The Benefits of Nano-Hydroxyapatite

With the growing concerns of the safety of fluoride, I am often asked about toothpaste alternatives that can still provide remineralization of teeth. While fluoride remains a cornerstone of cavity prevention, there is growing interest in nano-hydroxyapatite (nHA) — a biomimetic mineral that’s emerging as a safe and effective alternative for families who prefer fluoride-free oral care options. While I maintain that fluoride is safe if used appropriately, I want to provide information to any who are interested about this exciting alternative.

Nano-hydroxyapatite is a form of the same mineral that makes up the majority of human tooth enamel. When used in toothpaste or professional varnishes, nHA particles can integrate directly into the enamel surface, filling microscopic defects and helping to restore mineral density where early demineralization has occurred. This direct remineralization mechanism differs from fluoride, which works indirectly by enhancing the uptake of calcium and phosphate from saliva to form fluorapatite.

One clear benefit of nHA is its safety profile, especially for young children who may swallow toothpaste. Unlike fluoride, which can pose a risk of dental fluorosis and/or neurotoxicity if excess amounts are ingested, nano-hydroxyapatite is non-toxic and biocompatible, posing no known risk if swallowed in small amounts.

Clinical Evidence Supporting nHA

Multiple clinical studies suggest that nano-hydroxyapatite-containing products can perform comparably to fluoride in remineralizing early carious lesions. One in-situ crossover study comparing a 10 % hydroxyapatite toothpaste to a 500 ppm fluoride toothpaste found no significant difference in remineralization or inhibition of demineralization between the two — indicating that nHA can be just as effective as low-concentration fluoride in early lesion repair. (1)

A recent systematic review and meta-analysis also concluded that hydroxyapatite toothpaste performs similarly to fluoride toothpaste in preventing caries progression and promoting enamel remineralization, with the added advantage of superior biocompatibility and lack of toxicity. (2)

There are many other studies worldwide that are finding similar results. Though the research is relatively young compared to the data we have about fluoride, there is enough that I feel confident enough to offer it as a safe and effective alternative to fluoride.

Bottom Line

Scientific evidence supports that nHA is a viable alternative or supplement to fluoride for enamel remineralization.

FAQs:

Which nHA toothpaste brand should I use?

There are several reputable brands out there. I have used a few different ones and feel that there is not one right answer. I reached out to a few of my favorite brands about entering into a wholesale partnership. The company Fygg seemed to be the most excited about working with me, so I sell their toothpaste at a discounted rate. I also offer Fygg nHA varnish as an alternative to the fluoride varnish typically placed on the teeth after a cleaning. Feel free to ask us about this during your child’s appointment. I do not receive any financial kickback from Fygg for using or promoting their products.

Does nHA cross the blood-brain barrier?

Research has shown that needle-shaped nHA may cross the blood brain barrier and is associated with some health risks. Rod-shaped nHA (The form of nHA found in reputable toothpastes and varnishes), do not cross the blood-brain barrier when present in toothpaste and similar products. Any nHA product I recommend or approve for use is rod-shaped. (3) (4)