Hydroxyapatite toothpaste provides alternative to fluoride, study suggests

By Dental Tribune International

July 16, 2019

WÜRZBURG, Germany: The use of hydroxyapatite as an artificial tooth enamel to prevent erosion and even to contribute to the regeneration of natural tooth enamel has been investigated and discussed for years. However, there is still insufficient scientific evidence to prove its benefits. A recent German study has now demonstrated that hydroxyapatite for prophylaxis is as effective as fluoride.

For the comparison, 133 patients aged 11–25 years and scheduled for orthodontic therapy with fixed appliances were selected—a patient group with a relatively high caries risk. They were assigned to two randomised groups. The control group brushed with fluoride toothpaste at concentrations of 350 ppm and 1050 ppm for the trial period, and the other with 10% hydroxyapatite toothpaste.

Dental examinations were performed before the fixed appliances were placed and every four weeks thereafter for half a year. The International Caries Detection and Assessment System was used to assess the vestibular enamel surface. The researchers also used the plaque index and the gingival index.

Results showed that there was a significant increase in enamel caries during the observation period. However, neither fluoride nor hydroxyapatite stood out significantly. In the hydroxyapatite group, 54.7% of the patients had a lesion after six months, and in the fluoride group, 60.9%. The plaque and gingival indices also increased slightly, but no clear differences were demonstrated.

According to the study, toothpaste containing hydroxyapatite can be considered an alternative to fluoride toothpaste.

The study, titled “Impact of a non‐fluoridated microcrystalline hydroxyapatite dentifrice on enamel caries progression in highly caries‐susceptible orthodontic patients: A randomized, controlled 6‐month trial”, was published in the May 2019 issue of the Journal of Investigative and Clinical Dentistry.