Toothpaste containing synthetic tooth minerals prevents cavities as effectively as fluoride

hydroxyapatite toothpaste
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Most toothpastes use fluoride, a powerful tool for oral hygiene. However, fluoride can pose health problems in some cases, especially for children who consume too much fluoride by swallowing most of their toothpaste: children normally use only a tiny dose of toothpaste to avoid these problems, but that reduces toothbrushing efficacy.

In the search for alternatives, a team of international scientists and Polish clinicians have identified a hydroxyapatite toothpaste that works just as well as fluoride toothpaste to protect against cavities.

“Hydroxyapatite is a safe and effective alternative to fluoride in caries prevention for daily use,” said Professor Elzbieta Paszynska of the Poznan University of Medical Sciences, co-principal investigator and corresponding author of the study published in Frontiers in Public Health.

Hydroxyapatite is a calcium phosphate mineral found in the skeleton. It’s known to be very safe for human consumption and has previously been shown to help with oral conditions like periodontitis. It can both inhibit the demineralisation of teeth, a key step towards a cavity, and contribute to remineralisation, which reinforces damaged tooth surfaces.

To see if it would help patients without specific dental conditions, the clinicians recruited 189 adults aged 18–45 to take part in an 18-month-long double blind randomised clinical trial. They aimed to see all patients through to the end of the study without an increase in cavities.

171 patients completed the trial, evenly split between the hydroxyapatite toothpaste group and the control group with fluoridated toothpaste. All patients had at least 10 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 toothpaste or a fluoride toothpaste. Neither patients nor examiners knew which toothpaste a given patient was using, and patients used no other oral care products. 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 they were not asked to change their diets.

Throughout the trial, patients visited the clinicians every six months for an examination and to receive a fresh supply of toothpaste. Their teeth were visually examined and checked for any shadows that might reveal an early-stage cavity. A plaque disclosing solution was also used to see how clean their teeth were.

Each stage of the trial was monitored for consistency between patients, and patient safety was monitored at every appointment to make sure there weren’t any unanticipated side effects.

At the end of the trial, the scientists found that nearly 90 per cent of patients in both groups had no new cavities. There was no statistical difference in efficacy between the patients using a hydroxyapatite toothpaste and the control group using a fluoride toothpaste: both worked equally well.

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