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HealthPublished by NPR Health • 11/2/2026, 10:00:00 AMOpen Original Report (NPR Health) ↗

How does this fluoride-free toothpaste compare when it comes to oral health?

Hydroxyapatite toothpaste is a fluoride-free option that has some research backing its effectiveness. mihailomilovanovic/Getty Images hide caption

How does this fluoride-free toothpaste compare when it comes to oral health?
Image supplied by NPR Health.

Reported by NPR Health

Hydroxyapatite toothpaste is a fluoride-free option that has some research backing its effectiveness. mihailomilovanovic/Getty Images hide caption

How you brush your teeth — and what you use to do it — matters.

Recently, dentist Dr. Jin-Ho Phark says he's noticed patients asking about fluoride-free toothpaste options. Phark is an associate professor of clinical dentistry at the Herman Ostrow School of Dentistry of University of Southern California.

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"There's a lot of interest from the patients," Phark says. "I hear that also regularly from students."

One product that patients are asking about in particular is a calcium phosphate mineral called hydroxyapatite. Many patients, Phark says, may have seen the products on social media, "being pushed by influencers and other people quite intensively."

The traditional fluoride toothpaste became common in the late 1950s , according to the Centers for Disease Control and Prevention, when Procter & Gamble Co. released Crest nationally. Over the next few decades, oral care products with fluoride as their active ingredient became widely available around the world. These products help protect the outer layer of teeth from cavity-causing bacteria.

And dental health is important because it's related to so many systems in your body, from your heart to digestion.

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"There are these connections made between your oral health, and the bugs that you have in your mouth, and systemic health and even the composition of your gut microbiome," says Dr. Livia Tenuta , a dentist who specializes in preventing tooth decay and associate professor at the University of Michigan School of Dentistry.

The promise of hydroxyapatite? Many of the things you care about when it comes to toothpaste: cavity protection, whitening, enamel-strengthening. But without fluoride.

Health experts widely agree that fluoride — a naturally occurring mineral — is beneficial to health. But curiosity is growing about fluoride-free options.

"There is an increasing number of people who are refusing fluoride totally, or hesitant to take it, especially for their children," says Bennett Amaechi , a professor of dentistry at the University of Texas at…

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