Fluoride vs. Hydroxyapatite
Both fluoride and hydroxyapatite remineralize the teeth, and they are both comparable in terms of effectiveness. However, hydroxyapatite offers additional benefits that fluoride lacks, such as support for a healthy oral microbiome, better enamel fortification, a tooth whitening effect, and zero toxicity. Dentists have been recommending fluoride for decades, and it’s widely considered to be the gold standard. Yet, hydroxyapatite is a strong contender for its replacement.
A closer look at fluoride
Fluoride is a naturally occurring mineral commonly added to municipal drinking water and oral care products. To understand how it works, it’s helpful to have basic knowledge of your oral biome. Your teeth are covered by a hard layer of enamel, comprised mainly of calcium and phosphate. Each time you eat or drink, the food debris feeds the bacteria in your mouth, producing acidic byproducts. As the acidity level in your mouth rises, it attacks the integrity of the enamel by demineralizing it. This also occurs when you eat or drink acidic food. Demineralization is problematic because it increases the risk of developing cavities.
Fluoride counteracts the demineralization process by partnering with calcium and phosphate to form fluorapatite. Fluorapatite is a crystalline lattice that covers the enamel to remineralize it and restore its integrity. Although fluoride is highly effective at remineralizing the teeth, it does have certain downsides.
For example, fluoride kills bacteria. This might sound like a positive attribute; however, your mouth has both good and bad bacteria. Fluoride does not discriminate; it attacks both kinds, which affects the healthy balance of your oral biome. Another downside is its toxicity. Too much fluoride can cause dental fluorosis, which adversely affects the health of the teeth. It may also result in skeletal fluorosis, which affects the bones throughout the body.
Comparing fluoride to hydroxyapatite
Like fluoride, hydroxyapatite is a type of mineral. To be precise, it’s a form of calcium. The majority of your enamel is comprised of hydroxyapatite. It’s also naturally found in the dentin—the softer layer underneath the enamel. One specific form of hydroxyapatite is called nano-hydroxyapatite. It is characterized by particle sizes ranging from 20 to 80 nanometers. Thanks to this tiny particle size, nano-hydroxyapatite can work its way into very tiny spaces in the tooth’s enamel. Essentially, it remineralizes the teeth from within, making them stronger and more resilient.
One study found that fluoride and hydroxyapatite were comparable in terms of remineralization effectiveness. However, hydroxyapatite offers benefits that fluoride lacks. For example, it doesn’t indiscriminately kill both good and bad bacteria. It does bind to bacteria to prevent the harmful bacteria from settling onto the enamel. Hydroxyapatite is also capable of making the enamel harder, and it can even gently whiten the teeth. Plus, it’s completely non-toxic.
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