque & naturally whitening. Naturally flavored with beneficial essential oils, Safe enough to eat! When used twice daily, one 4 oz. tube lasts about 3 months. Risewell has a pro line that has SCCS approved nano-hydroxyapatite.
Why I Love This Toothpaste: This toothpaste really makes my mouth feel clean. It has a nice minty orange flavor and I like how easy the tube dispenses.
Shop: Risewell Natural Hydroxyapatite Toothpaste
Wellnesse
Wellnesse Toothpaste
Cost: $19 for 4 oz ($4.75 per ounce)- Amazon, website is $13.50, but add on shipping
Flavor: Fresh Mint
Cavity Fighting Ingredient: micro hydroxyapatite
From the Wellnesse website: Glycerin-free, Fluoride-Free, SLS free and Going Strong. Instead of fluoride, our formula contains green tea leaf extract, which is loaded with antioxidants. Plus, a phytochemical in green tea is shown to fight bacteria that leads to tooth decay. We combined this phytochemical with hydroxyapatite (a naturally-occurring mineral and main component of tooth enamel) to strengthen teeth and prevent cavities. Did we mention our toothpaste is Glycerin-Free?
Why I Love This Toothpaste: This toothpaste has a mild minty flavor. The consistency was also a little thicker than most of the other brands tested. I liked that all of the individual ingredients have an EWG score of 1 (products are rated on a scale of 1-10, with 10 being harmful to human health). Bonus points that the toothpaste tube is made from sugarcane bioplastic. A great toothpaste all-around!
Shop: Wellnesse Toothpaste
Happy Tooth
Happy Tooth Hydroxyapatite Toothpaste
Cost: $12 for 4 oz ($3 per ounce)
Flavor: Mint
Cavity Fighting Ingredient: micro hydroxyapatite
From the Happy Tooth website: A tasty toothpaste for whiter, stronger, and healthier teeth for kids and adults. Made with 10% micro-hydroxyapatite (HA) & natural ingredients – no fillers ever.
Why I Love This Toothpaste: If you want a mild mint flavor that isn’t too strong, this toothpaste is for you. It’s also on the thinner side, so you won’t have a foamy mess with this toothpaste.
Shop: Happy Tooth Hydroxyapatite Toothpaste
Cocofloss
CocoShine Toothpaste
Cost: $22 for 4 oz ($5.50 per ounce)
Cavity Fighting Ingredient: nano hydroxyapatite (SCCS approved)
Flavors: Mint, Lychee
From the Cocofloss website: This deeply restorative toothpaste whitens and brightens without the use of toxins, coarse abrasives, or symptom-masking ingredients. It rebuilds your enamel to whiten, reverse sensitivity, strengthen, and balance your microbiome.
Shop: CocoShine Toothpaste
Boka
Boka Ela Mint Toothpaste
Cost: $11.69 for 4 oz. ($2.92 per ounce)
Cavity Fighting Ingredient: nano hydroxyapatite (SCCS approved)
Flavors: Mint, Coco Ginger, Lemon Lavender
From the Boka website: This toothpaste contains soothing aloe vera, bacteria-fighting xylitol, antioxidant-rich green tea, nana hydroxyapatite and refreshing mint. It’s fluoride-free, SLS-free, Paraben-free, Sensitivity-fighting.
Why I Love This Toothpaste: This toothpaste has a really pleasant mint taste – it’s not too sweet or too zingy. It really makes my gums feel soothed after brushing, like they’ve just been hugged. One questionable ingredient is Sodium Lauroyl Sarcosinate, which has the potential to form nitrosamines.
Shop: Boka Ela Mint Toothpaste
Fygg
Fygg Hydroxyapatite Toothpaste
Cost: $14 for 4 oz ($3.50 per ounce)
Flavors: Mild Mint, Coconut Cream
Cavity Fighting Ingredient: nano hydroxyapatite (SCCS approved)
From the Fygg website: No burn, no foam, no fluoride. Formulated with a unique blend of both nano-Hydroxyapatite and micro-Hydroxyapatite for optimal cavity-fighting action. Formulated without essential oils, detergents, or glycerin to nourish the oral microbiome.
Why I Love This Toothpaste: This toothpaste contains a prebiotic for your oral microbiome. I tried the mild mint flavor and it was really sweet, almost like a mint vanilla candy (maybe a little too sweet for my taste buds).
Professional Formula: Fygg Nano-Hydroxyapatite Dental Varnish
Shop: Fygg Hydroxyapatite Toothpaste
Great Oral Health
Great Oral Health Toothpaste
Cost: $15.29 for 4 oz ($3.82 per ounce)
Cavity Fighting Ingredient: nano hydroxyapatite (SCCS approved) & micro hydroxyapatite
Flavors: Citrus Blast, peppermint Wow
From the Great Oral Health website: This mineralizing toothpaste has a low RDA (relative dentin abrasivity) of 87 & a pH range of 7.2 – 7.4 for optimal enamel protection. With an 11% concentration of a unique bioavailable nano and non-nano hydroxyapatite formulation, our dentist researched formulation targets sensitivity and remineralization from two paths using the nano to dig deep into your damaged enamel and the non-nano hydroxyapatite to support your saliva’s natural mineralization process.
Shop: Great Oral Health Toothpaste
Suggestions For How To Use Hydroxyapatite Toothpaste
Floss before you brush your teeth. Apply a pea-sized amount of hydroxyapatite toothpaste on your toothbrush and brush for 2 minutes. Spit out any excess toothpaste, but don’t rinse – allow the hydroxyapatite to sit on the tooth surface and coat the microfissures in your tooth enamel. Of course, if you want to rinse, go for it!
Good Dental Habits
No matter what toothpaste you’re using, you should also be practicing proper oral care habits. This includes avoiding certain food and beverages known for causing cavities (food and drinks high in sugar, starches and acid), brushing twice daily, flossing and getting regular dental checkups.
Ingredients To Avoid In Toothpaste
- Triclosan– Triclosan is an antibacterial agent that’s linked to bacterial resistance and endocrine disruption. A popular brand of toothpaste that I used for years had Triclosan in it.
- Sodium lauryl sulfate (SLS)– this is associated with canker sores and perioral dermatitis (my daughter is susceptible to this hard-to-eradicate rash around the mouth).
- Artificial colors– Who needs blue toothpaste if it’s linked to hyperactivity in kids?
- Parabens– These preservatives prevent the growth of bacteria, but they disrupt hormone function and were able to stimulate breast cancer cell growth in a lab study.
- Propylene glycol– Propylene glycol is used to make personal care products thicker and better able to transport moisture to the skin. The manufacturing process introduces impurities and by-products, such as ethylene oxides and 1,4-dioxane, which are known carcinogenic materials (8).
As for whether fluoride should be in toothpaste, my dad the dentist was very pro-fluoride. It protects teeth from cavities and strengthens tooth enamel. However, ingestion of fluoride in high doses can cause fluorosis in young children (who may swallow large amounts) and high levels of fluoride in pregnant women can cause nervous system damage to the fetus (9). If you’re at all worried that your child may ingest a large amount of fluoride toothpaste, if you’re pregnant, or if you just want a fluoride-free toothpaste option, add hydroxyapatite toothpaste to your oral care routine. It also works really well for those with sensitive teeth. Whatever toothpaste you decide to use, make sure it contains either hydroxyapatite or fluoride in order to prevent cavities and strengthen tooth enamel.
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References
- Meyer F, Amaechi BT, Fabritius HO, Enax J. Overview of Calcium Phosphates used in Biomimetic Oral Care. Open Dent J. 2018;12:406-423. Published 2018 May 31. doi:10.2174/1874210601812010406
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5997847/?_ga=2.27426748.1073827304.1599421251-2018910469.1599421251 - Limeback H, Enax J, Meyer F. Biomimetic hydroxyapatite and caries prevention: a systematic review and meta-analysis. Can J Dent Hyg. 2021 Oct 1;55(3):148-159. PMID: 34925515; PMCID: PMC8641555.
- Ramis, J., Coelho, C., Cordoba, A., Quadros, P., and M. Monjo. Safety Assessment of Nano-Hydroxyapatite as an Oral Care Ingredient according to the EU Cosmetics Regulation. Cosmetics 2018, 5, 53; doi:10.3390/cosmetics5030053.
https://pdfs.semanticscholar.org/20a0/6a41dfadbf8097bf9878a6ed76e7b7592815.pdf - Komiyama S, Miyasaka R, Kikukawa K, Hayman R (2019) Can nano-hydroxyapatite permeate the oral mucosa? A histological study using three-dimensional tissue models. PLoS ONE 14(4): e0215681. https://doi.org/10.1371/journal. pone.0215681
https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0215681&type=printable - Browning, WD, Cho, SD and EJ Deschepper. Effect of a nano-hydroxyapatite paste on bleaching-related tooth sensitivity. J Esthet Restor Dent. 2012 Aug;24(4):268-76. doi: 10.1111/j.1708-8240.2011.00437.x.
https://pubmed.ncbi.nlm.nih.gov/22863133/ - Singh, A., Shetty, B., Mahesh, C.M., Reddy, V., Chandrashekar, B.S., and S. Mahendra. Evaluation of Efficiency of Two Nanohydroxyapatite Remineralizing Agents with a Hydroxyapatite and a Conventional Dentifrice: A Comparative In vitro Study. Journal of Indian Orthodontic Society. Volume 51, Issue 2, April-June 2017.
https://journals.sagepub.com/doi/pdf/10.4103/jios.jios_13_16 - Ebadifar A, Nomani M, Fatemi SA. Effect of nano-hydroxyapatite toothpaste on microhardness ofartificial carious lesions created on extracted teeth. J Dent Res Dent Clin Dent Prospects. 2017;11(1):14-17. doi:10.15171/joddd.2017.003
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5390120/ - Amaechi BT, AbdulAzees PA, Alshareif DO, et al. Comparative efficacy of a hydroxyapatite and a fluoride toothpaste for prevention and remineralization of dental caries in children. BDJ Open. 2019;5:18. Published 2019 Dec 9. doi:10.1038/s41405-019-0026-8
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6901576/ - Lim, T.Y. et al. Propylene Glycol Toxicity in Children. J Pediatr Pharmacol Ther. 2014 Oct-Dec; 19(4): 277–282.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4341412/ - Green R, Lanphear B, Hornung R, et al. Association Between Maternal Fluoride Exposure During Pregnancy and IQ Scores in Offspring in Canada [published online ahead of print, 2019 Aug 19]. JAMA Pediatr. 2019;173(10):940-948. doi:10.1001/jamapediatrics.2019.1729.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6704756/