Hydroxyapatite vs fluoride?
July 13, 2022 7:45 AM Subscribe
So what's the deal with hydroxyapatite toothpaste anyway? I use fluoride toothpaste and have no problem with it but just wondering if hydroxyapatite is really better, if it actually does remineralize teeth, etc. Has anyone used it? What effects have you noticed?
Like many "ingredients added" pastes, if you have the condition they are designed to address they can be beneficial, but if not, then they work like any other.
Fluoride is great because it actually makes the enamel of the tooth stronger than it was before remineralization. HA helps as well because it makes those molecules available for the remineralization process.
If you have a lot of active decay, or are constantly battling demineralization (in braces for instance), then HA might give you a better chance of avoiding cavities that need to be filled.
If you have a healthy mouth then adding HA is not going to have a noticeable benefit.
posted by OHenryPacey at 9:26 AM on July 13, 2022 [5 favorites]
Fluoride is great because it actually makes the enamel of the tooth stronger than it was before remineralization. HA helps as well because it makes those molecules available for the remineralization process.
If you have a lot of active decay, or are constantly battling demineralization (in braces for instance), then HA might give you a better chance of avoiding cavities that need to be filled.
If you have a healthy mouth then adding HA is not going to have a noticeable benefit.
posted by OHenryPacey at 9:26 AM on July 13, 2022 [5 favorites]
Here's a recent review article that covers a lot of ground "Hydroxyapatite and Fluorapatite in Conservative Dentistry and Oral Implantology—A Review". They talk about a bigger picture, but eventually cite "Nano-hydroxyapatite and its applications in preventive, restorative and regenerative dentistry: a review of literature". There, we get to some clear simple claims, namely: In terms of restorative and preventive dentistry, nano-hydroxyapatite has significant remineralizing effects on initial enamel lesions, certainly superior to conventional fluoride, and good results on the sensitivity of the teeth. Note this work is prior to that linked by randomnity above, but the specific questions addressed are different too.
Not all Hydroxyapatite toothpastes are the same. Some use synthetic nano-particles, some are derived from natural sources like egg shells. Note also that the EU SCCS cannot yet offer an opinion on human safety of nano-hydroxyapatite, mainly due to lack of data, so " not sufficient to exclude concerns over the genotoxic potential of HAP-nano". (emphasis mine)
On balance, it seem this stuff "works", to remineralize, it does not at all appear to be snake oil. If you already have enamel lesions, it may work better than fluoride. But if you just need general preventative care, there may be no difference. There are safety concerns with the nano stuff, and I personally wouldn't use that unless directed by my dentist for my specific case.
(I was not that familiar with this but I decided to dig in. I started at the Wikipedia page for Hydroxyapatite, checked their references for key claims, went from there etc, so take all the caveats that implies. It would be cool to get input from some of our resident dentists! )
posted by SaltySalticid at 9:26 AM on July 13, 2022 [3 favorites]
Not all Hydroxyapatite toothpastes are the same. Some use synthetic nano-particles, some are derived from natural sources like egg shells. Note also that the EU SCCS cannot yet offer an opinion on human safety of nano-hydroxyapatite, mainly due to lack of data, so " not sufficient to exclude concerns over the genotoxic potential of HAP-nano". (emphasis mine)
On balance, it seem this stuff "works", to remineralize, it does not at all appear to be snake oil. If you already have enamel lesions, it may work better than fluoride. But if you just need general preventative care, there may be no difference. There are safety concerns with the nano stuff, and I personally wouldn't use that unless directed by my dentist for my specific case.
(I was not that familiar with this but I decided to dig in. I started at the Wikipedia page for Hydroxyapatite, checked their references for key claims, went from there etc, so take all the caveats that implies. It would be cool to get input from some of our resident dentists! )
posted by SaltySalticid at 9:26 AM on July 13, 2022 [3 favorites]
As another factor, there exists high strength fluoride toothpaste and the usual stuff.
posted by sebastienbailard at 12:38 PM on July 13, 2022
posted by sebastienbailard at 12:38 PM on July 13, 2022
It would be cool to get input from some of our resident dentists!
I weigh in on most dental questions (see above)
posted by OHenryPacey at 1:32 PM on July 13, 2022 [2 favorites]
I weigh in on most dental questions (see above)
posted by OHenryPacey at 1:32 PM on July 13, 2022 [2 favorites]
I started using a HA toothpaste because I have oral issues. I wasn't recommended it, I looked into it myself because I suddenly experienced multiple dental failures. Not sure if it's related to another health issue though as the multiple failures were concerning. Anyway. I've only been using it a year so I can't speak to the efficacy of remineralization yet. It seems to be helping but it's not a fast process at all; it's not a miracle. I also use a topical flouride and calcium paste.
In my experience it's not either/or it's both. One isn't better really, they are both for prevention, though HA can help more if you have mineralisation issues in theory. Again it's super slight, and will not remineralize a big cavity or anything, you need a dentist for that. But I think it's helpful if you have pretty good oral hygiene already. I will say that HA makes a difference in my tooth feel compared to regular toothpaste. I can feel it over my teeth. I don't get that with my topical flouride or flouride toothpaste. It definitely feels very good in my mouth. I haven't experienced any whitening or anything though, as some claim. I do get the shiny surface scatter effect which makes the teeth seem whiter on use.
The other thing is that at least in Australia the dentists I talked to had no clue that there was such a thing available in toothpaste. They knew what hydroxyapatite is in theory but they were extremely confused when I mentioned the toothpaste. They kept pushing for flouride instead and were super wary of HA as a concept. It's weird. (For the record I use both daily already) It feels like a pretty new thing here. The US has more brands available. At the moment I have one brand in Aus that has it, the rest I gotta import.
I wish I had it available when I was younger, I think it's making a difference in preventing further decay, and I wouldn't be surprised if it becomes the new norm in 20 years. It's already a thing in Japan. I feel like everyone should alternate HA into their dental routine, in addition to topical flouride, as it doesn't hurt at all and can help significantly. HA and a water flosser have been game changers for me personally.
posted by Dimes at 6:06 PM on July 17, 2022
In my experience it's not either/or it's both. One isn't better really, they are both for prevention, though HA can help more if you have mineralisation issues in theory. Again it's super slight, and will not remineralize a big cavity or anything, you need a dentist for that. But I think it's helpful if you have pretty good oral hygiene already. I will say that HA makes a difference in my tooth feel compared to regular toothpaste. I can feel it over my teeth. I don't get that with my topical flouride or flouride toothpaste. It definitely feels very good in my mouth. I haven't experienced any whitening or anything though, as some claim. I do get the shiny surface scatter effect which makes the teeth seem whiter on use.
The other thing is that at least in Australia the dentists I talked to had no clue that there was such a thing available in toothpaste. They knew what hydroxyapatite is in theory but they were extremely confused when I mentioned the toothpaste. They kept pushing for flouride instead and were super wary of HA as a concept. It's weird. (For the record I use both daily already) It feels like a pretty new thing here. The US has more brands available. At the moment I have one brand in Aus that has it, the rest I gotta import.
I wish I had it available when I was younger, I think it's making a difference in preventing further decay, and I wouldn't be surprised if it becomes the new norm in 20 years. It's already a thing in Japan. I feel like everyone should alternate HA into their dental routine, in addition to topical flouride, as it doesn't hurt at all and can help significantly. HA and a water flosser have been game changers for me personally.
posted by Dimes at 6:06 PM on July 17, 2022
I had a lot of tooth sensitivity that has been resolved with using Sensodyne imported from Canada or the UK with HA. It costs more than buying US versions locally, but it's easily available on Amazon. Just one point of annecdata.
posted by cameradv at 6:41 PM on July 17, 2022 [1 favorite]
posted by cameradv at 6:41 PM on July 17, 2022 [1 favorite]
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I found this study which seems to show no differences in efficacy (including remineralization) between hydroxyapatite and fluoride, but again, your dentist will likely have a more informed view of the overall literature and expert consensus.
posted by randomnity at 8:34 AM on July 13, 2022 [1 favorite]